When researchers asked a group of British teenagers about polio, one of them delivered an answer that has since become shorthand for an entire public health challenge: “I didn’t even know humans could get polio … I swear that’s for dogs.” That candid admission, captured during a new qualitative study of adolescent attitudes toward vaccines, reveals a generational gap in disease awareness that experts say could threaten hard-won immunisation gains. The study, published in BMC Public Health by a team from King’s College London and the UK Health Security Agency, set out to do something that vaccine research has rarely attempted: listen directly to adolescents rather than to the parents and healthcare professionals who usually speak on their behalf. What the researchers heard was a portrait of young people who are largely supportive of vaccination but often underinformed about the diseases vaccines prevent, frequently anxious about the needles themselves, and eager for a greater say in decisions that affect their own bodies.
The stakes of the question are far from abstract. In England, uptake of the human papillomavirus vaccine among adolescents has fallen well short of the World Health Organization’s target of 90 percent coverage by 2030. In the 2023/24 school year, only 72.9 percent of girls and 67.7 percent of boys in year 8, typically aged 12 to 13, had received the HPV vaccine. Similar shortfalls affect other routine immunisations offered during adolescence, including boosters against tetanus, diphtheria and polio, as well as the meningococcal ACWY vaccine. Public health officials have long recognised that each percentage point of missed coverage leaves a growing pool of susceptible individuals, weakening the herd immunity that protects those who cannot be vaccinated for medical reasons. Yet while a substantial body of research has examined why parents hesitate or why school nurses struggle to deliver programmes, the adolescents themselves, the people who ultimately roll up their sleeves, have been largely absent from the evidence base.
To close that gap, the research team adopted an unusually participatory design. More than 80 adolescents were recruited to help co-produce every stage of the study, from its conceptual foundations to its final interpretation. These young collaborators received formal training in qualitative research methods and thematic analysis, a technique that allows researchers to systematically identify patterns of meaning across interview data. They selected the interview format used in the study, co-developed the participant information materials and the discussion guide that shaped the conversations, and led pilot sessions with younger adolescents to test whether the questions landed appropriately. Crucially, they also contributed to the coding of transcripts and to the development and interpretation of the resulting themes. The researchers argue that this co-production model produced more honest, less guarded conversations than a purely adult-led study might have achieved, because the young interviewers and advisers understood the social dynamics and anxieties that adolescents bring to discussions about their health.
For the core study, the team conducted in-depth interviews with 30 adolescents aged 12 to 17 living in England, exploring how they think and feel about vaccines in general and about the immunisations offered to them specifically. Using thematic analysis, the researchers identified five overarching themes that structured the teenagers’ attitudes: understanding of vaccines; fear and comfort; autonomy and control; information sources and conspiracy theories; and identity and social norms. Within these themes, a consistent picture emerged. Most participants were broadly in favour of some or all vaccines, and only a small minority reported having received no adolescent vaccines at all. But positivity did not translate automatically into uptake. The adolescents’ willingness to be vaccinated was shaped heavily by how dangerous they perceived vaccine-preventable diseases to be, and by a powerful, sometimes overwhelming, fear of needles that several participants described as a genuine barrier to accepting injections at school or in clinical settings.
The needle phobia documented in the study is more than a minor inconvenience, and the researchers suggest it deserves serious clinical attention. For some adolescents, anxiety about injections was intertwined with a broader discomfort around medical procedures and a lack of practical coping strategies. The study’s conclusions make clear that young people are not asking to be exempted from vaccination; rather, they want to be given techniques to manage their anxiety, whether through breathing strategies, distraction, numbing creams, or simply being taken seriously when they voice their fears. This finding has practical implications for school-based immunisation programmes, which deliver the majority of adolescent vaccines in England but which have limited time and resources to support individual students through procedural anxiety. The researchers suggest that equipping young people with anxiety-management tools before vaccination day could meaningfully improve uptake, particularly among those who would otherwise avoid the appointment altogether.
Perhaps the most nuanced finding concerns autonomy. Public health policy often assumes that giving adolescents more control over their vaccination decisions will increase uptake, on the theory that ownership breeds engagement. The study complicates that assumption. Decision-making dynamics between parents and teenagers proved to be complex, with autonomy acting as a disruptive force as well as a driving one. Some older adolescents who asserted independence from their parents also drifted away from vaccination, either because they lacked the information to make a confident choice or because the logistics of booking appointments fell through the cracks once responsibility shifted from parent to teenager. Others described difficult negotiations in which their own preferences clashed with parental authority. Across the board, most participants said they wanted to be more involved in vaccine decisions than they currently were, suggesting that the solution lies in supported, informed autonomy rather than in either parental compulsion or unsupervised choice.
