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Wade SA, Ali I, Milstone AM, Clever SL, Xiao S, Koontz DW, Hansoti B. Medical education during the COVID-19 pandemic: a reflection on the JHUSOM experience. BMC MEDICAL EDUCATION 2024; 24:335. [PMID: 38528473 PMCID: PMC10964593 DOI: 10.1186/s12909-024-05266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND We sought to understand the relative risk of COVID-19 infection and identify risk factors for infection to identify targets for mitigation among medical students. METHODS An observational cohort study of Johns Hopkins School of Medicine students was conducted from June 2020 to July 2021. Blood samples were collected and tested at three visits to assess for antibodies against SARS-CoV-2. Additionally, a questionnaire was administered at each visit to collect demographic information and assess potential social and behavioral risk factors. RESULTS 264 students enrolled in the study, and 38 participants completed all study requirements by study end. Roughly 6% of the first- and second-year classes had a reported positive COVID-19 test compared to 5% of third- and fourth-year students. By visit 3, 92% of medical students had detectable antibodies against COVID-19 compared to 4% during the study enrollment period. From study enrollment to visit 3, there was a 10-fold increase in the percentage of students reporting attending large social gatherings and dining in restaurants. CONCLUSIONS Overall, few COVID-19 cases were found among medical students, even those on clinical rotations. As the study progressed, students reported engaging in higher-risk social behaviors in conjunction with increasing vaccination rates among students.
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Affiliation(s)
- Sydney A Wade
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Iman Ali
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron M Milstone
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah L Clever
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shaoming Xiao
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Danielle Winner Koontz
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bhakti Hansoti
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of International Health, Bloomberg School of Public Health, Baltimore, MD, USA.
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Carlos-Dollaga PD, Dy ABC, Cabigon JJJ. COVID-19 Breakthrough Infections among Medical Students under the SLICE and CLARO Programs: Ateneo School of Medicine and Public Health Experience. ACTA MEDICA PHILIPPINA 2024; 58:34-41. [PMID: 38939856 PMCID: PMC11199367 DOI: 10.47895/amp.vi0.6523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Objective This study aims to report the incidence and characteristics of breakthrough infections among medical students in the first Philippine private medical school that resumed limited face-to-face classes and clinical rotations from July to December 2021. Methods This is a descriptive study using secondary worksheet from multiple-source records review of breakthrough infections among medical students from July to December 2021. Results Among the 837 vaccinated medical students, 23 (2.7%) experienced COVID-19 breakthrough infections. Of these, 9 were male and 14 were female. Four were asymptomatic and 19 were symptomatic. Of the 19 symptomatic, 18 had mild and 1 had severe disease. Mild infections presented with upper respiratory tract symptoms. Duration of symptoms ranged from 4 to 27 days with an average of 10 days. Timing of breakthrough infections ranged from 35 to 212 days after the second dose of COVID-19 vaccine with a mean of 86 days. Contact with confirmed cases was reported in 14 of 23 cases, 13 were from household members and none within the SLICE and CLARO programs. Conclusion Our study showed that even in the midst of the Delta surge, low breakthrough infection rate with mostly mildly symptomatic cases and no case transmissions within the SLICE and CLARO programs are possible with vaccination, regular health surveillance, and strict adherence to minimum health protocols.
