Social Contexts and Public Health Control: Addressing Vaccine Hesitancy: The TRUST Study on SARS-CoV-2 Booster Uptake in Individuals Aged 50+ in the UK

Background: New strains of SARS-CoV-2 have brought to light the importance of booster jabs as a public health intervention. While individuals aged 50+ are at a heightened risk of severe disease and were prioritised for booster vaccination, uptake varied significantly among ethnic groups, socioeconomic background and education level. This highlights the importance of understanding the intentions, psychological behaviours and concerns of underrepresented populations within the broader context of social determinants of health. Methods and Materials: The TRUST study employed a demographic pre-screen tool, to identify and invite 30 individuals aged 50+ who had declined the booster jab in London (n=15) and the West Midlands (n=15) for qualitative interviews. These interviews delved into participants' attitudes towards COVID-19 vaccine boosters and their interactions with (mis)information about COVID-19. Thematic analysis was conducted using NVivo V.12 with transcriptions generated by Otter.ai. Results: The analysis revealed four pivotal themes: 'Vaccine production and administration', 'Health (mis)information and beliefs', 'Personal circumstances and social influences', and 'Policy and logistical factors'. Within the social context, the primary drivers of booster jab hesitancy were concerns over 'Vaccine manufacturing' and 'The role of family and friends'. Psychological constructs such as epistemic trust and the “bandwagon” effect were found to shape booster vaccination behaviour. Discussion: The TRUST study provides critical insights into the factors influencing SARS-CoV-2 booster vaccine hesitancy among individuals aged 50+ in the UK, particularly within the framework of social contexts and public health control. The findings underscore the necessity of culturally relevant and transparent public health messaging to address vaccine hesitancy, combat healthcare misinformation, and establish trust in the safety and efficacy of booster vaccinations. Conclusions: Tailored communication strategies, encompassing diverse channels and focusing on education regarding vaccine safety, are essential to engage effectively with diverse populations and mitigate concerns. Implementing robust monitoring and adaptation mechanisms is crucial to align public health messaging with official guidelines and promptly address emerging concerns. These insights serve as a foundational step towards designing more effective and inclusive booster vaccination campaigns, advocating for a holistic approach that integrates scientific evidence, transparency, education, and cultural sensitivity.