Training Students to Address Vaccine Hesitancy and/or Refusal

COVID-19 vaccination in low and middle-income countries: Creating a sustainable roadmap for promoting public health intervention

The Coronavirus Disease 2019 (COVID-19) pandemic is a global public health threat ravaging the health systems. In low and middle-income countries (LMICs), COVID-19 and several other challenges concurrently worsen the health outcome indicators. Interestingly, vaccines have been identified as the most reliable and cost-effective public health intervention, and the governments in LMICs have instituted an array of plans to ensure every eligible person gets vaccinated. However, there is still considerable apathy around the use of the available COVID-19 vaccines in LMICs which is impeding the fight against the COVID-19 pandemic. In this paper, we explore the multiple interrelated factors behind low COVID-19 vaccination coverage in LMICs. It is therefore recommended that the governments in LMICs embrace multicomponent and wide-ranging strategies. This should involve utilising community-based approaches such as community pharmacy-led vaccination to promote community access to COVID-19 vaccines and to revive trust in national health authorities by offering population-specific, target-driven, transparent, and timely communication to the community who they serve about the safety and efficacy of the COVID-19 vaccine. Communication strategies should be tailored to reflect diverse political orientations as this can enhance vaccine acceptance. Additionally, local political parties and representative should be engaged in broad alliances to facilitate community mobilisation and support for vaccination campaigns. Also, relevant Nongovernmental Organisations and Community-based Organisations should institute programs at the grassroots that incorporate the gatekeepers to the community aimed at influencing population behaviour regarding COVID-19 vaccine hesitancy. Besides, the public health department in the ministry of health in LMICs should create more awareness, through social and mass media, particularly in the rural, semi-urban, and slum communities about the pivotal role of vaccination. Thus, we opined that these strategies will help LMICs achieve the COVID-19 vaccination target and further reposition the healthcare systems, and promote other public health interventions now and in the future.

Mitigating Misinformation Toolkit: Online Simulation and Standardized Patient Cases for Interprofessional Students to Address Vaccine Hesitancy and Misinformation

Introduction

Medical misinformation, which contributes to vaccine hesitancy, poses challenges to health professionals. Health professions students, while capable of addressing and advocating for vaccination, may lack the confidence to engage with vaccine-hesitant individuals influenced by medical misinformation.

Methods

An interprofessional in-person simulation activity (90 minutes) using standardized patients was developed and instituted for students in medicine, nursing, pharmacy, and public health programs. Student volunteers were recruited from classes approximately halfway through their respective degree programs (i.e., second or third year of a 4-year program). Online simulation was used as a method to prepare for in-person simulation. Impact on students was assessed primarily through a postprogram student self-assessment.

Results

A total of 220 students participated in the program; 206 (94%) had paired data available to analyze. Following program participation, self-assessed abilities increased from pre to post, from 2.8 out of 5 (good) to 3.9 out of 5 (very good; p < .001). Ninety-eight percent of students felt that their ability to address medical misinformation was somewhat/much better after the activity, compared to before, and that their ability to address vaccine hesitancy was somewhat/much better. The overall program was rated highly, with mean scores for each program evaluation item >4 out of 5 (very good).

Discussion

An interprofessional cohort of students demonstrated improvement in self-assessed skills to participate in a conversation with an individual with hesitancy to receive vaccines and/or beliefs informed by misinformation. Students felt that this program was relevant and important to their professional development.

An Examination of Student Pharmacists' Perceptions Toward Immunization

Introduction: Pharmacists are considered the most accessible health care professionals, especially when it comes to preventative services such as immunizations. Studies have assessed student knowledge and comfort in administering vaccinations immediately after receiving formal training or completing a vaccination clinic experience; however, few have examined students after applying the knowledge to a pharmacy work experience. A survey of student pharmacists regarding these experiences may identify areas that students are less confident in and thus where immunization training could be improved. Methods: A non-validated survey was created in Google Forms and distributed via email from November through December of 2019. The survey was sent to student pharmacists enrolled in one doctor of pharmacy program at a US institution in Western New York who had completed immunization training almost one year prior to the survey. Results: The survey was distributed to 365 student pharmacists. A total of 189 students (51.8%) completed the survey. Student perceptions of providing immunizations were positive overall, with 173 students (91.5%) responding that they agreed or strongly agreed to feeling confident administering intramuscular injections. In contrast, only 110 students (58.2%) agreed or strongly agreed to feeling confident administering subcutaneous injections. Also, 111 students (58.7%) indicated they had not administered an immunization in the 9 months after they had completed their immunization training. Conclusions: Based on this cohort, perceptions are positive overall; however, there is room for continued improvement in training pharmacy students for immunization proficiency as well as increasing the cooperation of pharmacies to allow students to immunize.