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Manna S, Ghosh Dastidar S, S R, Ahluwalia H, Kaur M. Preferential Impairment of Auditory Working Memory in Long COVID: An Observational Study of Undergraduate Medical Students. Cureus 2024; 16:e51457. [PMID: 38298288 PMCID: PMC10829530 DOI: 10.7759/cureus.51457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
Background Long COVID is a multisystem condition with prolonged symptoms that develop after recovery from the COVID-19 infection, often following a mild infection. Few studies have been conducted on cognitive function among medical students after recovery from mild COVID-19. This study aimed to assess the attention span and working memory (WM) capacity of medical students after six months of recovery. Methods A cross-sectional study was performed on 17 young adult medical students who had suffered a mild COVID-19 infection at least six months prior. Eighteen age-matched healthy medical students served as the controls. Audio-visual WM tasks and attention spans were assessed using computerized software for both the cases and controls. Results The mean ages of the case and control were 19.67±1.6 and 20.0±1.2 years, respectively. The most common symptoms among cases were fatigue (33%), weight loss (26%), and nasal stuffiness (13%). The overall proportion of correct responses across all visual and auditory WM tasks (p=0.085) and reaction times (p=0.609) did not differ between the cases and controls. However, the overall target hit rate of the auditory WM task was significantly lower in cases than in controls (p=0.002). This difference was not observed in the visual WM task (p=0.374). Conclusion In the current study, the overall WM functions (visual and auditory combined) and attention span did not differ between cases and controls. However, auditory WM performance was significantly impaired in patients compared with controls, indicating selective impairment of auditory WM in patients with long COVID.
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Affiliation(s)
- Soumen Manna
- Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Shaon Ghosh Dastidar
- Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Ramkumar S
- Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Himani Ahluwalia
- Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Manpreet Kaur
- Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Pandher R, Bilszta JLC. Novel COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students: a scoping review. MEDICAL EDUCATION ONLINE 2023; 28:2175620. [PMID: 36788502 PMCID: PMC9930839 DOI: 10.1080/10872981.2023.2175620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Medical students are likely to be exposed to COVID-19 patients so achieving high vaccination coverage rates for this group of healthcare workers is important, as is their potential as vaccination role models. The aim of this scoping review was to evaluate the current literature to determine the rates of COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students. Systematic searches of the Medline Ovid, Embase, PubMed, and Education Resources Information Centre (ERIC) online databases was conducted for relevant articles with keywords: 'COVID-19', 'vaccine hesitancy & acceptance' and 'medical students'. Articles were included for review if they reported the rates of vaccine hesitancy and acceptance, and associated factors, amongst medical students. Of the 258 articles identified, 52 met the inclusion criteria and underwent full-text review. Rates of vaccine hesitancy ranged from 5.4-86.7%, with generally positive attitudes towards COVID-19 vaccination. The main factors associated with vaccine hesitancy were concerns about the safety and efficacy of vaccines due to their accelerated development, being a pre-clinical medical student, and low perceived personal risk of COVID-19 infection. Inconsistencies were found for the influence of gender on attitudes towards vaccinations. Previous vaccination behaviours were predictive of willingness to receive the COVID-19 vaccine. Knowledge about COVID-19 vaccinations and their importance was found to be deficient amongst vaccine hesitant medical students. Generally, medical students express low levels of vaccine hesitancy. However, due to the variability in the factors associated with vaccine hesitancy across different populations and the dynamic and contextual nature of hesitancy, it is recommended that vaccination intent and associated attitudes are monitored on a longitudinal basis. It is important to map vaccine hesitancy at a local level to allow medical schools to develop strategies to encourage vaccination specific to their school's needs.
