Study from St. Mary’s Identifies Factors Behind Adult Vaccine Hesitancy

Mistrust and Poor Communication Drive Vaccine Booster Hesitancy Among Older Adults, Study Finds

A groundbreaking study from St Mary’s University in London has identified that mistrust, misinformation, and ineffective communication are primary factors behind COVID-19 booster refusal among adults over 50, with these issues particularly pronounced in ethnically diverse and socioeconomically disadvantaged communities.

The research, dubbed the TRUST Study, reveals that vaccine hesitancy stems from a complex interplay of psychological, social, and practical considerations rather than single isolated concerns. Researchers aimed to enhance future booster campaigns by understanding these multifaceted barriers to vaccination.

Conducting in-depth online interviews with 30 adults aged over 50 in London and the West Midlands who had declined COVID-19 boosters, investigators uncovered four central themes influencing vaccine decisions: concerns about vaccine production and administration; health misinformation circulating through social networks; personal circumstances and social influences; and policy and logistical barriers to vaccine access.

“Our findings show that vaccine hesitancy is not simply lack of information,” explained Samual Lam, Research Fellow at St Mary’s University’s School of Allied Health and Life Science. “Many participants described feeling excluded from public health conversations or unsure whether messaging reflected their lived experience. Building trust requires listening, transparency, and communication that speaks to different communities in meaningful ways.”

The research indicates that mistrust extends beyond vaccines themselves to encompass broader healthcare systems. Many participants reported feeling unheard or marginalized during public health campaigns, suggesting that future initiatives must prioritize inclusive communication strategies that respect diverse perspectives.

Dr. Silvia Riva, Associate Professor in Psychology at St Mary’s University and Principal Investigator, highlighted the cultural dimensions affecting vaccine acceptance: “Mistrust is influenced by cultural practices and the knowledge schemas through which individuals interpret scientific information. In many cultural contexts, science is commonly understood as a gradual process involving time, trials, and errors.”

The rapid development of COVID-19 vaccines, while representing a remarkable scientific achievement, may have inadvertently fueled skepticism among populations accustomed to more prolonged development timelines. This disconnect between public expectations and pandemic-driven scientific acceleration created a trust gap that health communicators struggled to bridge.

These findings arrive at a critical juncture for public health initiatives. With seasonal vaccination campaigns continuing and the potential for future pandemic responses, understanding the nuanced reasons behind vaccine hesitancy could prove invaluable for health authorities and policymakers.

The implications extend far beyond COVID-19 vaccination efforts. Researchers suggest their findings could inform more effective approaches to annual flu vaccination campaigns and other public health initiatives, particularly when engaging hard-to-reach populations.

Funded through an unconditional research grant from pharmaceutical company Moderna, the study demonstrates how academic institutions can partner with industry while maintaining scientific independence. This collaboration allowed St Mary’s researchers to focus on public insight and health equity while exploring sensitive issues around vaccine confidence.

The complete study, titled “Barriers to equitable COVID-19 booster uptake among adults aged 50 and older in the UK: psychological factors and misinformation influencing vaccine hesitancy,” has now been published, providing valuable insights for healthcare professionals, policymakers, and communicators working to improve vaccination rates across diverse populations.

As health systems worldwide continue navigating the challenges of vaccine hesitancy, this research underscores the importance of building trust through culturally sensitive communication, addressing misinformation effectively, and creating accessible vaccination pathways that consider the varied circumstances of all community members.