Reduced COVID-19 vaccine uptake in under 30s

The UK’s vaccination programme has been one of the successes of the pandemic, and high vaccination rates are likely what has led to the dramatic drop in Covid fatalities. However, as younger age groups have gradually become eligible to receive their vaccination, we have seen the uptake is much slower. At the moment three in ten people under 30 have still not received their first dose of vaccine. Sally Le Page asked University of Edinburgh public health specialist, Linda Bauld why this might be...

Linda - If you look at the 18- to 29-year-olds in the UK, around 72% of them have had a first dose of the vaccine. And you can see that in people in their thirties it's significantly higher. We're looking at about, I think, 80% at the moment and higher than that in people in their forties. What I would say though, there are some caveats around that. Although there are a number of 18- to 29-year-olds who will have been eligible for quite some time, because they've got an underlying health condition, there are others who only relatively recently have become eligible earlier in the summer, for example. So it's natural that they would have a slower uptake. But what I would say is striking, and I've been looking at the figures very closely over the last, for example, month, is the rate of increase is slower than it has been for older age groups, and that does cause me some concern.

Sally - Why do you think uptake has been so low in younger groups if it's not just a matter of there hasn't been enough time?

Linda - The first point is we could do better, but let's face it over 70% with the first dose is not bad. So credit to the young people who've come forward. That's absolutely brilliant. Main reasons for not taking up the vaccine are; the first one would be convenience, and the fact that they may not be in their locality, know where they can go, or the vaccines may not be as available to them.

Sally - Especially as I imagine more young people are likely to move house more often. Certainly I was. So having to change GP surgeries all the time is another thing on top of that.

Linda - Well, that's right. And with students with university and college students, that's a big issue, you know, registering with another GP. The other point, which is probably the main one is that young people don't see COVID-19 as a direct threat to their health.

Sally - You're right. I mean, as a 29-year-old, I remember a good period in the spring and early summer where everything was opening up, we were told non-essential retail, that's safe for you. Workplaces, pubs, museums, even small gatherings inside is all safe, even though I hadn't even been offered my first dose of the vaccine because of my age. If it was safe, then why do young people need the vaccine now?

Linda - Well, that's the thing. I think the communication has been mixed. The key thing is that we know that COVID is still in the community and it was there at that time when other things were opening up. But the comms has been complex and to try and communicate relative risks by age is quite a difficult thing to do. And perhaps we forgot that young people needed to be protected as well. The other thing from a scientific point of view is long COVID. The evidence on that is accumulating all the time. And we now know that younger people are also at risk of long COVID, not as much as older groups, but they are. And then the third point is younger people are more common consumers of social media than particularly much older groups. And that's where a lot of misinformation about vaccines exists. And I think young people may be seeing more of that misinformation than older groups.

Sally - Now obviously COVID isn't the only public health issue that has ever existed. Have there been any successful initiatives in changing public behaviour in past public health issues?

Linda - Oh, there's loads and loads. Reducing rates of smoking in young people where people have come forward and recognise that reducing smoking in indoor public places or encouraging people to take up the offer of a quit campaign. Those are things that we can do. So behaviour change, generally, I think has some basic principles. Clear evidence-based communication, accessible affordable interventions, whether that be a vaccine or a treatment or a counseling option, whatever, and also changing social norms. So I think there's things we can learn from other aspects of public health. And then the final one, I would say, which is a bit of an outlier for vaccines is even incentivising people to come forward to take up a public health intervention is something we've done actually tried and tested.

Sally - Yeah. You mentioned these vaccine incentives. We've seen recently things like discounts on takeaways and taxi services, but there are also, I suppose, non-vaccine disincentives. So making it harder for people who aren't vaccinated with things like restriction on travel. Which tends to work better; carrot methods or stick methods when it comes to changing public behaviour?

Linda - Well it's very interesting, because there's at least one study on this for COVID vaccines. And actually interestingly, in that study from Germany, for younger groups, they were more motivated by not being able to do things, not go to a pub, not being able to go on holiday, etc., if they were not vaccinated than by, you know, winning a prize or having the option of an incentive. And internationally, the need for vaccine certification is something we're just going to have to live with for travel. And I think for young people, actually that is a motivating feature, whether we do it much to get into a nightclub or other aspects of social and economic life, I'm not so keen, but I do think it has its place.