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Affiliation(s)
- Robyn Pandher
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Justin L C Bilszta
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
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Sipos D, Biro AA, Busa F, Freihat O, Tollár J, Pandur AA, Kovács Á, Deutsch K, Csima MP. Reduced burnout in medical and health science students during the pandemic COVID-19 - a follow-up study of a single institution in Hungary. BMC MEDICAL EDUCATION 2023; 23:893. [PMID: 37993921 PMCID: PMC10666327 DOI: 10.1186/s12909-023-04867-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The coronavirus pandemic has significantly impacted lives worldwide, especially of medical and health science students. In Hungary, education has been relegated to the online space, with a substantial proportion of students having to attend medical secondments. Increased stress, uncertainty, and the presence of medical secondments can have an impact on students' premature burnout. METHODS In 2021, we conducted a follow-up survey among students of the University of Pécs studying medicine and health sciences in two data collection periods (from March to May and September to November). Our online questionnaire consisted of the Maslach Burnout Inventory General Survey for Students and our self-designed questionnaire. We used descriptive and paired two-sample t-tests for data analysis at a 95% confidence interval (p ≤ 0.05). RESULTS We excluded from our survey respondents whose data we could not follow-up; finally, 183 students' responses were analyzed. The majority of students were female (n = 148; 80.9%). Overall, there was a significant decrease in both exhaustion (EX) and cynicism (CY) scores (p = 0.001; p = 0.004). Female respondents had higher EX scores, but a significant decrease was observed for both genders (p ≤ 0.05). Excluding paramedic students, a significant decrease in EX scores was observed for the specialties we studied (p ≤ 0.05). General medicine students' CY scores decreased; physiotherapy students' profesisonal efficacy (PE) scores increased significantly (p ≤ 0.05). Students who were on medical secondments (n = 127; 69. 4%) were found to be more affected by burnout, but in all cases, these scores significantly improved (p ≤ 0.05). Students serving in the National Ambulance Service (n = 76; 41.5%), Hospitals (n = 44; 24.0%), or both (n = 7; 3.8%) had a significant decrease in their burnout score (p ≤ 0.05). Students who served in either a hospital or a hospital and National Ambulance Service had significantly improved CY and PE scores (p ≤ 0.05). Students concerned about their health had elevated EX and CY scores, which also improved (p ≤ 0.05). CONCLUSIONS In conclusion, medical secondments positively affected student burnout scores for medicine and health sciences students at our institution. This fact implies that it is necessary to have more internships in real-life settings during the training. TRIAL REGISTRATION Our survey has been approved by the Medical Research Council (Case No IV/4573-1/2021/ECU).
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Affiliation(s)
- David Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary.
- Radiation Oncology, Research, and Teaching Center, Dr. József Baka Diagnostic, "Moritz Kaposi" Teaching Hospital, Guba Sándor street 40, Kaposvár, 7400, Hungary.
| | - Anett Anna Biro
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
| | - Flora Busa
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
| | - Omar Freihat
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
- College of Health Science, Abu Dhabi University, Department of Public Health, Abu Dhabi, United Arab Emirates
| | - József Tollár
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
- Radiation Oncology, Research, and Teaching Center, Dr. József Baka Diagnostic, "Moritz Kaposi" Teaching Hospital, Guba Sándor street 40, Kaposvár, 7400, Hungary
| | - Attila András Pandur
- Department of Oxyology, Emergency Care, Faculty of Health Sciences, University of Pécs, Vörösmarty 4, Pécs, 7621, Hungary
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Nagyerdei 98, Debrecen, 4032, Hungary
| | - Krisztina Deutsch
- Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, Pécs, 7621, Hungary
| | - Melinda Petőné Csima
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre street 14/B, Kaposvár, 7400, Hungary
- Institute of Education, MATE - Hungarian University of Agriculture and Life Sciences, Guba Sándor street 40, Kaposvár, 7400, Hungary
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Wade SA, Ali I, Milstone AM, Clever SL, Xiao S, Koontz DW, Hansoti B. Medical Education during the COVID-19 Pandemic: A Reflection on the JHUSOM Experience. RESEARCH SQUARE 2023:rs.3.rs-3328706. [PMID: 37841861 PMCID: PMC10571620 DOI: 10.21203/rs.3.rs-3328706/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background We sought to understand the relative risk of COVID-19 infection and identify risk factors for infection to identify targets for mitigation among medical students. Methods An observational cohort study of Johns Hopkins School of Medicine students was conducted from June 2020 to July 2021. Blood samples were collected and tested at three visits to assess for the presence of antibodies against SARS-CoV-2. Additionally, a questionnaire was administered at each visit to collect demographic information and assess potential social and behavioral risk factors. Results 264 students enrolled in the study, and 38 participants completed all study requirements by study end. Roughly 6% of the first- and second-year classes had a reported positive COVID-19 test compared to 5% of third- and fourth-year students. By visit 3, 92% of medical students had detectable antibodies against COVID-19 compared to 4% during the study enrollment period. From study enrollment to visit 3, there was a 10-fold increase in the percentage of students reporting attending large social gatherings and dining in restaurants. Conclusions Overall, few COVID-19 cases were found among medical students, even those on clinical rotations. As the study progressed, students reported engaging in higher-risk social behaviors in conjunction with increasing vaccination rates among students.
