Factors associated with adherence to COVID-19 vaccination in young adults: a systematic review

e202510057

Authors

Keywords:

Coronavirus infections, COVID-19 vaccine, Compliance and adherence to treatment, Mistrust in vaccination

Abstract

BACKGROUND // Young adults may be more likely to spread COVID-19 as they have low adherence to public health guidelines and are more reluctant to get vaccinated.
The purpose of this review was to provide the most current evidence regarding the assessment of adherence to COVID-19 vaccination in young adults.

METHODS // The bibliographic search was carried out in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, Scielo, MedLine/PubMed, Cochrane databases and in the Google Scholar search engine, with free and controlled language, using the MeSh search terms: “Treatment Adherence and Compliance”, “COVID-19
Vaccines”, “Young Adult”. Ten selected articles were analyzed. The articles were selected based on their relevance, published in peer-reviewed academic journals and published between 2021 and 2024.

RESULTS // The main study tool represents the adherence of COVID-19 vaccines. The most important discussion topics extracted in the analyzed articles refer to concern about side effects, mistrust, beliefs or low income level.

CONCLUSIONS // The findings of this study indicate the need to carry out vaccination promotion programs to provide accessible, transparent and age-appropriate information. Thus, it could be considered a useful tool to improve adherence and confidence in the COVID-19 vaccine.

Downloads

Download data is not yet available.

References

World Health Organization. WHO health emergency dashboard. 2020. [Acceso 25/03/2024]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Tran VD, Pak TV, Gribkova EI, Galkina GA, Loskutova EE, Dorofeeva V et al. Determinants of COVID-19 vaccine acceptance in a high infection-rate country: a cross-sectional study in Russia. Pharm Pract (Granada). 2021;19:2276. DOI: https://doi.org/10.18549/PharmPract.2021.1.2276

WHO. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. 2020 [acceso 25/03/2024]. Disponible en: https://www.who.int/director-general/speeches/detail/whodirector- general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020

Our World in Data. Coronavirus pandemic (COVID-19); 2022 Feb 22 [acceso 25/03/2024]. Disponible en: https://ourworldindata.org/coronavirus

Bergman J, Ballin M, Nordstrom A, Nordstrom P. Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study. Eur J Epidemiol. 2021;36(3):287-298. DOI: https://doi.org/10.1007/s10654-021-00732

Ling Y, Zhong J, Luo J. Safety and effectiveness of SARS-CoV-2vaccines: A systematic reviewandmeta-analysis. JMedVirol2021;93(12):6486-6495. DOI: https://doi.org/10.1002/jmv.27203

Thomas SJ, Moreira ED, Kitchin N, Absalon J, Gurtman A, Lockhart S et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine through 6 months. N Engl J Med 2021;385(19):1761-1773. DOI: https://doi.org/10.1056/ NEJMoa2110345

Kaplan RM, Milstein A. Influence of a COVID-19 vaccine’s effectiveness and safety profile on vaccination acceptance. ProcNatlAcadSci2021;118(10). DOI: https://doi.org/10.1073/pnas.2021726118 e2021726118

Afifi TO, Salmon S, Taillieu T, Stewart-Tufescu A, Fortier J, Driedger SM. Older adolescents and young adults willingness to receive the COVID-19 vaccine: Implications for informing public health strategies. Vaccine. 2021 Jun 11;39(26):3473-3479. DOI: https://doi.org/10.1016/j.vaccine.2021.05.026

MacDonald NE. Vaccine hesitancy: Definition, scope and determinant Vaccine. 2015;33:4161-4164. DOI: https://doi.org/10.1016/j.vaccine.2015.04.036

World Health Organization. Ten threats to global health in 2019. 2019 [acceso 25/03/2024]. Disponible en: https://www.who.int/newsroom/spotlight/ten-threats-to-global-health-in-2019

Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: Causes, consequences, and a call to action. Vaccine. 2015 Nov 27;33 Suppl4:D66-71. DOI: https://doi.org/10.1016/j.vaccine.2015.09.035

