1. Purpose of the report
This report summarises findings from a public survey exploring awareness, uptake and attitudes towards vaccinations. The survey sought to understand public knowledge of different vaccination programmes, identify barriers to vaccine uptake and gather insight into what would encourage more people to accept vaccinations in the future.
The findings will help inform vaccination communications, engagement activity and service planning across NHS Essex and partner organisations.
2. Survey methodology
The survey was conducted between May and June 2025 and received 1,441 responses.
Participants were asked about:
- Awareness of vaccination programmes
- Eligibility for vaccinations
- Vaccinations received in the previous 12 months
- Vaccinations they chose not to receive
- Factors that would make them more likely to be vaccinated in the future
The survey included a mixture of multiple-choice, checkbox and rating-scale questions.
3. Respondent profile
A total of 1,441 people completed the survey.
The survey attracted a predominantly older audience, reflecting the fact that many of the vaccination programmes included in the survey are targeted at older adults.
The largest age group was people aged 65–74 years, who accounted for 32.2% of respondents (463 people). This was followed by people aged 55–64 years (22.2%, 319 respondents) and 75–84 years (21.4%, 308 respondents). Smaller proportions of respondents were aged 45–54 years (10.7%), 35–44 years (6.5%), 25–34 years (2.2%) and 18–24 years (0.6%). A further 3.1% of respondents were aged 85 years or over.
Overall, almost four in five respondents (78.9%) were aged 55 years or older. This means the survey findings are particularly representative of older adults, who are more likely to be eligible for vaccinations such as flu, COVID-19 boosters, shingles, RSV and pneumococcal vaccinations.
The survey also included people living with a wide range of long-term health conditions. Respondents reported conditions including diabetes, asthma, chronic obstructive pulmonary disease (COPD), heart disease, arthritis, cancer, autoimmune conditions, neurological conditions, visual impairments and mental health conditions.
As a result, the survey captured the views of many people who may be at increased risk of serious illness from vaccine-preventable diseases and who are often prioritised within national vaccination programmes.
It should be noted that the respondent profile was heavily weighted towards older adults. While this provides valuable insight into the views of those most likely to be eligible for vaccination programmes, the findings may be less representative of younger adults, parents and pregnant women.
4. Key findings
Awareness of vaccination programmes
Awareness was highest for well-established vaccination programmes:
- Flu vaccination (99.2%)
- COVID-19 booster (98.9%)
- Shingles vaccination (90.6%)
Awareness was significantly lower for:
- Pneumococcal vaccination (68.1%)
- RSV vaccination (60.9%)
This suggests newer and less widely promoted vaccination programmes require greater public awareness activity.
Vaccine uptake
The most commonly received vaccinations during the previous 12 months were:
- Flu vaccination (73.9%)
- COVID-19 booster (60.8%)
Nearly half of respondents (44.7%) reported receiving all vaccinations for which they were eligible.
5. Additional insights
The survey identified a notable level of uncertainty among respondents.
- 21.3% were unsure whether they had been eligible for a vaccination.
- 7.9% were unsure whether they had been eligible for any vaccination in the previous year.
These findings suggest that eligibility criteria are not always well understood and that invitations and public communications may not be reaching or resonating with all eligible groups.
The results also demonstrate that awareness does not necessarily translate into uptake. While awareness of flu and COVID-19 vaccinations was extremely high, a proportion of eligible people still chose not to receive them.
6. Barriers to vaccination
Among people who had not received all vaccinations they were eligible for, several key barriers emerged.
The most significant barriers related to information and confidence:
- Uncertainty about eligibility
- Lack of understanding about the benefits of vaccination
- Concerns about vaccine safety
- Questions about vaccine effectiveness
- Lack of clarity about what individual vaccines protect against
Many respondents also highlighted practical barriers such as access and appointment convenience.
A sizeable proportion indicated they would be more likely to accept vaccination if they received clearer and more personalised information.
7. Other findings
Several additional themes emerged from the survey:
- Consistent messaging across health organisations was viewed as important.
- People wanted clearer explanations of the diseases vaccines prevent.
- Respondents valued evidence-based information and reassurance.
- Convenience remains an important factor, with many people wanting easier access to vaccination appointments.
- Some respondents expressed a desire for vaccinations to be spaced appropriately rather than receiving multiple invitations in a short period.
Overall, respondents demonstrated a preference for transparent, factual and easy-to-understand information.
8. Recommendations
Based on the findings, the following actions should be considered:
Communications and engagement
- Develop clearer public information about vaccine eligibility.
- Increase awareness of RSV and pneumococcal vaccination programmes.
- Explain more clearly what each vaccine protects against.
- Use evidence and real-world examples to demonstrate vaccine effectiveness.
- Address common concerns around vaccine safety through trusted NHS sources.
Service delivery
- Continue to explore opportunities to improve access and convenience.
- Ensure invitations clearly explain why an individual is eligible.
- Consider targeted communications for groups with lower awareness or uptake.
Partnership working
- Promote consistent messages across NHS organisations, local authorities and community partners.
- Work with trusted community voices to increase confidence and reach underserved groups.
9. Use of insight
This insight can be used to:
- Inform future seasonal vaccination campaigns.
- Support development of RSV and pneumococcal vaccination communications.
- Shape public-facing information materials and FAQs.
- Inform targeting and segmentation of vaccination campaigns.
- Support work to improve vaccine confidence and address health inequalities.
- Guide future engagement activity with communities that experience lower vaccination uptake.
The findings also provide evidence to support the development of behavioural insight-led vaccination campaigns across Essex.
10. Conclusion
The survey demonstrates strong awareness and uptake of established vaccination programmes, particularly flu and COVID-19 vaccinations. However, awareness of RSV and pneumococcal vaccinations remains lower, and many people remain unclear about their eligibility for certain vaccines.
The findings highlight that information, confidence and understanding are the primary drivers of vaccination decisions. Clearer communication about eligibility, benefits, effectiveness and safety is likely to have the greatest impact on improving future uptake.
By addressing these information gaps and continuing to improve access, NHS Essex and partners can help increase vaccination uptake and protect more people from vaccine-preventable illnesses.