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'Political conservatism' associated with COVID-19 vaccine hesitancy in undergrads, study finds

Students have "eminently reasonable" qualms about the new vaccines, counters Brown University epidemiologist.

Updated: June 7, 2021 - 10:24pm

The political and higher education establishments are focused on getting as many college students vaccinated as possible. 

The White House started a "COVID-19 College Vaccine Challenge" to get colleges and universities to engage their communities to get vaccinated and make the vaccination process easy. 

Many already require students to get COVID-19 vaccines, and some are dangling the end of campus mask mandates to incentivize students to get jabbed. The CDC updated its guidance last week to say that "fully vaccinated" campuses can return to "full capacity in-person learning" with no masks or social distancing.

A new study by Pennsylvania State University researchers seeks to understand why students resist vaccination against COVID-19, so that authorities can design "tailored strategies" to overcome their hesitancy. It's a medical preprint, meaning it hasn't been peer-reviewed yet.

One of the best predictors they found may be particularly resistant to change, however. "Political conservatism" was the fifth-most positively correlated factor with vaccine hesitancy.

"Approaching high levels of population immunity by fall 2021 is important to colleges and universities hoping to reopen and welcome students back to pre-pandemic activities in campus classrooms, dorms, and event venues," the paper concludes. 

Lead author Meg Small, director of social innovation at Penn State's Prevention Research Center, did not answer a query about the study's disclosure that it didn't look at "racial or gender differences as predictors of hesitancy." Race is historically correlated with vaccine hesitancy.

Just the News also asked for Small's take on college vaccination requirements and vaccination incentives for students in light of her research.

While the study claimed it was critical to vaccinate college students because they constitute 10% of the American population and often live in high-density housing, not all medical experts agree.

Brown University epidemiologist Andrew Bostom has regularly challenged portrayals of campuses as potential hotbeds of COVID-19 carnage that require strict mitigation measures. He recently testified in favor of banning so-called vaccine passports in Rhode Island.

Bostom scoffed at the study's abstract on Twitter for selective citation of evidence that mass vaccination of students is required to return to a normal campus environment.

The survey responses of vaccine-hesitant students were "eminently reasonable," Bostom told Just the News, arguing that "the en masse vaccination of extraordinarily low-risk people" is out of whack with their risk for vaccine complications.

He pointed to a recent Connecticut announcement that 18 out of 400,000 fully vaccinated residents ages 16-34 had subsequently developed myocarditis. At 4.5 per 100,000, that's twice the estimated myocarditis "background rate" for non-vaccinated active duty military personnel, who are largely in the same age range, Bostom said, citing a 2005 study of smallpox vaccination side effects.

"I'm not a conspiracy theorist," but college COVID vaccine requirements "just don't make any ... good epidemiological sense," he said.

The study was conducted last fall before COVID-19 vaccines were available. It's based on responses from nearly 700 students, ages 18-29, from a "large public university" who lived on or near campus, recruited through the university itself.

On a 5-point scale, students were asked how likely they were to get a free FDA-approved COVID-19 vaccine, if they worried about unknown side effects and "unforeseen problems in children," how much they trust the system for evaluating vaccine safety, and their level of "cynicism" that vaccination programs are more about financial gain than health.

Students could also check boxes for all views they held: that COVID-19 vaccines were not sufficiently evaluated for safety or efficacy, that political pressure interfered with the regulatory process, and too few minority participants were enrolled in studies.

They were asked to rate their political beliefs on a 7-point scale from very conservative to very liberal.

The factor with the strongest positive correlation with vaccine hesitancy was worries about unknown side effects. That was followed by unforeseen problems in children, vaccine cynicism, insufficient safety evaluation, and political conservatism. (The question about political beliefs had the highest "missingness" value, with 4% of participants declining to answer.)

Weaker positive correlations: concerns about COVID-19 vaccine efficacy, perceived severity of COVID-19 if infected, and concerns about political pressure on the regulatory approval process.

The survey found high correlations between some factors, including conservatism and concerns about side effects in children and vaccine cynicism. By contrast, concerns about COVID-19 vaccine efficacy were "moderately positively correlated" with COVID-19 vaccine hesitancy.

Significant demographic differences emerged: Women (64%) were more concerned than men (55%) about insufficient safety evaluation, and less concerned about political pressure (45% and 59%). Black students were far more concerned than non-blacks about efficacy (59% and 34%) and minority enrollment in research (55% and 20%).

Limitations included the makeup of the survey population. White students represented 86% of the study but 76% of the undergraduate population, though blacks, Latinos and Asian-Americans more closely matched their percentages. 

"High vaccine coverage is important to protect students, faculty, staff, and the residents of college town communities," but it's not enough for campus authorities to promote the utility of vaccines in general, the study concludes. "This coverage is only achievable with strong, targeted messaging to reach those who are vaccine hesitant."

The incessant push for student vaccination, regardless of individual risk factors for serious COVID-19 reactions, is not based on a cost-benefit analysis, according to Bostom. "As a clinician investigator for nearly 40 years now I really don't understand it," he said.

U.S. vaccine rollouts have historically targeted high-risk, medically frail populations, Bostom noted. Distribution of pneumococcal vaccines, for example, is "very carefully stratified" even though the infection is life-threatening, he said.

Bostom would have authorities much more carefully monitor populations under 30 for severe vaccine reactions, perhaps studying a cohort of 100,000 over several months.

The risk of sudden death for those with even mild or undetected heart conditions is not worth the amorphous benefit of vaccination for young people outside of "niche populations," he said. The possible effect of COVID-19 vaccines on young people's reproductive health and bodily growth should also be studied.

Just as baffling to the epidemiologist is the rejection of natural immunity as a basis for vaccine exemption. He noted the University of Rhode Island will not exempt those who have recovered from prior COVID-19 infection, which is "inventing some new immunology."

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