“I want to chat with a person”: a qualitative longitudinal cohort study in England exploring drivers of sub-optimal childhood vaccination uptake

Background: Childhood vaccination rates in the UK have declined for the thirteenth year in a row. This study explores parents' vaccination experiences to identify key barriers affecting uptake, helping stakeholders better understand and support families.

Methods: A qualitative longitudinal study following a cohort (n = 22) of parents from birth to age one. Three waves of data collection took place in line with key vaccination due dates at approximately two (July 2023–February 2024), four (October 2023–May 2024), and twelve months of age (May 2024–December 2024). In total, the dataset comprises 63 interviews and 98 diary entries (including 119 picture submissions) across all waves of data collection. Data were analysed using temporal thematic analysis.

Results: Information provision was a critical temporal theme accounting for divergences in parents' experiences and, in some instances, the outcome of their vaccination journeys. Parents received minimal information in the lead up to vaccination and during the appointment itself. Parents had different relationships with vaccination (confident, curious, or concerned), however, this was subject to change between waves of data collection. In addition to a lack of proactive information provision, there was nowhere for parents to turn to having developed vaccine-related concerns leaving some stuck “on the fence”. Parents were further nudged towards vaccine deferral or refusal based on a breakdown of trust with their General Practice, search engine results, and content on social media.

Conclusion: To address declining vaccination coverage in England, it is essential that parents have opportunities to meaningfully discuss their questions with healthcare providers. For many, information provision is too little, too late, and there is no opportunity for dialogue. This study deepens our understanding of parents' experiences of information provision regarding childhood vaccinations and provides recommendations for policy and practice.