Preparing student-pharmacists to utilize motivational interviewing techniques to address COVID-19 vaccine hesitancy in underrepresented racial/ethnic patient populations

BACKGROUND AND PURPOSE

Vaccine hesitancy disproportionally impacts racial/ethnic minority populations. Regarded as trusted, accessible, and knowledgeable, pharmacists are strategically positioned to address this threat using effective communication strategies such as motivational interviewing (MI). Little data exists on programs that prepare student-pharmacists to use MI to combat vaccine hesitancy in underrepresented populations.

EDUCATIONAL ACTIVITY AND SETTING

Student pharmacists elected to participate in co-curricular training on addressing COVID-19 vaccine hesitancy in racial/ethnic minority populations. The training included a web-based module on using MI to address COVID-19 vaccine hesitancy and a live group objective structured clinical examination (OSCE) with standardized patient encounters that included prevalent COVID-19 vaccine concerns. Faculty assessed the group's ability to employ core elements of MI to correct vaccine misinformation. After the OSCE, students received feedback from the standardized actors and evaluators. Change in student confidence was assessed. After the training, students volunteered at eight different community events to utilize MI to address vaccine hesitancy in underrepresented patient populations.

FINDINGS

A total of 17 students completed the training. Four out of the six groups received a passing score on the OSCE. Students performed satisfactory in the major domains of MI but struggled to answer knowledge-based questions regarding COVID-19 vaccines. As a result of the training, a significant increase in student confidence was seen. All participating students rated the training as either "excellent" or "good."

SUMMARY

A novel, co-curricular educational initiative was an effective tool to prepare student-pharmacists to utilize MI to combat vaccine hesitancy in underrepresented racial/ethnic minority populations.

A systematic review of pre-service training on vaccination and immunization

INTRODUCTION

The World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 sets policy recommendations and targets for in-service and pre-service training programs to improve workforce competency. To date, comprehensive reviews on immunization training have mainly focused on in-service trainings. This systematic review aimed to synthesize current literature on pre-service immunization training, including primary immunization competencies covered, methods used, outcomes on improving competencies and behavior change for immunization service delivery, and student readiness for immunization practice, in both low-resource and high-income settings.

METHODS

A systematic search of seven scholarly databases identified published literature on pre-service training on immunization published between January 2001 and November 2021. It included all geographic regions and languages, study designs, and individuals preparing to enter the immunization workforce. Additional search methods included reviewing references of retrieved articles, scanning journals, and engaging pre-service training experts for unpublished reports.

RESULTS

Search results yielded 5,611 articles; 39 articles met the inclusion criteria. Five articles were identified through other search methods. Studies took place mostly in high-income countries (35/44), targeted professional (medical, nursing, and pharmacy) students and tutors at health training institutions. Eight of the ten recommended immunization competencies were included in the curricula and methods used to deliver pre-service training varied. Teaching techniques and applied learning strategies using realistic situations increased students' knowledge, attitudes, and awareness of vaccine benefits; built confidence to administer vaccines and communicate with hesitant patients; and increased the likelihood of recommending vaccines.

CONCLUSION

This review was the first step to understanding pre-service training on immunization. Further research is needed to inform pre-service training programs in low- and middle-income countries, particularly for nurses, vaccinators with low-level educational backgrounds, and other healthcare professional students. Prioritizing essential audiences, designing and delivering practical training, and evaluating results will help prepare students for the immunization challenges of tomorrow.

Acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt: a nationwide survey

BACKGROUND

The public's willingness to be vaccinated will determine the success of the COVID-19 vaccination program. The aim of this study was to identify acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt, assess their level of knowledge about COVID-19 vaccine and identify factors that influence their intention towards COVID-19 vaccination.

