Psychological Factors and Misinformation Patterns Influencing COVID-19 Booster Uptake in the UK

Background: The spread of misinformation and declining trust in public health institutions have weakened COVID-19 booster vaccination efforts. Understanding how misinformation fuels vaccine hesitancy in vulnerable populations is essential for designing effective interventions. This study explored the psychological drivers behind booster refusal among individuals in socioeconomically deprived areas of the UK. Methods: A qualitative descriptive study was conducted using semi-structured online interviews with 30 individuals aged 50+ who declined the COVID-19 booster. Participants were recruited from London and the West Midlands, diverse urban areas. Interviews explored perceptions of vaccines, exposure to (mis)information, and sources of trust or mistrust. Thematic analysis was conducted using NVivo V.12, with two researchers independently coding for reliability. Results: Four key themes emerged: (1) widespread mistrust in vaccine development, including concerns about speed, safety, and pharmaceutical profit motives; (2) exposure to conflicting, overwhelming information across media, fostering confusion and scepticism; (3) strong influence of family, friends, and public figures, reinforcing a social “bandwagon” effect; and (4) psychological reactance to perceived coercive policies, such as workplace mandates or travel rules, heightening resistance. Psychological mechanisms like erosion of epistemic trust, the availability heuristic, and groupthink underpinned hesitancy. Participants often prioritized peer experiences over official guidance, especially within culturally diverse networks. Conclusions: To address booster hesitancy, public health strategies must go beyond factual messaging. They should rebuild epistemic trust through culturally sensitive, transparent communication, engage trusted community leaders, amplify expert voices online, and address emotional and social drivers. Strengthening these efforts is vital for improving booster uptake and preparedness. Key messages • Misinformation and declining trust heavily influence COVID-19 booster hesitancy among vulnerable UK groups. • Public health strategies must rebuild trust with culturally tailored, transparent, and community-based communication.