Table 4. Vaccine or vaccination specific issues supporting quotes, by participant (with participant number and engagement with vaccination).

Facilitators     a. Every year they contact me to get me booked in. OPI019, always vaccinated     b. The main thing I find is, with the COVID vaccine it seems GP surgeries were actively checking that their patients were booked in and had had it. Whereas I feel like–last year for example I had my [flu] vaccine done privately and I don’t think they told my GP about it. Nobody bothers to call me, check up on me. It feels like in comparison nobody really cares… potentially there are some things from there that they could apply to the pneumonia and the flu vaccine. OPI022, sometimes vaccinated     c. I think the only thing that would make me get it at this moment in time is a healthcare professional telling me that I should because of the situation I’m in. OPI162, often not vaccinated     d. I suppose if it’s repetition of reminding you that you should have it, like even having this conversation makes me think why am I not having it? OPI135, often not vaccinated     e. If I said no I wouldn’t of got the immunosuppressants and then I would have become even more ill. So I had no choice, I was pushed in the corner, that’s why I had to have it … I wanted the lupus flares to stop. OPI089, sometimes vaccinated     f. Any reaction you get is far less than the risk of not having the injection. OPI035, sometimes vaccinated     g. As the vaccination programme expanded, my confidence in that expanded. OPI019, always vaccinated

Barriers     h. GP has said, “You’re immunosuppressed, so you should be being invited by the system if you haven’t had one.” And Rheumatology has said the same as well. When I’ve said, “I’ve never been invited for pneumococcal,” they say, “Well, your GP should be sorting that out for you.” And GP says, “Well, if you’re tagged correctly in the system you’ll get invited.” I guess they view it as an admin task… It’s more the inconvenience of having to push for it. The costs outweighs the benefits for me at the moment on that. OPI022, sometimes vaccinated     i. What I tried to do was go back and look at some scientific information, and again just weighed up the risks and thought it was worth the risk. OPI035, sometimes vaccinated     j. As soon as I had it I had really bad side effect which makes me cough for nearly, I can say, 20 days, even I think more. It was like so bad coughing… there were a fever and felt unwell… So I am not going to have this again if I have the same symptoms or same side effects. OPI210, often not vaccinated