1 November, 2024

**We are delighted to repost this piece by one of PhD students, Angie Pitt, which won a prize in the UKHSA Post Graduate Public Engagement Essay Competition 2024**

What were your teenage years like? Mine were years of angst and discovery: one moment wearing a bandana and listening to Bros, the next listening to Bob Dylan and trying to change the world. Being a teenager in 2024 is a unique experience, different to yours or mine. It is one of the most exciting and liberating times in our lives, but it can also be confusing, scary and lonely.  The teenage brain is busy, learning at a vast rate, it’s reward system working overtime. The frontal lobe, however, – the part of the brain which controls decision-making – won’t be fully developed until our mid-20s. This means that for teenagers, immediate, risky behaviours can often overrule more sensible long-term choices.  And teens are facing health risks often not experienced or understood by older generations, such as vaping, mental health and social media. Drinking and smoking are so Noughties! Increasingly influenced by both friends -- and strangers via social media -- in adolescence, teens develop their own opinions on issues that matter to them, from politics, to personal values, to health behaviour. Teenagers begin to make crucial decisions about their bodies and how to protect themselves from health risks. Do they agree with vaccinations, for example?

But does it really matter what teenagers think? Surely it’s up to parents to sign the vaccine consent form, and teenagers to just do as they’re told? As one social media user told me: “Their brains aren’t even fully developed, who cares what teenagers think?”

Between the ages of 12 and 15 years, young people are offered an intense schedule of vaccinations via the National Immunisation Programme. These include the flu, 3-in-1 booster (which protects against tetanus, diphtheria and polio), the Meningitis and HPV (human papilloma virus) vaccines. We all remember queuing with our class in the school corridor, nervously awaiting a vaccine while rumours circulate: “apparently someone fainted earlier… my sister couldn’t move her arm for a month…”. But now the rumours spread beyond school: they are global: “…my friend’s cousin in America saw on TikTok that vaccinations put trackers in our arms”. In this climate, unsurprisingly, data shows that uptake rates of vaccinations are dropping amongst younger people. And with fewer people vaccinated, diseases such as measles and polio are returning. Furthermore, research shows that those who establish a pattern of having vaccines in adolescence, are more likely to accept new vaccines in adulthood. Good and bad health habits can carry through into adulthood and influence how we make health decisions for the rest of our lives. A generation who grows up mistrusting vaccines - and the authorities which promote them - presents a future public health crisis for us all.

So, I’m spending 3 years building a picture of what UK teenagers think about vaccinations. I’ll begin by pulling together existing research on Covid-19 vaccines. Having missed out on education, exams and proms during the Covid-19 pandemic, did teenagers see vaccination as their ticket out of isolation, an irrelevance, or a risk? Who did they turn to for reliable information? Friends, family, celebrities, politicians, or scientists? I’ll summarise the mass of research to find out what mattered most to young people when deciding whether to have the Covid-19 vaccination. Next, it sounds obvious, but I’ll ask teenagers themselves what they think. We often hear parents’ and doctors’ views on vaccines, but teenagers’ own voices are seldom heard. I’ll chat to teenagers about the different vaccinations offered. Have they said yes or no to vaccines? Who or what influences their decision? What information do they wish they had?

Importantly though, not only should teenagers have a say in health decisions that affect them, but they should also have a say in how we research these decisions. When I was a teenager, there were no mobile phones or social media: the internet hadn’t even been invented. Let’s be honest, I need help to understand not only what questions to ask teenagers, but how to ask them and how to even reach teenage participants in the first place. So, I’ll be co-producing this research with teenagers. They’ll ensure my questions are relevant. They will stop me from imposing my own views on what teenagers tell me, and they will help me work out what our findings mean for the future.  In doing so, I hope that together teenagers and I can answer these questions: in an era of information overload, how can we help teenagers to make informed vaccine decisions? How can we hear, respect and address teenagers’ concerns, whilst also meeting public health objectives to increase rates of vaccination take up amongst teenagers? Hearing teenagers’ worries and ideas is crucial if we want to picture what public health will look like in the future. We all need to care what teenagers think.