Paul E, Steptoe A, Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. Lancet Reg Health Eur. 2021 Feb;1:100012. DOI: https://doi.org/ 10.1016/j.lanepe.2020.100012

Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, RabinK et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med2021;27 (2):225-228. DOI: https://doi.org/10.1038/s41591-020-1124-9

Andrews JL, Foulkes L, Blakemore SJ. Peer Influence in Adolescence: Public-Health Implications for COVID-19. Trends Cogn Sci. 2020 Aug;24(8):585-587. DOI: https://doi.org/10.1016/j.tics.2020.05.001

Nivette A, Ribeaud D, Murray A, Steinhoff A, Bechtiger L, Hepp U et al. Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study. Soc Sci Med. 2021 Jan;268:113370. DOI: https://doi.org/10.1016/j.socscimed.2020.113370

Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L et al. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med. 2022 Oct;52(14):3127-3141. DOI: https://doi.org/10.1017/S0033291720005188

Adams SH, Schaub JP, Nagata JM, Park MJ, Brindis CD, Irwin CE. Young Adult Perspectives on COVID-19 Vaccinations. J Adol Health. 2021;69(3):511-514. DOI: https://doi.org/10.1016/j.jadohealth.2021.06.003

Brandt EJ, Rosenberg J, Waselewski ME, Amaro X, Wasag J, Chang T. National Study of Youth Opinions on Vaccination for COVID-19 in the US. JAdolesc Health 2021;68(5):869-872. DOI: https://doi.org/10.1016/j.jadohealth.2021.02.013

Zhu P, Tatar O, Griffin-Mathieu G, Perez S, Haward B, Zimet G et al. The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial. JMIR Public Health Surveill. 2022 May 30;8(5):e37328. DOI: https://doi.org/10.2196/37328

Walsh JC, Comar M, Folan J, Williams S, Kola-Palmer S. The psychological and behavioural correlates of COVID-19 vaccine hesitancy and resistance in Ireland and the UK. Acta Psychol (Amst). 2022 May;225:103550. DOI: https://doi.org/10.1016/j.actpsy.2022.103550

Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis [PRISMA declaration: a proposaltoimprovethepublicationofsystematicreviews and meta-analyses]. Med Clin (Barc). 2010;135(11):507-511. DOI: https://doi.org/10.1016/j.medcli.2010.01.015

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. DOI: https://doi.org/10.7326/M18-0850

Higgins JP, Altman DG, Gotzsche PC et al. Herramienta para evaluar el riesgo de sesgo en los ensayos aleatorios. BMJ. 2011 [consultado 25 de marzo 2024]. Disponible en: https://es.cochrane.org/sites/es.cochrane.org/files/uploads/Manual_Cochrane_510_reduit.pdf

Kim S, Willis E, Wehlage S, Scheffer-Wentz H, Dulitz M. COVID-19 vaccine hesitancy and short-term and long-term intentions among unvaccinated young adults: a mixed-method approach. BMC Public Health. 2022 Nov 7;22(1):2030. DOI: https://doi.org/10.1186/s12889-022-14448-3

Hossain MS, Islam MS, Pardhan S, Banik R, Ahmed A, Islam MZ et al. Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: Findings from a cross-sectional study. PLoS One. 2022 Aug 23;17(8):e0269944. DOI: https://doi.org/ 10.1371/journal.pone.0269944

Noh Y, Kim JH, Yoon D, Choe YJ, Choe SA, Jung J et al. Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in Korea: a nationwide cross-sectional survey. Epidemiol Health. 2022;44:e2022061. DOI: https://doi.org/10.4178/epih.e2022061

Dai H, Barrington-Trimis JL, Unger JB, Baezconde-Garbanati L, Leventhal AM. Patterns and mediators of racial and ethnic disparities in COVID-19 vaccine hesitancy among young adults. Prev Med. 2022 Jun;159:107077. DOI: https://doi.org/10.1016/j.ypmed.2022.107077

