Why Young Adults Are Among the Biggest Barriers to Mass Immunity

KANSAS CITY, Mo. — Bridget Burke, 22, a college student in Michigan, said she was unsettled by rumors that Covid-19 vaccines could affect her reproductive health. Bryson Hardy, 19, a fiber optic cable splicer from Georgia, said he was not worried about contracting the virus and had no plans to get vaccinated. And Cinda Heard, 27, an in-home health care assistant in Missouri, said she feared potential side effects from the vaccine and got a shot only because her employer required it.

As the country’s vaccination campaign slows and doses go unused, it has suddenly become clear that one of the biggest barriers to mass immunity will be persuading skeptical young adults of all backgrounds to get shots. Federal officials expressed alarm in recent days about low vaccination rates among Americans in their late teens and 20s, and have blamed them for the country’s all-but-certain failure to reach President Biden’s goal of giving 70 percent of adults at least an initial dose by July 4.

But the straightforward sales pitch for older people — a vaccine could very possibly save your life — does not always work on healthy 20-somethings who know they are less likely to face the severest outcomes of Covid.

As public officials race to find ways to entice young adults to get vaccinated, interviews across the country suggest that no single fix, no easy solution, is likely to sway these holdouts. Some are staunchly opposed. Others are merely disinterested. And still others are persuadably skeptical. But pretty much everyone who was eager for a vaccine already has one, and public health officials now face an overlapping mix of inertia, fear, busy schedules and misinformation as they try — sometimes one person at a time — to cajole Gen Z into getting a shot.

Public health experts say vaccinating young adults is essential to keeping infection numbers low and preventing new case outbreaks, especially as the more infectious Delta variant spreads in Missouri and other states.

Since vaccines became available six months ago, health departments have focused with varying degrees of success on urging groups identified as reluctant — including people living in rural communities, African American residents, conservatives — to get vaccines. But in recent days, public health officials have identified young adults as a significant challenge for a country where fewer than a million people a day are receiving a vaccine, down from an April peak of more than 3.3 million.

In a federal report released last week, just over one-third of adults ages 18 to 39 reported being vaccinated, with especially low rates among Black people; among people 24 or younger; and among those who had lower incomes, less education and no health insurance.

“I’m nervous about what’s in the vaccine,” said Ms. Burke, a senior at Western Michigan University who is from Chicago. “I think personally I’ll put it off until I absolutely must get it.”

Ms. Burke said that her family wanted her to get the shot but that she worried about the vaccines affecting women’s reproductive systems, a concern that came up in multiple interviews with young women. Scientists have said there is no evidence that the vaccines affect fertility or pregnancy.

Still, rare but real side effects have emerged as a serious concern, especially for young people who feel they are at low risk from the virus itself. Johnson & Johnson vaccinations were paused briefly this spring after the discovery of rare blood clots in young women. And federal health officials said last week that the Moderna and Pfizer-BioNTech vaccines may have caused heart problems in about 1,200 Americans, many of them under age 30, though they said the benefits of vaccination continued to far outweigh the risks

Not all that long ago, most people in their teens and 20s were not eligible for a vaccine. In the winter and early spring, as demand outpaced supply, states prioritized their oldest and sickest residents for shots. By late April, all adults were eligible. But by then, case numbers had fallen sharply from their winter peak, and demand in the youngest age groups never approached the levels seen among older adults. Many colleges, but far from all, will require students to be vaccinated before returning for fall classes.

“I think that, for the younger generation, we now really have to build the case for them to be vaccinated,” said Dr. Sarah Van Orman, the chief health officer for the University of Southern California’s student health system. “I think we have a long ways to go for that.”

Of course, millions of young adults have already been vaccinated and others still plan to get a shot. Pop-up vaccine clinics at workplaces, transit stops and Major League Soccer games, including one last week in Kansas City, Kan., have helped reach more people in that age group. Several states are trying lotteries and other incentives to drum up interest. Still, many young people said they did not see a pressing reason to get vaccinated.

Ms. Heard, the in-home health care assistant in Kansas City, Mo., who said she was required by her employer to get the shot, said she worried there could be side effects that might not emerge for years. Most of her friends, she said, had opted not to get vaccinated.

“If I didn’t work for them and didn’t have a new car payment, I wouldn’t have got that,” Ms. Heard said.

White House officials said that they expected 70 percent of people 27 and older to receive at least a first dose by July 4. But add in Americans aged 18 to 26, the officials said, and the country was likely to fall short of Mr. Biden’s goal for all adults.

“When people my age get it, I’ll probably get it,” said Jermain Allen, 20, a college student in Brooklyn who said most vaccinated people he knew were older. “I don’t live with my grandma, but if I did, I would have probably gotten it, just for her sake.”

Luke Norris, 23, who works as a cook at Moody Bible Institute in Chicago, said he was undecided about the vaccines. He usually does not get vaccinations unless they are required, he said, but might still be persuaded to get a Covid shot, especially if it was required for him to pursue his goal of becoming a missionary.

“I have a friend who really wants me to get it, and I have family members telling me not to get it,” Mr. Norris said. “I have people pulling me on both sides.”

Many young adults are relatively healthy, and they often have work, school and young children to worry about. Getting vaccinated does not always register as a top priority, experts and young adults said.

“These aren’t people who are connected to the health system,” said Arthur Caplan, a New York University bioethicist who studies vaccine hesitancy. “They don’t have a doctor — they have their parent’s doctor.”

Throughout the pandemic, the public health message has emphasized that older residents were at greatest risk. Jodie Guest, a professor of epidemiology at Emory University, said that “had an unintended consequence of helping young people feel like it wouldn’t be a big deal if they get Covid-19.”

“There’s a bit of immortality baked into this age group to start with,” Dr. Guest said.

But there is also the question of whether public health agencies have been doing enough — or even know how — to connect with the young holdouts.

Jordan Tralins, 20, who will be a junior at Cornell, said that she thought her peers had been largely overlooked and that officials were not meeting them in the online spaces where they spend time.

Discouraged by the amount of misinformation she was finding on social media, Ms. Tralins founded the Covid Campus Coalition, which now has people at more than 25 universities running Instagram accounts that debunk myths and tell students how to get vaccinated.

“In order to really capture people my age, and get us to focus and get excited, you need to use creativity,” Ms. Tralins said. “And I think that this wasn’t something that adults, and whoever is in charge of the vaccine rollout, were really thinking about.”

Mitch Smith reported from Kansas City, Mo., and Giulia Heyward and Sophie Kasakove from New York. Deena Winter contributed reporting from Surfside Beach, S.C., and Kerry Lester Kasper from Chicago. Rick Rojas also contributed reporting.