The study also punctures a widespread assumption about where vaccine misinformation comes from. Contrary to the popular narrative that social media is radicalising young people against vaccines, the adolescents interviewed reported little interest in online vaccine content. Social media was not a major source of vaccine information for this group, and many participants expressed active disinterest in vaccine-related posts, scroll-past material in an feed dominated by entertainment and friendships. When the teenagers did encounter anti-vaccine narratives online, they often attributed them to adults. Participants implicated grown-ups, including parents and older relatives, as the ones who were actually engaging with and sharing vaccine disinformation on platforms like Facebook. This reversal of the usual story suggests that interventions targeting adolescents’ social media use may be aimed at the wrong demographic, and that combatting misinformation among adults may be the more urgent task for protecting adolescent vaccine uptake.
Age and developmental stage emerged as a critical lens through which to interpret the findings. Younger participants, closer to the start of adolescence, tended to adopt a collective family attitude toward vaccines, describing their immunisation status as simply what their family did rather than a matter of personal conviction. Older participants, by contrast, were more capable of weighing long-term benefits against immediate discomfort, and were more likely to have established an independent position on vaccination. This developmental trajectory carries implications for how vaccine information should be delivered: materials pitched at 12-year-olds need to work with, not against, the family-oriented mindset of early adolescence, while programmes reaching 16- and 17-year-olds can engage them as autonomous decision-makers who respond to evidence about risk and benefit. The finding that older teens could think in terms of long-term protection, including protection against cancers caused by HPV, suggests that age-appropriate education about vaccine-preventable diseases could build on this growing capacity for abstract, future-oriented reasoning.
Woven through all of these themes was a striking deficit in basic disease knowledge, epitomised by the teenager who believed polio was a canine condition. Several participants struggled to name the diseases that adolescent vaccines protect against, and a few were unaware that diseases like polio still exist at all, an understandable but concerning consequence of vaccines’ own success in making once-feared epidemics disappear from lived memory. The researchers argue that this knowledge gap is itself a driver of hesitancy: it is difficult to accept the discomfort of an injection for a disease you have never heard of and cannot picture as a threat. Their conclusions call for adolescents to be better educated about vaccine-preventable diseases and supported in developing the critical thinking skills needed to evaluate health information and make genuinely informed decisions, rather than simply being told to comply.
The study, led by Angie Pitt, a doctoral researcher funded by the UK Health Security Agency, together with Richard Amlôt, Catherine Heffernan, G. James Rubin and Louise E. Smith, offers policymakers a rare, textured account of adolescent voices in a debate that has long been conducted over their heads. Its participatory methodology, in which young people were trained as researchers rather than treated merely as subjects, provides a template for future work in adolescent health. The message from the teenagers themselves is ultimately constructive: they are not hostile to vaccines, they are not secretly radicalised by their feeds, and they are not indifferent to their own health. They want better information about what they are being protected from, practical help with their fears, and a meaningful seat at the table when decisions about their bodies are made. Meeting those demands, the researchers suggest, may be the most direct route to restoring the coverage rates that public health goals demand.
Subject of Research: Adolescent attitudes toward vaccines, based on a co-produced qualitative thematic analysis of interviews with adolescents aged 12–17 in England
Subject of Research: Medicine
Article Title: “I didn’t even know humans could get polio … I swear that’s for dogs.” A co-produced, thematic analysis exploring adolescent attitudes to vaccines
Article References: Pitt, A., Amlôt, R., Heffernan, C., Rubin, G. J., & Smith, L. E. (2026). “I didn’t even know humans could get polio … I swear that’s for dogs.” A co-produced, thematic analysis exploring adolescent attitudes to vaccines. BMC Public Health. https://doi.org/10.1186/s12889-026-29131-0
Image Credits: AI Generated
DOI: 10.1186/s12889-026-29131-0
Keywords: Immunisation, Vaccination, Adolescents, HPV vaccine, Vaccine hesitancy, Autonomy, Participatory research, Public health, Needle fear, Thematic analysis, UK Health Security Agency, Social media misinformation
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Kristina Jarvis. (September 5, 2026). Adolescent vaccine attitudes revealed through co-produced thematic analysis study. Scienmag. https://scienmag.com/adolescent-vaccine-attitudes-revealed-through-co-produced-thematic-analysis-study/
Kristina Jarvis. “Adolescent vaccine attitudes revealed through co-produced thematic analysis study.” Scienmag, 5 September 2026, https://scienmag.com/adolescent-vaccine-attitudes-revealed-through-co-produced-thematic-analysis-study/. Accessed 5 September 2026.
Kristina Jarvis. “Adolescent vaccine attitudes revealed through co-produced thematic analysis study.” Scienmag. September 5, 2026. https://scienmag.com/adolescent-vaccine-attitudes-revealed-through-co-produced-thematic-analysis-study/
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