Survey Finds COVID-19 Vaccine Hesitancy Among Many Adolescent and Young Adult Cancer Survivors

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Despite recommendations from ASCO and other national organizations that cancer survivors, as well as patients on active treatment, receive the COVID-19 vaccine if they have no contraindications, a survey of adolescent and young adult cancer survivors finds many have vaccine hesitancy. According to the survey results, 37.1% of respondents had reservations about receiving the vaccine. Female survivors and those with a high school education or less reported greater vaccine hesitancy than their male or college graduate counterparts. Greater vaccine hesitancy was also reported among Hispanic participants compared with White respondents. The study is published in JNCI Cancer Spectrum.

Study Methodology

The researchers surveyed 675 eligible adolescent and young adult cancer survivors to identify sociodemographic factors associated with COVID-19 vaccine hesitancy. The survey asked about participants’ age, treatment status, gender, education, race and ethnicity, and COVID-19 factors, including essential worker status. Participants were aged 18 years or older, were diagnosed with cancer between the ages of 15 and 39, and had received oncology services through the Huntsman-Intermountain Adolescent and Young Adult Cancer Care Program.

The survey was conducted between October 2020 and January 2021 via e-mail, mail, and text. A total of 342 participants completed the cross-sectional survey. The primary outcome—COVID-19 vaccine hesitancy—was surveyed as a 5-point Likert scale and operationalized as a binary outcome: agree vs hesitant.


  • 42% of female adolescent and young adult cancer survivors expressed COVID-19 vaccine hesitancy compared with 30.1% of males.
  • Young survivors with a high school education or less had a 3.15 times higher odds of reporting vaccine hesitancy compared to those with a college education; and 52.9% of Hispanic survivors exhibited vaccine hesitancy compared with 31.6% of White survivors.
  • Oncology providers can play an important role in encouraging young survivors to receive the COVID-19 vaccine.


The researchers found that although 62.9% of the respondents intended to receive the COVID-19 vaccine, more than one-third (37.1%) expressed hesitancy. There were statistically significantly more females expressing vaccine hesitancy than males, 41.6% vs 30.1%, respectively. Of the Hispanic participants surveyed, nearly 53% exhibited vaccine hesitancy compared with 31.6% of White participants.  

“COVID-19 vaccine hesitancy persists among AYA survivors despite their recommended priority vaccination status and higher chances of severe COVID-19 outcomes,” concluded the study authors.

Encouraging Vaccine Participation

In a statement, lead author Austin R. Waters, MSPH, Research Program Manager at Huntsman Cancer Institute at the University of Utah, highlighted the importance of educating and encouraging young cancer survivors, especially those from minority populations, to get vaccinated against the COVID-19 virus.

“As life returns to some resemblance of normal, receiving the COVID-19 vaccine is as important as ever. Cancer survivors should not wait to get the COVID-19 vaccine. Oncology care providers and cancer centers should play an important role in encouraging young survivors to receive the vaccine. To ensure equitable protection of vulnerable populations, special attention should be paid to vaccine hesitancy among at-risk groups, such as young adult cancer survivors and groups that may have higher vaccine hesitancy, such as female survivors or those with a high school education or less.”

Dr. Waters is the corresponding author of the study in JNCI Cancer Spectrum.

Disclosure: Funding for this study was provided by the Huntsman Cancer Foundation and the National Cancer Institute. For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.