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Background: Observational data suggest that most people with cystic fibrosis (PwCF) who contract COVID-19 have outcomes similar to those of the general population, although PwCF who are older or have CF-related diabetes, poor lung function, or a history of lung transplantation may be at greater risk for more severe disease. Therefore, the CF Foundation advocates for PwCF to discuss vaccination with care teams. At present, the FDA has authorized emergency use of 3 COVID-19 vaccines. ACIP/CDC guidance allows each state to determine vaccine distribution based on an individual’s exposure and risk for severe disease. This study describes the attitudes of adolescents with CF followed by Children’s Mercy Kansas City (CMKC)’s CF center whowere eligible for COVID-19 vaccination in the state of Missouri. Methods: The CMKC Cystic Fibrosis Center is located in Missouri but provides care for 234 PwCF from Missouri and Kansas. COVID-19 vaccine was received from Missouri’s and Kansas’ allocation, with distribution based on state-wide, phased, and tiered systems. Phase 1B–Tier 2 in Missouri included, among others, individuals with chronic obstructive pulmonary disease (COPD). CMKC used the inclusion of COPD to advocate for PwCF to qualify for vaccination. Phase 4 in Kansas included PwCF. CMKC was allotted doses (first and second) to be administered over 7 vaccine clinic days for all CMKC patients meeting vaccination criteria. Center staff contacted (telephone and electronic medical record messaging) and documented vaccine status of all PwCF aged 16 and older receiving care at CMKC. Results: Of the 234 individuals followed at CMKC, 56 (24%) were aged 16 and older and eligible for COVID-19 vaccination. The median age was 18.0 (16. 1–20.8), and 31 (55%) were female. Of the 56 vaccine-eligible patients, we were unable to contact 10 (18%), 18 (32%) declined, and 28 (50%) scheduled vaccination. For thosewho declined, logistical issues were most common; 2 could not travel, and 3 had scheduling conflicts. Other reasons for decliningwere mistrust in the vaccine or pandemic severity (n = 3,17%), concerns about adverse reactions (n = 1), perceived lack of susceptibility to infection (n = 1), and current SARS-COV-2 infection (n = 2); 5 (28%) individuals refused without stating a reason, and one caregiver desired consent from a minor child. Of those receiving the vaccine, 25 (89%) had received an influenza vaccination in the 2 years prior; of those that refused, 16 (89%) had received an influenza vaccination. Conclusion: Of the 56 PwCF contacted, the majority agreed to COVID-19 vaccination. Avariety of reasons were given for declining vaccination. Most troubling of these were skepticism regarding the pandemic and vaccine necessity and misconceptions about safety and efficacy. As access to SARSCoV- 2 vaccination is expanded nationally and includes younger children with CF, it will be critical for CF care center staff to proactively address issues surrounding vaccination hesitancy.


Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences | Pulmonology


Presented at the North American Cystic Fibrosis Conference, November 2-5, 2021, Virtual.

COVID-19 vaccination in individuals with cystic fibrosis at a pediatric cystic fibrosis center