Study reveals teenagers' vaccine hesitancy in England stems from knowledge gaps and emotional factors, not social media influence

Research involving young people in England uncovers that teenagers’ reluctance to routine vaccines is driven by limited disease understanding and emotional concerns, challenging assumptions about social media’s role in hesitancy.

Teenagers in England are not chiefly being put off routine vaccines by social media, according to new research, but by something more basic: patchy knowledge of the diseases involved, fear of injections and frustration that adults often make the decisions without properly involving them. The findings land as health officials continue trying to rebuild school-age vaccination coverage that has improved since the pandemic but remains below target. (medrxiv.org)

The study drew on interviews with 30 adolescents aged 12 to 17 in England and was co-produced with young people rather than carried out solely by adult researchers. In evidence later submitted to a parliamentary committee, the authors said that approach was designed to capture what adolescents actually think about vaccination barriers and incentives. The work first appeared as a medRxiv preprint on 4 November 2025. (committees.parliament.uk)

What mattered most to many participants was whether a disease felt serious and real. In the parliamentary evidence, the researchers said vaccines linked in teenagers’ minds to severe outcomes such as cancer were more readily accepted, but only when adolescents knew what the vaccine was preventing. Where that knowledge was missing, the offer could seem remote or unnecessary. One participant’s response became the study’s title: “I didn’t even know humans could get polio … I swear that’s for dogs”. Official guidance for schools says the HPV jab is offered in year 8 and protects against cervical cancer, other genital cancers and some cancers of the head and neck, as well as genital warts. (committees.parliament.uk)

Fear of needles, meanwhile, was not a minor inconvenience. In the preprint, one teenager reduced the whole experience to three words: “Needle. Scared. Sports hall.” Another said: “It was really bad. I started crying … yeah, I think after that I don’t think I’d get one if I didn’t need to.” The evidence to Parliament said some pupils felt adults brushed those fears aside and that classmates, not staff, sometimes provided the real comfort, with one adolescent recalling a friend who “held my hand”. The researchers said practical changes such as privacy, distractions and better emotional support could help. (medrxiv.org)

Control over the decision was just as complicated. Parents remained the main determinant of uptake, and some adolescents said they arrived at school sessions with little understanding of what was being offered because information and consent materials were directed chiefly to adults. “I was relatively on board, but I think my parents were quite unsure, so I ended up not having it,” one participant said. Another argued that “The idea of someone else saying … you can or can’t have it …is a bit, um, silly … it’s not them being infected, it’s you being infected”. Yet the researchers also found that more adolescent agency did not automatically mean higher uptake; in the preprint, they said there was “no consistency between adolescent agency and vaccine uptake”. (committees.parliament.uk)

The study also challenges an assumption that platforms such as TikTok are the main engine of routine vaccine hesitancy among teenagers. Participants told researchers they generally did not trust social media for health advice and often scrolled past vaccine content. “When it comes to, like, real life, I wouldn’t trust TikTok”, one said. Rumours were more often described as arriving indirectly through adults, especially around Covid vaccines, and some adolescents thought that distrust had spilled over into attitudes to other jabs. At the same time, the parliamentary submission said almost all participants remained positively disposed towards health workers and the NHS, even when their trust in government was shakier. (committees.parliament.uk)

The policy backdrop is a school vaccination programme still short of where officials want it to be. NHS England said HPV coverage in the 2023/24 academic year remained below its 80% efficiency target, at 72.9% for girls in year 8 and 67.7% for boys, although both figures were up on the previous year. Uptake for the year 9 teenage booster against tetanus, diphtheria and polio reached 71.1%, while MenACWY stood at 72.1%. Separate government statistics show London had the weakest year 8 HPV coverage, at 61.6% for girls and 57.0% for boys, with local authority figures ranging as low as 32.9% for girls in Brent and 27.4% for boys in Westminster. The same NHS accountability statement noted that a national measles incident declared in January 2024 helped drive catch-up activity that delivered more than 180,000 additional MMR doses. (gov.uk)

The mechanics of delivery matter as well. Government figures show all 151 local authorities routinely offered HPV vaccination in year 8 in 2023/24, but catch-up work had been completed in only 94, with 54 still incomplete and three not requiring it. The programme moved from two HPV doses to one in September 2023 following advice from the Joint Committee on Vaccination and Immunisation. Officials say catch-up can work: for the same cohort, year 9 coverage was 2.8 percentage points higher for girls and 3.3 points higher for boys than it had been a year earlier in year 8. Current school guidance says year 9 pupils are also offered MenACWY, which protects against meningitis and septicaemia, and the three-in-one booster that extends protection against tetanus, diphtheria and polio into adulthood. Teenagers aged 14 and over who miss school sessions can also be vaccinated through their GP. (gov.uk)

For the researchers, the lesson is not that adolescents need firmer instruction, but that they need to be addressed more directly and more honestly. In their submission to MPs, they called for earlier and more interactive vaccine education, communication aimed at young people as well as parents, and straightforward support for anxiety on the day. One participant who had refused all vaccines proposed a school question-and-answer session: “There should be a day … in school, where… someone comes in and they, like, talk to the classes and, like, people can ask questions … ‘Cause not everyone likes asking questions. So, if one person can ask, then they can all hear”. NHS England has said it is working with the Department for Education, the UK Health Security Agency and the Department of Health and Social Care to reduce barriers around consent, information-sharing and access. The study suggests that effort may go furthest if teenagers are treated not as passive recipients of public health messages, but as participants in the conversation. (committees.parliament.uk)