Healthcare Students' Flu Vaccine Uptake in the Last 5 Years and Future Vaccination Acceptance: Is There a Possible Association?

Abstract

Background: Despite the free-of-charge offer of influenza vaccines to at-risk subgroups, vaccine coverage remains low and far from the target, probably due to the false myths and misperceptions. We aimed to explore the healthcare students’ vaccination behavior and beliefs to find any association between vaccination uptake during the last 5 years and future vaccination acceptance. Study design: A multicentre cross-sectional study. Methods: From Oct 2017 to Nov 2018, the Italian healthcare students from 14 different universities in 2017/2018 were enrolled, through an online and anonymous questionnaire previously validated. Absolute and relative frequencies were calculated and Pearson's Chi-square test was used. A multinomial logistic regression model was performed. Results are expressed as relative Risk Ratio (RR) with 95% Confidence Intervals (95% CI). The level of significance chosen was P-value <0.05. Results: A total of 3137 students were enrolled and 3131 questionnaires were analysed. 82.7% of the sample declared they had not received any flu vaccination during the last 5 years. Students who received flu vaccination 4 times or more during the last 5 years were more likely to do it again next year as well (95.1% vs 4.9%). The regression model showed that having received flu vaccination over the last 5 years was statistically associated with the intention of getting vaccinated during next season. Conclusions: Frequency of flu vaccination is predictive for future acceptance among healthcare students. This association could have both implications for the organization of vaccination campaigns and improve educational strategies for this category of students.

Influenza Vaccination Coverage and Intention to Receive Hypothetical Ebola and COVID-19 Vaccines among Medical Students

“…Medical students, having similar contact with patients as HCWs, are also an important target group for annual influenza vaccinations. If people are motivated to receive vaccinations as students, they are likely to continue being vaccinated as HCWs in the future [ 11 ]. Studies show that vaccination coverage among medical students ranges from 4.7% in Iran to 86.3% in Canada (in various seasons) [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Influenza Vaccination Assessment according to a Value-Based Health Care Approach

“…Of the 40 studies included in our systematic review [ 3 , 4 , 5 , 8 , 10 , 11 , 12 , 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], seven (17.5%) had a non-European perspective and were conducted in Canada ( n = 1) [ 18 ], the USA ( n = 3) [ 19 , 21 , 42 ], China ( n = 1) [ 36 ], Iran ( n = 1) [ 49 ], and low-income countries (LICs) ( n = 1) [ 32 ]; ten (25%) had a global perspective [ 5 , 10 , 12 , 20 , 22 , 24 …”

“…Among the European studies, eight (36.4%) were conducted specifically in Italy [ 3 , 4 , 13 , 31 , 38 , 39 , 43 , 47 ]. In addition, of the 40 articles included in our work, 17 (42.5%) were systematic reviews or literature reviews [ 3 , 5 , 10 , 11 , 12 , 22 , 24 , 25 , 28 , 29 , 30 , 31 , 32 , 37 , 41 , 47 , 48 ], ten (25%) were economic evaluations [ 8 , 13 , 19 , 21 , 23 , 26 , 27 , 34 , 44 , 45 ], seven (17.5%) were cross-sectional studies [ 18 , 35 , 36 , 38 , 42 , 43 , 49 ], two studies (5%) were HTA reports [ 4 , 39 ], one study (2.5%) was a nonlinear regression model [ 33 ], and three studies (7.5%) were expert opinions [ 20 , 40 , 46 ]. The main features of the studies are shown in Table 1 .…”

“…Regarding the influenza vaccination target population investigated in the studies included in our systematic review, 11 studies (27.5%) focused on vaccination in the general population [ 5 , 12 , 18 , 20 , 25 , 37 , 39 , 40 , 44 , 46 , 48 ], five (12.5%) on vaccination in the pediatric population [ 3 , 19 , 29 , 33 , 45 ], three (7.5%) on vaccination in the population aged 6 months to over 85 [ 21 , 27 , 28 ], seven (17.5%) on vaccination in elderly individuals (over 65) [ 4 , 11 , 24 , 30 , 31 , 41 , 47 ], two (5%) specifically on adults over 18 [ 38 ] and over 50 [ 26 ], one study (2.5%) specifically on influenza vaccination in elderly individuals and at risk groups [ 22 ], one (2.5%) on the target population for which the WHO recommends flu vaccination [ 8 ], one (2.5%) on customs officers [ 23 ], four (10%) on HCWs [ 10 , 34 , 35 , 36 ], one (2.5%) on workers in general [ 13 ], two (5%) on health care students [ 42 , 43 ], one (2.5%) on pregnant women [ 32 ], and another study (2.5%) on influenza vaccination in the cancer population [ 49 ].…”

“…Of the 40 studies included in the systematic review, 37.5% ( n = 15) also addressed other general features of the influenza vaccination value [ 11 , 24 , 25 , 26 , 33 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 47 , 49 ], with particular reference to the following aspects: the cultural value and social benefits of flu vaccination both from the citizens’ perspective [ 24 ] and from that of health care professionals [ 36 ]; the value of influenza vaccination in specific target populations such as elderly individuals [ 11 , 26 , 41 ], adults [ 47 ], risk groups, such as patients with cardiovascular [ 41 ] and cancer [ 49 ] diseases, and health care students [ 43 ]; the importance of the whole value of flu vaccination [ 25 ] and the need for an appropriate methodology to assess this value and support an evidence-based decision-making process [ 37 ], also thanks to evidence-based tools such as HTA [ 39 ]; the value of surveillance systems for influenza and the need to consider new innovative surveillance methods such as social media [ 33 ]; the value of educational interventions on influenza vaccination for nursing students [ 42 ]; and the value of citizens’ literacy [ 38 ].…”