Perspectives of US Youth During Initial Month of the COVID-19 Pandemic

Eric Waselewski, MD; Marika Waselewski, MPH; Chloe Harper; Sarah Dickey; Sue Anne Bell, PhD, FNP-BC; Tammy Chang, MD, MPH, MS


Ann Fam Med. 2021;19(2):141-147. 

In This Article


In this national longitudinal text message poll, a majority of the adolescent and young adult respondents felt they had specific knowledge of COVID-19. By March 20, 2020, nearly all participants reported being impacted, largely from school and work closures, and self-isolation. As the pandemic progressed, more respondents also reported worry, primarily for others, and increased use of prevention measures, such as social distancing.

Contrary to the common perception that adolescents and young adults are disengaged, youth in our study demonstrated high levels of engagement in learning about the pandemic, with many youth turning to news outlets for information.[9–11] Although most information reported was accurate, some individuals cited inaccurate or non–evidenced-based information. A scientific understanding of COVID-19, from infection risks to impacts on schools, is important as this information influences youths' perceptions and behaviors. Accurate information targeted toward youth is necessary to ensure engagement in appropriate behaviors, particularly given that findings from our study suggest adolescent and young adults are consuming and acting upon this information. Additional consideration should also be given to educating youth on critically assessing and interpreting the sources of online information.[32] Leveraging youths' interest in understanding the evolving COVID-19 phenomenon may be important in developing efforts to promote healthy behaviors during the pandemic and beyond.

Between the 2 survey dates of our study, every state recorded a COVID-19 case and coronavirus disease 2019 was declared a pandemic, which may explain why nearly all participants reported being impacted by the pandemic by March 20, 2020, with increasing numbers of youth expressing worry or concern.[33] Notably, youth in our sample primarily expressed concern for others, like family, friends, or individuals at higher risk due to their job, socioeconomic status, or health conditions. This finding is also contrary to a commonly held belief and media portrayal of youth as self-centered and unempathetic.[22–26] As public health planning evolves, it is important to acknowledge youths' concern for others as a driver of their behavior and to create programs that are informed by their beliefs and perspectives.

Feelings of invincibility and the lack of perceived impact of COVID-19 on youth populations have been noted as fueling poor compliance with recommended prevention guidelines.[2,30,34–36] Youth in our sample noted similar concern about their age group not engaging in prevention. However, only 4 days after the White House released guidelines on use of social distancing (March 16, 2020), one-half of all respondents reported practicing social distancing.[37] This is particularly significant as youth were not primed with specific prevention measures in our open-ended question on what they were doing to prepare. National data note a comparable uptake of social distancing during this time indicating that, like adults, youth were engaged with the evolving pandemic and adapting their behaviors.[38,39] Our results further note that many respondents who indicated a lack of worry or concern about the ongoing pandemic cited their current prevention practices as reducing their fears. Regardless of their reasoning, many youth are participating in prevention of transmission to a larger degree than the media portrays.

The generalizability of these results is limited as the MyVoice cohort is not a nationally representative sample of youth. Identification of themes in coding may also be biased based on reviewer experiences. This impact is mitigated, however, by the use of 2 independent coders with a third reviewer, inclusion of youth experts in the analysis process, and the short nature of text-message–based surveying.

Many youth in our sample are engaged in learning about the ongoing COVID-19 pandemic, with most being knowledgeable about the disease, concerned about its impacts (particularly on others), and taking appropriate preparation measures. Some youth reported inaccurate information, however, which may play a role in future spread. Understanding these behaviors and perceptions of youth in the United States adds to the growing body of knowledge on COVID-19 that may be useful in informing public planning. Our results suggest that sustained public health efforts should focus on maintaining youth engagement, ensuring accuracy of public information, and using youth-centered messaging to promote prevention measures to protect the health and well-being of youth and their friends and family. Given recommendations for youth to continue receiving routine care,[40] primary care clinicians have an opportunity to more directly address youth questions and correct misinformation on the pandemic that may impact youths' behaviors.