I WROTE about Covid-19 vaccines for teenagers in Scotland last week in this column and asked when they might be approved. Well, we now have confirmation from the UK medicine’s regulator that they have endorsed trial results for the Pfizer-BioNTech vaccine and that it is safe and effective for young people aged 12-15.

The Joint Committee on Vaccination and Immunisation should issue guidance shortly on how and when teenagers will be eligible, and I hope that will be soon. In the meantime, 18-29 year olds in Scotland have been invited to register to receive their first dose and many other young adults in their 30s are now receiving invitation letters. All of this is fantastic. We need young adults and teens to be vaccinated both to protect themselves and to build population immunity.

I had to remind my 18-year-old son to register for a vaccine appointment as soon as the portal opened. It wasn’t front of his mind, and he hadn’t noticed that his age group was next in line. He has now submitted his details and awaits his appointment. For obvious reasons, I am watching this more closely than most.

Both my children have heard me drone on about this for months, although whether they’ve been listening is another matter. Young people should be making the decision for themselves. Can we expect the same enthusiasm for Covid-19 vaccines as we have seen in older adults?

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A survey conducted by the Office for National Statistics towards the end of May suggests that ‘positive vaccine sentiment’ (willingness to take up a Covid-19 vaccine) is lower among younger adults. Among people aged 70 years and above, sentiment is almost 100% and we know that almost everyone in this age group in Scotland has received a first dose and over 99% a second dose.

Among 50-69 year olds vaccine sentiment is almost as high, and even among 30-49 year olds it is 94% according to the ONS Opinions and Lifestyle Survey that currently reports weekly on Covid-19 related attitudes and behaviours. But among 16-29 year olds willingness to take up a vaccine is lower at 85%. This is an increase from when the vaccination programme started in December 2020 when 63% of this age group reported that they would come forward for a vaccine appointment.

To put the statistics into context, this is still one in eight young people in Great Britain below the age of 30 who are unsure about the vaccine. A smaller survey conducted in Scotland in mid-May was a bit more positive, with just one in ten 18-29 year olds indicating that they wouldn’t take up the vaccine. But it would be preferable if all of those eligible in that age group would come forward when eligible. What might the reasons be for any hesitancy, and what can be done to address it?

The first and most obvious reason is that younger adults don’t perceive an immediate risk to their own health from Covid-19 compared to older people. This can be influenced by evidence about age-related risks, or indeed by the fact that people in this age group have tested positive in the past and had none or just mild symptoms. They may also have friends or colleagues who’ve had Covid-19 but made a full recovery. If a disease is not perceived as a direct threat to those eligible for vaccination, we know that uptake can be lower. A second reason is convenience or time. Some younger adults may be less used to accessing health services and view the time required to make an appointment or travel to receive a vaccine as inconvenient or difficult to fit in with education, training or work.

There is also evidence that younger adults are particularly targeted by anti-vaccination advocates online and via social media. They are more likely than older adults to see posts and adverts with false information about vaccine safety or side-effects. There have also been young celebrities who have been fairly vocal about their reasons for refusing a Covid-19 vaccine and this is likely to contribute to hesitancy.

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Strategies to address these concerns need to focus on appropriate, tailored and accurate information for young adults from trusted sources. This is why the NHS recently partnered with YouTube in a campaign to encourage young people to accept vaccines.

Organisations like Young Scot have also developed content and advice on Covid-19 vaccines with frequently asked questions. Social norms will also play a role. If peers indicate they intend to get the vaccine and share information about having done so, this encourages others.

The good news is that more than one in four 18-29 year olds in Scotland have already had a first Covid-19 vaccine dose. Given the ordering of eligibility these will be young adults with underlying health conditions, informal carers and those working in NHS and social care.

In England, Simon Stevens the Chief Executive of NHS England said this week that more than a million people made a vaccine appointment on Wednesday through their portal, working out to 750 appointments booked per minute. He commented that young people coming forward to make appointments had sent bookings to ‘blockbuster levels’.

Here the First Minister has already said in one of her daily briefings that vaccine registration for 18-29 year olds is going well. The portal for this opened on 24th May for two weeks but has now been extended to close of play today. If you haven’t already registered to receive an appointment and are in this age group, or know someone who is, you can find the details on the NHS Inform website.

Linda Bauld is Chair of Public Health at the University of Edinburgh.