6489 Why did you choose to not be vaccinated?

Objectives Vaccines remain one of the most successful public health measures for preventing infectious diseases. The UK schedule includes 16 vaccinations covering 20 diseases. WHO advises uptake rates of >95% to stop transmission.¹ Reducing immunisation inequalities for children and adolescents is an ongoing Public Health Wales objective. Despite this, some children remain unvaccinated against certain diseases.² ³ The additional temporary decline in vaccination rates attributable to COVID-19 has highlighted the importance of identifying reasons behind vaccine refusal.⁴ We aimed to identify families' uptake of childhood vaccines and the reasons behind specific vaccine refusal. These results were compared against local Cardiff Public Health data. Methods A service evaluation questionnaire exploring uptake/views was piloted amongst five families for clarity. It assessed baseline demographic data, service satisfaction, individual vaccination uptake, and reasons for refusal. An amended version of the questionnaire was utilised for face-to-face interviews in outpatient departments in 2023. Local children's vaccine uptake reports were obtained from Public Health Wales. Results 136 responses were obtained; 14 were incomplete, leaving 122 results. Most respondents (n=99, 81.1%) were satisfied with vaccination services. Immunisation uptake varied between highs for the 6-in-1 vaccine (95.8%) and Pneumococcal (93.9%), to lows for HPV (57.6%) and Teenage Boosters (60.7%). Our survey demonstrated similar vaccine uptake rates of <95% in 12/16 vs Public Health's 15/16. Table 1 summarises data and refusal reasons for a selection of vaccines. Conclusion The majority were satisfied with vaccination services, but most uptakes were below the 95% standard. Hesitancy hindering uptake differed by vaccine, mainly influenced by media misinformation and worries about side effects. To reduce inequalities in healthcare, Public Health campaigns need to address families' concerns and refute 'social-media' misinformation. References Ten threats to global health in 2019. World Health Organisation (WHO). 2019. Available at: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Vaccine Uptake in Children in Wales COVER Annual Report 2023. Public Health Wales. Available at: https://phw.nhs.wales/topics/immunisation-and- vaccines/cover-national-childhood-immunisation-uptake-data/cover-archive-folder/annual-reports/vaccine-uptake-in-children-in-wales-cover-annual-report-2023/. Cardiff and Vale of Glamorgan. Population Needs Assessment. 2022. Available at: https://www.valeofglamorgan.gov.uk/Documents/_Committee%20Reports/Scrutiny-HLSC/2022/22-01-11/Cardiff-and-VoG-Population-Needs-Assessment-2022.pdf. Causey K, Fullman N, Sorensen RJ, Galles NC, Zheng P, Aravkin A, et al. Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study. The Lancet 2021;398(10299):522–34.