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Affiliation(s)
| | - Iman Ali
- Johns Hopkins University School of Medicine
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Mudenda S, Ngalande N, Mukosha M, Hikaambo CN, Daka V, Matafwali SK, Banda M, Mfune RL, Mayoka G, Witika BA. Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia. Front Public Health 2022; 10:1028312. [PMID: 36530704 PMCID: PMC9748439 DOI: 10.3389/fpubh.2022.1028312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Background The COVID-19 pandemic led to the disruption of physical classes for university students globally, as large gatherings fuelled the transmission of the virus. In the efforts to mitigate its transmission and return to normality, prevention measures, including vaccination, have been encouraged. Therefore, it is critical to understand the knowledge and practices of students regarding COVID-19. This study assessed the knowledge and practices toward COVID-19 among healthcare students at the University of Zambia. Materials and methods This questionnaire-based cross-sectional study was carried out from August 2021 to October 2021 among 478 healthcare students (pharmacy, physiotherapy, nursing, biomedical, medicine, and radiography). We used a previously validated questionnaire to measure knowledge and practice. The predictors of knowledge and practices were assessed using logistic regression with robust estimation of standard errors. Statistical analysis was conducted using Stata/BE version 17.0. Results Of the 478 respondents, 243 (50.8%) were females. A larger proportion, 175 (36.6%) were in Pharmacy training, and 156 (32.6%) were in their fifth year of study. The overall mean knowledge score of the participants was 87.9 (SD = 16.1), being higher at 89.6 (SD = 14.3) among medical students and the lowest at 86.7 (SD = 17.1) among Pharmacy students, although this was statistically non-significant (p = 0.488). The overall mean practice score was 60.0 (SD = 24.7), being significantly higher at 63.5 (23.4) among nursing, physiotherapy and environmental students compared to other students (p = 0.048). In multivariable analysis, the participant training program was non-significantly associated with knowledge and practice toward COVID-19. However, increased age (AOR = 1.09, 95% CI: 1.01-1.117) and residing in urban areas (AOR = 1.79, 95% CI: 1.07-3.01) than in rural areas were associated with higher odds of good practice toward COVID-19. Conclusion The healthcare students generally showed good knowledge levels and poor practices toward COVID-19. Further, there was no evidence of a difference in knowledge of COVID-19 among healthcare students. These findings suggest the need for implementation strategies to be centered on improving the practices of students toward COVID-19.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Nelly Ngalande
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | | | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Scott Kaba Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michelo Banda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Ruth Lindizyani Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Godfrey Mayoka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Bwalya Angel Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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COVID-19 among Czech Dentistry Students: Higher Vaccination and Lower Prevalence Compared to General Population Counterparts. Vaccines (Basel) 2022; 10:vaccines10111927. [PMID: 36423022 PMCID: PMC9695306 DOI: 10.3390/vaccines10111927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
The restrictions on medical students’ clinical education during the COVID-19 pandemic has affected their professional readiness and often lengthened their training. These negative impacts are often considered a necessary price as clinical education is hypothesized to be associated with a high risk of pandemic spread. This work assesses this hypothesis based on COVID-19 epidemiological data among Czech dentistry students and their comparison to data of the Czech general population of similar age. We addressed two of the five Czech medical faculties (Charles University, Faculty of Medicine in Hradec Kralove and in Pilsen) providing dentistry study program with a survey. A total of 240 students participated, representing a 66.9% response rate. Over 75% of respondents participated in clinical education during the pandemic. The school environment was identified as a place of infection by only 9.8% of respondents who were aware of where they were infected. Overall, 100% of students used FFP2 respirators, and 75.3% used face shields or protective glasses while working with patients. By the end of May 2022, COVID-19 full vaccination and 1st booster rates among students were 93.8% and 54.6%, respectively, which is significantly higher (p < 0.0001, OR 7.3, 95% CI 4.4−12; p < 0.0001, OR 3.7, 95% CI 2.9−4.8, respectively) compared to their peers from the general population (67.1% and 24.4%, respectively). A total of 75.4% of respondents supported mandatory COVID-19 vaccination for healthcare professionals. To the same date, PCR and/or antigen test verified COVID-19 prevalence among students was 37.1%, while among peers from the general population, it was 45.1% (p = 0.015, OR 1.2, 95% CI 1.0−1.5). The combination of extensive protective measures and high vaccination against COVID-19 led to significantly lower COVID-19 prevalence among the students compared to their general population counterparts.