METHODS

A standardized and self-administered questionnaire was distributed among university students allover Egypt. The questionnaire included sociodemographic data, intention to receive COVID-19 vaccine, knowledge and beliefs about it and status of COVID-19 vaccination. Logistic regression analysis was used to determine factors associated with COVID-19 vaccine acceptancy.

RESULTS

A total of 1071 of university students were involved, with a mean age of 20.51 years (SD = 1.66) and 68.2% were females. COVID-19 vaccination acceptability rate was 69.0% while hesitancy was 20.8% and resistancy was 10.2%. Median knowledge score of 4 out of 8 (IQR = 8). The main motivation for vaccine acceptance was fear of being infected (53.6%) and desire to get back to normal life (51.0%) while the main barriers against getting vaccinated were being afraid of serious side effects. Univariate regression analysis revealed an increasing likelihood of vaccine acceptancy associated with an active lifestyle (OR 1.35, 95% CI 1.04-1.75, p = 0.025), a high knowledge score (OR 1.53, 95% CI 1.42-1.66, p < 0.001), and positive vaccine beliefs.

CONCLUSION

There is a high rate of acceptability of COVID-19 vaccination among university students. Vaccine acceptability is associated with an active lifestyle, a high knowledge score and positive vaccine beliefs. Educational campaigns and efforts aiming to raise awareness about safety and efficacy of COVID-19 vaccines need to be directed to this important population.

Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review

In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.

Addressing COVID-19 Vaccine Hesitancy: The Role of Medical Students

We conducted a survey study at the Icahn School of Medicine at Mount Sinai to assess COVID-19 vaccine attitudes and behaviors among medical students. Almost all respondents (96.5%, n = 222) believed vaccines were effective and reported being asked about the COVID-19 vaccine by family members (79.0%, n = 180). However, when asked how they respond when someone shares misinformation, 89.0% (n = 202) responded they agree to avoid conflict, 44.9% (n = 102) listened empathically, and 9.3% (n = 21) corrected the misinformation. Medical school education can address this disconnect, using standardized patients and role-playing to give students the tools to address vaccine hesitancy within their communities.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01670-2.

A qualitative investigation of facilitators and barriers to accessing COVID-19 vaccines among Racialized and Indigenous Peoples in Canada

Structural and systemic inequalities can contribute to susceptibility to COVID-19 disease and limited access to vaccines. Recognizing that Racialized and Indigenous Peoples may experience unique barriers to COVID-19 vaccination, this study explored early COVID-19 vaccine accessibility, including barriers and potential solutions to vaccine access, for these communities in Canada. We conducted semi-structured interviews about challenges to accessing COVID-19 vaccination with Racialized and Indigenous Peoples, including linguistic minorities and newcomers, in Spring 2021, just as COVID-19 vaccines were becoming more widely available in Canada. Participants were purposely selected from respondents to a Canadian national online survey. Three researchers analyzed the interviews for emergent themes using a descriptive content analysis approach in NVivo. At the time of the interview, interview participants (N = 27) intended to receive (n = 15) or had received (n = 11) at least one vaccine dose, or did not state their status (n = 1). Participants described multiple barriers to COVID-19 vaccination that they personally experienced and/or anticipated they or others could experience - including technology requirements, language barriers, lack of identification documentation, and travel challenges - as well as related solutions. These were organized into three broad categories: 1) COVID-19 disease and vaccination information, 2) vaccination booking procedures, and 3) vaccination sites. These structural and systemic barriers during the initial months of vaccine rollout substantially restricted participants' COVID-19 vaccination access, even when they were eager to get vaccinated, and should be addressed early in vaccine rollouts to facilitate optimal uptake for everyone everywhere.

Incorporating a learning unit on vaccine hesitancy into a first-year doctor of pharmacy immunization course

INTRODUCTION

Vaccine hesitancy is a growing threat to public health. The objective of this research was to investigate the effect of incorporating a learning unit on addressing vaccine hesitancy into a doctor of pharmacy immunization delivery course.