Moscardino U, Musso P, Inguglia C, Ceccon C, Miconi D, Rousseau C. Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy and resistance in the young adult population in Italy. Vaccine. 2022 Apr 6;40(16):2379-2387. DOI: https://doi.org/10.1016/j.vaccine.2022.03.018

Moccia G, Carpinelli L, Savarese G, De Caro F. Vaccine Hesitancy and the Green Digital Pass: A Study on Adherence to the Italian COVID-19 Vaccination Campaign. Int J Environ Res Public Health. 2022 Mar 3;19(5):2970. DOI: https://doi.org/10.3390/ijerph19052970

Zhang P, Li Y, Wang H, Luo L, Wang P, Wang H et al. COVID-19 Vaccine Hesitancy Among Older Adolescents and Young Adults: A National Cross-Sectional Study in China. Front Public Health. 2022 May 12;10:877668. DOI: https://doi.org/10.3389/fpubh.2022.877668

Su Y, Li S, Huang F, Xue J, Zhu T. Exploring the Influencing Factors of COVID-19 Vaccination Willingness among Young Adults in China. Int J Environ Res Public Health. 2023 Feb 23;20(5):3960. DOI: https://doi.org/10.3390/ijerph20053960

Yang F, Li X, Su X, Xiao T, Wang Y, Hu P et al. A study on willingness and influencing factors to receive COVID-19 vaccination among Qingdao residents. Hum Vaccin Immunother. 2021 Feb 1;17(2):408-413. DOI: https://doi.org/10.1080/21645515.2020.1817712

El-Elimat T, AbuAlSamen MM, Almomani BA, Al-Sawalha NA, Alali FQ. Acceptance and attitudes toward COVID-19 vaccines: A cross-sectional study from Jordan. PLoS One. 2021 Apr 23;16(4):e0250555. DOI: https://doi.org/10.1371/journal.pone.0250555

Zarbo C, Candini V, Ferrari C, d’Addazio M, Calamandrei G, Starace F et al. COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination. Front Public Health. 2022 Apr 29;10:873098. DOI: https://doi.org/10.3389/fpubh.2022.873098

Machida M, Nakamura I, Kojima T, Saito R, Nakaya T, Hanibuchi T et al. Trends in COVID-19 vaccination intent from pre- to post-COVID-19 vaccine distribution and their associations with the 5C psychological antecedents of vaccination by sex and age in Japan. Hum VaccinImmunother. 2021 Nov 2;17(11):3954-3962. DOI: https://doi.org/10.1080/21645515.2021.1968217

Qiao S, Friedman DB, Tam CC, Zeng C, Li X. Vaccine acceptance among college students in South Carolina: Do information sources and trust in information make a difference? medRxiv: the preprint server for health sciences. 2020. DOI: https://doi.org/10.1101/2020.12.02.20242982

Cellule d’Analyseen Sciences Sociales (CASS). Humanitarian Programme Recommendations for COVID-19 Based on Social Sciences Evidence from the DRC Ebola Outbreak Response. 2020 [acceso 25/03/2024]. Disponible en: https://www.socialscienceinaction.org/resources/humanitarian-programmerecommendations-covid-19-based-social-sciences-evidence-drc-ebola-outbreak-response/

Schwartz JL. Evaluating and Deploying Covid-19 Vaccines-The Importance of Transparency, Scientific Integrity, and Public Trust. N Engl J Med. 2020; 383: 1703–1705. DOI: https://doi.org/10.1056/ NEJMp2026393

Lucia VC, Kelekar A, Afonso NM. COVID-19 vaccine hesitancy among medical students. J Public Health (Oxf). 2020; 43: 445-449. DOI: https://doi.org/10.1093/pubmed/fdaa230

Paul E, Steptoe A, Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. Lancet Reg Health Eur. 2021 Feb;1:100012. DOI: https://doi.org/10.1016/j.lanepe.2020.100012

Sønderskov KM, Vistisen HT, Dinesen PT, Østergaard SD. COVID-19 booster vaccine willingness. Dan Med J 2021;69:A10210765

