It’s World Immunisation Week, which partly exists to raise awareness of the collective action needed to protect people from vaccine-preventable diseases. This year’s theme is “The Big Catch-up”, and it focuses on the millions of children who missed out on vaccines during the pandemic.
In the UK, we’re falling behind on optimum uptake for teenage vaccines. This could have a negative impact on the future health status of the country, increasing the risk of outbreaks of deadly diseases such as meningitis and measles. General attitudes towards, and perceptions of vaccines - for example, confidence in their value and understanding of their importance - influence uptake. However, little is known about this from the perspective of children and young people (CYP). In response, RSPH carried out new and unique research to understand what children know and think about vaccines, capturing their worries and concerns. We partnered with Dubit, a research organisation that specialises in children and young people, to conduct focus groups and a nationally representative survey of CYP across the UK.
The findings, implications and recommendations for solutions are published here. We also held a webinar, where Dr Fernanda Aguilar Perez (RSPH Policy Advisor and lead on the project) presented key findings of this research, alongside Dr Sue Sherman (reader in Psychology at Keele University), who explained why understanding perceptions is so important.
We learnt so much from the research, and the findings indicate that whilst the majority of CYP trust vaccines and think they are important to their health, they do not have a clear idea of which vaccines are available to them. Most go online when looking for information about vaccines, but they also go to their parents, GPs and school nurses. What is encouraging is that trust and knowledge are key factors that encourage CYP to have a vaccine, and the majority believe the decision to have it should be made jointly with their parents. In addition, CYP are concerned about side effects, vaccine safety and pain.
However, there was variation by nation and ethnic background, which tells us that vaccine programmes and interventions need to be better designed to reflect the needs of all CYP and their networks and communities.
CYP from Asian and black backgrounds have significantly different perceptions of vaccines. When compared to their white peers, fewer of them think vaccines are important to their health. They also trust vaccines less and are more likely to be concerned about their safety, side effects and costs. It is important we further understand, and act on, the reasons behind these differences, so that we can better support CYP from these groups. Could we do better at including them in our conversations about vaccines? Are we failing to deliver vaccines in accessible areas to these groups? The “Grab-a-jab” initiative has proven to increase Asian and black communities’ vaccine uptake by locating vaccination centres in sites that meet these communities’ needs. Learnings from these types of initiatives could potentially improve vaccine uptake across many communities.
CYP should be listened to and feel empowered to make decisions about their own health. This includes decisions about vaccinations. It was encouraging that CYP told us that they want to be part of the decision-making process, and have their own independent views and thoughts on vaccines. Collectively it is our responsibility to ensure that CYP and their networks have access to appropriate information and support to inform their collective decision-making. We also must make sure CYP feel confident they have access to people they trust in case they want to talk about vaccines. Empowering CYP also involves the range of people and organisations present in their lives. This includes parents, teachers, the public health workforce, faith leaders, social media companies and businesses, all of whom need reliable information and support to be able to counter misinformation.
Supporting the public health workforce and healthcare professionals is crucial. These people, who plan for and deliver vaccines, are in a crucial position: on the one side, they work on the ground and give advice to children, helping tackle misinformation and mistrust. On the other, they can also inform interventions and support the government in developing programmes that could potentially increase vaccine uptake. However, as the public health workforce have told us in the past, the Covid-19 pandemic increased pressures on their workload, making them feel overwhelmed and exhausted. If we want CYP to be better supported, we must support the vaccine workforce.
Schools are at the heart of the vaccine strategy for children this age. Educational settings already support routine immunisation programmes, and CYP told us that being told about a vaccine at school or being able to have it at school would encourage them to have a vaccine. They also said that they see school nurses and teachers as people they would go to ask for more information about vaccines. Schools are crucial to delivering vaccine programmes, but they are currently under pressure. School nurses are struggling with a diminished workforce. In order to reach the recommended vaccine uptake and protect CYP from infectious diseases, schools must be properly supported, so they can keep doing their excellent work at playing a central role in delivering and shaping immunisation strategies.
What next? One of the key learnings from this research is that all CYP must have access to reliable and trustworthy information. They must have the right support so they can make informed decisions about their health, and the provision of sound information forms part of this support. However, given that CYP from Asian and black backgrounds have different views and experiences of vaccines, the next step should include finding out the reasons why this happens and developing a plan of action to address potential issues. Developing a tailored strategy to deliver information and vaccines to Asian and black CYP is fundamental if we are to influence future vaccine uptake in this group.
RSPH will continue to build on this evidence base to shape vaccine programmes for CYP, in addition to providing qualifications and training, to support all involved in delivering vaccines. MSD UK has funded this project and has had no editorial input into the content.
If you have any questions, contact Dr Fernanda Aguilar Perez at [email protected]