METHODS

The learning unit, implemented fall 2019 at the University of Rhode Island, involved two interactive lectures and an at-home assignment. A family medicine physician spoke about her experiences with vaccine-hesitant families, and students viewed video scenarios depicting a pharmacist talking with vaccine-hesitant patients followed by an in-class discussion. Data was collected using pre- and post-surveys and a one-year follow-up survey.

RESULTS

Out of 125 students enrolled in the course, 121 completed the pre-survey, 113 the post-survey, and 120 the follow-up survey. For pre-/post-survey comparison questions, statistically significant improvements were seen in 9 of 13 items. The follow-up survey showed 83.4% of students had applied knowledge and 85.7% had applied skills gained from the learning unit.

CONCLUSION

Incorporating a learning unit on addressing vaccine hesitancy into a pharmacy immunization class resulted in improvements in student self-reported knowledge and comfort in talking with patients who are vaccine hesitant. Long-term use of self-reported knowledge and skills gained was seen one-year post-implementation.

Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status

Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.

Impact of COVID-19 health information sources on student vaccine hesitancy

BACKGROUND

The purpose of this study was to determine how health care professional and undergraduate students stay informed on COVID-19 and which characteristics influence the decision to receive or recommend a vaccine to focus efforts on addressing misinformation and vaccine hesitancy.

METHODS

A 13-item survey was administered to currently enrolled undergraduate and health care students (including nursing, dental, medical, and pharmacy) within the same university. Students were asked to rate their utilization and trust of COVID-19 resources and were asked about the importance and challenges of staying current with COVID-19 information. Student willingness to receive the vaccine was also assessed.

RESULTS

The school of pharmacy had the highest percentage of students (88.3%, n = 159) who would receive the vaccine. Only 73.6% (n = 323) of undergraduate students reported they would be willing. Students who were willing to receive the vaccine had higher average scores of trust for scientific journals, school curriculum/coursework, and school communication and utilized these sources for COVID-19 information more than those who would not receive the vaccine and were unsure about receiving the vaccine.

CONCLUSIONS

This study confirms that students who were most trusting of their COVID-19 information sources were more likely to receive the vaccine. Pharmacy students relied heavily on information provided by the school curriculum/coursework, indicating the need for pharmacy faculty to include methods of addressing vaccine hesitancy such as simulation modules and the Pharmacists' Patient Care Process to help students combat vaccine hesitancy and misinformation when communicating with patients.

Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training

OBJECTIVES

To determine if training residents in a structured communication method elicits specific behaviors in a laboratory model of interaction with vaccine-hesitant parents.

STUDY DESIGN

Standardized patients portraying vaccine-hesitant parents were used to assess the effectiveness of training in the Announce, Inquire, Mirror, Secure (AIMS) Method for Healthy Conversations. Blinded pediatric residents were pseudorandomized to receive AIMS or control training and underwent pre- and post-training encounters with blinded standardized patients. Encounters were assessed by blinded raters using a novel tool. Participant confidence and standardized patient evaluations of the participants' general communication skills were assessed.

RESULTS

Ratings were available for 27 AIMS and 26 control participants. Statistically significant increases in post-training scores (maximum = 30) were detected in AIMS, but not in control, participants (median, 21.3 [IQR, 19.8-24.8] vs 18.8 [IQR, 16.9-20.9]; P < .001). Elements (maximum score = 6) with significant increases were Inquire (0.67 [IQR, 0-1.76] vs -0.33 [IQR, -0.67 to 0.33]; P < .001); Mirror (1.33 [IQR, 0 to 2] vs -0.33 [IQR, -0.92 to 0]; P < .001) and Secure (0.33 [IQR, 0 to 1.67] vs -0.17 [IQR, -0.67 to 0.33]; P = .017). Self-confidence increased equally in both groups. Standardized patients did not detect a difference in communication skills after training and between groups. Internal consistency and inter-rater reliability of the assessment tool were modest.

CONCLUSIONS

Standardized patients proved useful in studying the effectiveness of structured communication training, but may have been limited in their ability to perceive a difference between groups owing to the predetermined encounter outcome of vaccine refusal. AIMS training should be studied in real-world scenarios to determine if it impacts vaccine acceptance.

Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal

INTRODUCTION

Although there is a lot of scientific evidence that the benefits of vaccines outweigh their risks, hesitancy about the safety of vaccines can occur in every segment of the community. In this study, we aimed to determine the knowledge, attitudes, and associated factors of vaccine hesitancy among Inonu University faculty members regarding childhood vaccinations.

METHOD

This is a cross-sectional study, and 258 faculty members were included in the study. The questionnaire used in the study explored the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors regarding childhood vaccination. A chi-square test and a fisher exact test were used for statistical analysis.

RESULTS

Of the faculty members, 31.8% were hesitant about childhood vaccines, 51.9% stated that there were studies reporting the side effects of vaccines, 48.1% did not agree with giving booster doses of vaccines, 35.7% stated that vaccines could cause autism due to the chemicals contained in the vaccines. The most important information sources of university faculty regarding childhood vaccines members are scientific publications and health professionals.

CONCLUSIONS

Faculty members level of hesitancy about vaccines was high and since health professionals and scientific articles are the most important information sources of faculty members, misinformation here may affect their knowledge, attitudes and behaviors about vaccination.

A Behavioral analysis of nurses' and pharmacists' role in addressing vaccine hesitancy: scoping review

The purpose of this review was to identify, characterize, and map the existing knowledge on a) nurses' and pharmacists' perceived barriers and enablers to addressing vaccine hesitancy among patients; and b) strategies or interventions for nurses and pharmacists to address vaccine hesitancy in their practice. Our comprehensive search strategy targeted peer-reviewed and grey literature. Two independent reviewers screened papers and extracted data. We coded narrative descriptions of barriers and enablers and interventions using the Behavior Change Wheel. Sixty-six records were included in our review. Reported barriers (n = 9) and facilitators (n = 6) were identified in the capability, opportunity and motivation components. The majority of the reported interventions were categorized as education (n = 47) and training (n = 26). This current scoping review offers a detailed behavioral analysis of known barriers and enablers for nurses and pharmacists to address vaccine hesitancy and interventions mapped onto these behavioral determinants.

Pharmacy student perceptions of their preparedness to address vaccine hesitancy and refusal

INTRODUCTION

Vaccine hesitancy/refusal is a growing issue worldwide. Pharmacists are well suited to address vaccine hesitancy; however, the extent to which they feel trained to do so may vary. The objective of this study was to determine pharmacy student confidence in addressing vaccine hesitancy/refusal.

METHODS

Students in their penultimate didactic and experiential years at United States schools of pharmacy were invited to participate in a 30-item electronic survey concerning perceptions of preparedness to address vaccine hesitancy/refusal. The primary outcome was pharmacy students' perception of their ability to address vaccine hesitancy/refusal. Secondary outcomes included student confidence in their knowledge of and ability to speak to vaccine controversies and support for pharmacist/patient vaccine responsibilities. Outcomes were addressed using five-point Likert-type items. Median values and interquartile ranges were reported, with chi-square analysis accounting for possible heterogeneity between groups.

RESULTS

A total of 1433 students (estimated response rate = 20%) completed the survey. Respondents indicated confidence in their preparedness to address patient immunization concerns, hesitancy, and refusal with a median score of 4 (scale of 5, with 1 = the least confident and 5 = the most confident). Secondary outcome analysis revealed varying degrees of confidence regarding specific vaccine hesitancy controversies.

CONCLUSIONS

Pharmacy students were confident in their ability to address vaccine hesitancy/refusal. Students held beliefs of responsibility for limiting non-vaccination, but felt less confident in addressing concerns regarding specific vaccine components and immune system overload.

Preparedness of current and future Saudi Pediatricians to face vaccine hesitancy: Cross-sectional study within the capital city of Saudi Arabia, Riyadh

BACKGROUND

Vaccines have helped in eradicating many communicable diseases. They are considered major players in preserving children's health. However, concerns about vaccines' ingredients and safety became hot topics globally. With doubt, some parents became hesitant to vaccinate their children. A recent study documented high prevalence of vaccine hesitancy among Saudi parents.

OBJECTIVES

This study aims to explore preparedness of current and future pediatricians to face vaccine hesitancy, a growing public health issue in Saudi Arabia.