Truong J, Bakshi S, Wasim A, Ahmad M, Majid U. What factors promote vaccine hesitancy or acceptance during pandemics? A systematic review and thematic analysis. Health Promot Int. 2022 Feb 17;37(1):daab105. DOI: https://doi.org/10.1093/heapro/daab105

Cascini F, Pantovic A, Al-Ajlouni Y, Failla G, Ricciardi W. Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review. EClinicalMedicine. 2021 Oct;40:101113. DOI: https://doi.org/10.1016/j.eclinm.2021.101113

Callaghan T, Moghtaderi A, Lueck JA, Hotez P, Strych U, Dor A et al. Correlates and disparities of intention to vaccinate against COVID-19. Soc Sci Med. 2021 Mar;272:113638. DOI: https://doi.org/10.1016/j.socscimed.2020.113638

Gold JAW, Rossen LM, Ahmad FB, Sutton P, Li Z, Salvatore PP et al. Race, Ethnicity, and Age Trends in Persons Who Died from COVID-19 - United States, May-August 2020. MMWR Morb Mortal Wkly Rep. 2020 Oct 23;69(42):1517-1521. DOI: https://doi.org/10.15585/mmwr.mm6942e1

The Centers for Disease Control and Prevention, 2021a. CDC COVID Data Tracker: Demographic Trends of COVID-19 Cases and Deaths in the US Reported to CDC. [Acceso 25/03/2024]. Disponible en: https://stacks.cdc.gov/view/cdc/99332

Lopez L 3rd, Hart LH 3rd, Katz MH. Racial and Ethnic Health Disparities Related to COVID-19. JAMA. 2021 Feb 23;325(8):719-720. DOI: https://doi.org/10.1001/jama.2020.26443

Robinson E, Jones A, Lesser I, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative esamples. Vaccine2021;39 (15):2024-2034. DOI: https://doi.org/10.1016/j.vaccine.2021.02.005

Brandt EJ, Rosenberg J , Waselewski ME, Amaro X, Wasag J, Chang T. National Study of Youth Opinions on Vaccination for COVID-19 in the US. J Adolesc Health 2021;68(5):86-872. DOI: https://doi.org/10.1016/j.jadohealth.2021.02.013

Rozek LS, Jones P, Menon A, Hicken A, Apsley S, King EJ. Understanding Vaccine Hesitancy in the Context of COVID-19: The Role of Trust and Confidence in a Seventeen-Country Survey. Int J Public Health. 2021 May 14;66:636255. DOI: https://doi.org/10.3389/ijph.2021.636255

Zhu FC, Guan XH, Li YH, Huang JY, Jiang T, Hou LH et al. Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet. (2020) 396:479-488. DOI: https://doi.org/10.1016/S0140-6736(20)31605-6

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. (2020) 383:2603-2615. DOI: https://doi.org/10.1056/NEJMoa2034577

Wake AD. The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: “Vaccination Refusal Could Prolong the War of This Pandemic” - A Systematic Review. Risk Manag Healthc Policy. 2021 Jun 21;14:2609-2623. DOI: https://doi.org/10.2147/RMHP.S311074

Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R. High contagiousness and rapid spread of severe acute respiratory syndrome Coronavirus 2. Emerg Infect Dis. 2020;26(7). DOI: https://doi.org/10.3201/eid2607.200282

Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. E Clinical Medicine. 2020; 26:100495. DOI: https://doi.org/10.1016/j.eclinm.2020

Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2020:1-4. DOI: https://doi.org/10.1038/s41591-020-1124-9

Published

2025-10-02 — Updated on 2025-10-07

Versions

How to Cite

1.
Escandell Rico FM, Pérez Fernández L. Factors associated with adherence to COVID-19 vaccination in young adults: a systematic review: e202510057. Rev Esp Salud Pública [Internet]. 2025 Oct. 7 [cited 2026 Apr. 1];99(1):21 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/1039

Issue

Section

Revisiones

Categories