COVID-19 vaccine uptake and attitudes in emerging adults with type 1 diabetes.

Purpose: Adolescents and young adults have lower uptake of vaccines for preventable diseases than children and older adults. Young adults with type 1 diabetes (T1D) are at risk of complications from many vaccine-preventable illnesses. Given the elevated health risks of SARS-COV-2 infection for people with T1D, it is important to understand COVID-19 vaccination rates and attitudes. We explored vaccine uptake and characterized self-reported reasons for declining vaccination in a cohort of young adults with T1D as they were leaving pediatric care during the COVID-19 pandemic.

Methods: Participants enrolled in a randomized controlled trial of a transition intervention for young adults with T1D reported COVID-19 vaccination at baseline (2/2021-6/2023). We report rates of COVID-19 vaccination in addition to demographic and medical characteristics. Participants who did not receive vaccination were asked to note the reason(s). From these qualitative responses we identified themes.

Results: Of the n = 97 participants reporting vaccination status, 70.1 % reported receiving at least one COVID-19 vaccine. No demographic or medical characteristics were significantly associated with vaccination status (p ≥ 0.05). Themes of reasons for not receiving the COVID-19 vaccination included Doubt, Fear, External Factors, and Indifference.

Discussion: In young adults with T1D, COVID-19 vaccine uptake is below public health targets. Addressing fears about vaccine-related effects on T1D, doubts surrounding vaccine development and efficacy, and other external factors influencing vaccination decisions may be helpful in initiating a dialogue between clinicians and young adults considering vaccination. Further investigation into attitudes about other preventative care measures in this vulnerable population is needed. Clinical trial registry site and number: ClinicalTrials.gov ID Number - NCT04247620.