METHODS

This study adopted non-interventional cross-sectional online questionnaire specifically designed to encompass general vaccine hesitancy related questions including Covid-19's vaccines.

RESULTS

The study recruited 119 participants form three main tertiary centers in Riyadh. Trainees were the majority with pediatric consultants representing 22%. Females were more than half of total participants (53%). Although familiarity with the term "vaccine hesitancy" was common, it was affected by training level. Among participants, 66% heard about it from social media. Furthermore, only 32% received designated training. Knowledge was suboptimal among all levels except for those who received formal training. Despite 80% encountered vaccine hesitancy, only 55% consider it a common public health issue. Attitude toward vaccine hesitant parents was negative among male physicians (odds ratio of 2.3, P value 0.045). Additionally, majority consider it a form of child neglect (95%). In regard to COVID19's vaccine, 31% were reluctant to get vaccinated themselves.

CONCLUSION

Pediatric workforce in Saudi Arabia commonly encounters vaccine hesitancy. The strong stand against vaccine hesitant parents might affect rapport with families. Sub-optimal knowledge, negative attitude and emerging COVID19 vaccine hesitancy might negatively impact future efforts. Tailored training and innovative educational platforms are essentials to address vaccine hesitancy in Saudi Arabia.

Investigating the determinants of vaccine hesitancy within undergraduate students' social sphere

Aims

Vaccine hesitancy is widely recognised as one of the most serious threats to current global health. While the causes underlying vaccine hesitancy have been extensively described and several mitigation strategies trialled amongst current and prospective parents, there is a relative scarcity of research investigating its extent and causative factors amongst university students, a critical demographic due to its temporal proximity to the average child-rearing age. The present study sought to address this literature gap by elucidating the social and demographic factors that might underpin vaccine hesitancy in university students.

Subject and methods

An anonymous online survey was carried out to investigate the opinions and perspectives on the practice of vaccination within undergraduate students’ social sphere. The statistical significance of the differences observed between groups of participants was analysed using non-parametric tests of variance.

Results

Amongst the 739 volunteers who participated in the survey, vaccine confidence varied significantly (p < 0.001) with age, ethnicity and religion, and to a lesser (yet still statistically significant) extent (p < 0.05) with graduate status. No statistically significant differences were observed with regard to gender or number of children.

Conclusions

By shedding new light on the factors underpinning vaccine hesitancy within undergraduate students’ social network, the present study provides a stepping stone towards the development of targeted mitigation strategies.

Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan

Vaccination to prevent coronavirus disease 2019 (COVID-19) emerged as a promising measure to overcome the negative consequences of the pandemic. Since university students could be considered a knowledgeable group, this study aimed to evaluate COVID-19 vaccine acceptance among this group in Jordan. Additionally, we aimed to examine the association between vaccine conspiracy beliefs and vaccine hesitancy. We used an online survey conducted in January 2021 with a chain-referral sampling approach. Conspiracy beliefs were evaluated using the validated Vaccine Conspiracy Belief Scale (VCBS), with higher scores implying embrace of conspiracies. A total of 1106 respondents completed the survey with female predominance (n = 802, 72.5%). The intention to get COVID-19 vaccines was low: 34.9% (yes) compared to 39.6% (no) and 25.5% (maybe). Higher rates of COVID-19 vaccine acceptance were seen among males (42.1%) and students at Health Schools (43.5%). A Low rate of influenza vaccine acceptance was seen as well (28.8%), in addition to 18.6% of respondents being anti-vaccination altogether. A significantly higher VCBS score was correlated with reluctance to get the vaccine (p < 0.001). Dependence on social media platforms was significantly associated with lower intention to get COVID-19 vaccines (19.8%) compared to dependence on medical doctors, scientists, and scientific journals (47.2%, p < 0.001). The results of this study showed the high prevalence of COVID-19 vaccine hesitancy and its association with conspiracy beliefs among university students in Jordan. The implementation of targeted actions to increase the awareness of such a group is highly recommended. This includes educational programs to dismantle vaccine conspiracy beliefs and awareness campaigns to build recognition of the safety and efficacy of COVID-19 vaccines.