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Ciliberti R, Lantieri F, Barranco R, Tettamanti C, Bonsignore A, Ventura F. A Survey on Undergraduate Medical Students' Perception of COVID-19 Vaccination. Vaccines (Basel) 2022; 10:vaccines10091464. [PMID: 36146542 PMCID: PMC9504072 DOI: 10.3390/vaccines10091464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to obtain information on medical students’ attitudes toward COVID-19 vaccination and to identify the main barriers to its acceptance. We conducted an anonymous online survey on a sample of undergraduate medical students from one main Italian University. The questions were aimed at exploring their attitudes toward vaccination to prevent COVID-19, their perceptions of the risk/threat of COVID-19 and the factors associated with their attitudes toward COVID-19 vaccination. A high percentage of students in our sample stated that they had been vaccinated or that they intended to be vaccinated against the COVID-19 coronavirus. A total of 239 questionnaires were analyzed. Age, social, geographic and demographic characteristics, health conditions and interest in vaccination were recorded; 93% of the students declared that they encouraged vaccination and 83% stated that the reason was “Moral responsibility towards the community”. Four students had not yet been vaccinated, mainly because of “Contradictory information on efficacy and safety”. The Likert-type questions revealed high agreement on the importance of vaccination and whether it should be made mandatory (“indispensable tool” and “ethical duty” were cited to explain this position). The results show a high level of acceptance of COVID-19 vaccination among these medical undergraduates who, being halfway through their training and involved in clinical practice, are already in possession of specific scientific knowledge and, to a small extent, come from different areas of Italy.
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Affiliation(s)
- Rosagemma Ciliberti
- Section History of Medicine and Bioethics, Health Science Department (DISSAL), University of Genoa, Via De Toni 12, 16132 Genova, Italy
| | - Francesca Lantieri
- Biostatistics Unit, Health Science Department (DISSAL), University of Genoa, Via Pastore 1, 16132 Genova, Italy
| | - Rosario Barranco
- Section of Legal Medicine, Health Science Department (DISSAL), University of Genoa, Via De Toni 12, 16132 Genova, Italy
| | - Camilla Tettamanti
- Section of Legal Medicine, Health Science Department (DISSAL), University of Genoa, Via De Toni 12, 16132 Genova, Italy
- IRCCS—Ospedale Policlinico San Martino Teaching Hospital, Largo R. Benzi 10, 16132 Genova, Italy
| | - Alessandro Bonsignore
- Section of Legal Medicine, Health Science Department (DISSAL), University of Genoa, Via De Toni 12, 16132 Genova, Italy
- IRCCS—Ospedale Policlinico San Martino Teaching Hospital, Largo R. Benzi 10, 16132 Genova, Italy
- Correspondence:
| | - Francesco Ventura
- Section of Legal Medicine, Health Science Department (DISSAL), University of Genoa, Via De Toni 12, 16132 Genova, Italy
- IRCCS—Ospedale Policlinico San Martino Teaching Hospital, Largo R. Benzi 10, 16132 Genova, Italy
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