Aug. 13, 2021 -- The dating behaviors of adolescents and young adults pose a challenge to fighting the COVID-19 pandemic because some young people prioritize their relationships over the risk of becoming infected and may not comply with recommended preventive measures.
“Recent research indicates that many [adolescents and young adults] are noncompliant or are inconsistent with adhering to these measures even when exhibiting COVID-19 symptoms,” says Yzette Lanier, PhD, an assistant professor at New York University’s College of Nursing, whose thoughts on the subject were published as a commentary in JAMA Pediatrics.
Nevertheless, romantic relationships are a key part of social development for these age groups, she writes, and it is crucial to find ways to enhance safety rather than discourage these romances or hamper their development.
Of course, the best way to ensure the safety of young people is to vaccinate them. But for a variety of reasons, Lanier points out, a large percentage of adolescents and young adults are unvaccinated. So public health messaging should focus on how to persuade them to follow COVID-19 safety guidelines, such as mask wearing, in their romantic relationships.
Young people in ongoing relationships, should have conversations about how to protect one another, Lanier wrote.
“Engaging in COVID mitigation behaviors to protect one’s partner may be a way for partners to demonstrate their love for each other and their commitment to the relationship,” she said.
Safety agreements between romantic partners, Lanier proposes, might include not only getting vaccinated, but also a plan to have routine testing, to lessen close contact with other people, and to engage in preventive strategies such as mask wearing.
“Agreeing to adhere consistently to COVID-19 preventive measures can be a shared goal between partners that may add meaning to their relationship and increase their romantic bond,” the article says.
Lanier wrote the commentary several weeks ago, before the CDC in July re-tightened its preventive measures guidance for vaccinated people.
But as the number of COVID-19 cases rises again, Lanier tells WebMD, “many states and local jurisdictions have either reinstated COVID-19 control measures, like mask mandates, or are considering reinstating them. The CDC is also said to be considering these mandates. Considering these factors, consistent uptake of these measures among all adolescents and young adults still remains important, even with the availability of COVID vaccines.”
Lanier is not suggesting that young adults stop kissing or holding hands or even having sexual relations.
“But it’s important for young people to recognize that engaging in normal behavior like kissing can put them at risk for COVID-19 acquisition,” she says.
Being vaccinated doesn’t mean that a person can forget about the safety aspects of dating, either, she argues.
“Often, when people are vaccinated, they have a different level of comfort about being around people and feeling the need to use these preventive measures. But we know that some vaccinated people are still getting COVID. Also, some young people aren’t vaccinated, so these preventive measures are still important for both the vaccinated and the unvaccinated.”
In an interview, Preeti Malani, MD, chief health officer of the University of Michigan, and a professor in the university’s Division of Infectious Diseases, says she views Lanier’s commentary not only from the viewpoint of an expert but also as the mother of two young adults. From that perspective, she says, the idea of focusing mainly on COVID-19 in romantic relationships is a bit limited.
“COVID can be mitigated through vaccination. The other risks that are well-known in this age group -- everything from drug use to bad decision making to risky sexual behavior -- we can’t vaccinate against those. What I tell my kids every day is ‘make good decisions.’ Have a conversation with your friends, not just about COVID, but about the risks.
“The idea that adolescents shouldn’t be with their friends because of COVID is also a risk. What I’ve done throughout the pandemic is focus on what they can do, and how they can do it safely. And I’d say the same about everything else around relationships.”
Overall, she says, “individual risk is less important than population risk. What I worry about with adolescents and young adults is that there will be a big outbreak, and they’ll infect someone who is vulnerable.”
Malani agrees with Lanier that romantic relationships can increase the risk of COVID-19 transmission. However, she says, “The public health messaging around other issues like unintended pregnancy, sexually transmitted diseases, trauma, and sexual assault are equally, if not more important than the COVID discussions.”
To increase their safety and the safety of those around them, she says, “Young people should be asking their friends whether they’re vaccinated. They should encourage the other people in their life to get vaccinated so that they’re all safer.”
Charlotte Hobbs, MD, a professor of pediatric infectious disease at Children’s of Mississippi in Jackson, tells WebMD that Lanier’s commentary is “extremely important and timely.”
Currently, she says, COVID-19 is increasingly affecting young people, who may also spread the disease.
In Hobbs’s view, the JAMA Pediatrics article recognizes the importance of socialization for adolescents and young adults while stressing the need to keep them safe. “Being safe and being able to engage in these relationships are not mutually exclusive,” she points out.
The best thing about the commentary, in her view, is that it shifts the focus to young people. In the earlier phase of the pandemic, the public health messaging was aimed mostly at older populations, who were the most vulnerable to becoming seriously ill with COVID-19. But now that more younger people are getting sick, the messaging needs to shift.
“If we’re going to get through this pandemic and minimize the chance of more variants rising, we need a more collective effort on a population level to get everyone vaccinated,” Hobbs says.
Correction: An earlier version incorrectly said Children's of Mississippi is in Gulfport. It is in Jackson.