{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T19:14:34Z","timestamp":1784229274185,"version":"3.55.0"},"reference-count":77,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T00:00:00Z","timestamp":1728086400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Youth have been uniquely affected by the COVID\u201019 pandemic. Despite high rates of COVID\u201019 infection, youth had one of the lowest vaccine uptake rates. Certain characteristics can affect vaccine uptake, such as mental health and substance use, but it is important to understand uptake for an effective response to pandemics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study examined the perspectives of youth with mental health or substance use concerns on COVID\u201019 vaccine confidence, hesitancy and overall COVID\u201019 vaccine perspectives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using photovoice, a community\u2010based participatory research method, a sample of 27 youth aged 14\u221224 years participated in a series of photography workshops and focus groups. Participants submitted final photographs for discussion. Focus groups were recorded, transcribed and thematically analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four themes were generated: (1) Youth deciphered the vaccine discourse in a changing information landscape; (2) mixed perspectives of families, friends and loved ones influenced the vaccine journey; (3) complex societal influences affected views and decisions around the COVID\u201019 vaccine; and (4) youth navigated their vaccine journeys through first\u2010 and second\u2010hand experiences. The four themes and subthemes highlight the evolution of youth's journeys with the COVID\u201019 vaccine over the course of the pandemic and into the late\u2010pandemic period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Youth with mental health or substance use challenges navigated a complex environment during the COVID\u201019 pandemic. The wide variety of factors influencing vaccine perspectives should be taken into account in public health messaging and future research on youth vaccine uptake. Youth\u2010led and youth\u2010engaged research can help solicit rich and meaningful perspectives of young people on important public health issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>This was a youth\u2010led study. A youth research analyst conducted the study activities together with the support of a youth advisory group, an adult photographer with lived experience, and a scientific team.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.70051","type":"journal-article","created":{"date-parts":[[2024,10,6]],"date-time":"2024-10-06T05:55:14Z","timestamp":1728194114000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u2018Is It Safe? Is it not?\u2019 A Youth\u2010Led Photovoice Study of Youth Perspectives of COVID\u201019 Vaccine Confidence"],"prefix":"10.1111","volume":"27","author":[{"given":"Shelby","family":"Mckee","sequence":"first","affiliation":[{"name":"Centre for Addiction and Mental Health Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0471-4735","authenticated-orcid":false,"given":"Natasha Y.","family":"Sheikhan","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health Toronto Ontario Canada"},{"name":"University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Patenaude","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Henderson","sequence":"additional","affiliation":[{"name":"Centre for Addiction and 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