Influences on University Students' Intention to Receive Recommended Vaccines: A Cross-Sectional Survey

Previous research has suggested that vaccine uptake is significantly predicted by an individual's intention to vaccinate. The Theory of Planned Behaviour and the Health Belief Model have both been shown to predict intention to vaccinate. Other predictors include perceived self-efficacy (PSE), which is a person's belief about their capability of accomplishing a task, previous vaccination experience, and needle fear. This study sought to explore predictors of university students' intention to receive the Meningococcal ACWY (MenACWY) vaccination, which protects against life-threatening meningitis and septicaemia, as well as the main sources of vaccine-related information accessed by university students.

Participants were recruited from University College London (United Kingdom, or UK) in summer 2015. The majority of the 177 students who completed the 48-item online survey were female (58%), white (68%), and said they had no religion (58%). Participants were aged 18 to 42 (mean age = 23.6).

Primary outcome measures included vaccine attitude, perceived subjective norm (PSN - whether the respondent thinks that significant others would approve of them getting a vaccine and their motivation to comply with these wishes), perceived behavioural control, perceived self-efficacy, past receipt of recommended childhood vaccines, perceived adverse reaction to past vaccination, and needle fear. As a secondary outcome, sources of vaccine-related information were assessed.

Past vaccine receipt had the strongest influence on intention. Students who had received all recommended childhood vaccines were over 3 times more likely to be high vaccine intenders than students who had not. More specifically: Students classified as high intenders were more likely to have received all recommended childhood vaccines (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.21 to 10.59; p=0.022), be less afraid of needles (OR 2.44; 95% CI 1.12 to 5.36; p=0.026), and to have lived in the UK until at least the age of 4 compared with those not living in the UK until at least the age of 4 (OR 0.39; 95% CI 0.18 to 0.83; p=0.015) and those who lived both in the UK and elsewhere (OR 0.42; 95% CI 0.04 to 4.06; p=0.424). (The latter set of findings could be an interesting direction for future research that could assess differences in immunisation schedules between countries and the effects of disparities on uptake.) In all, the multivariable model explained 25.5% of variance in intention to receive a recommended vaccine.

The 5 most commonly reported vaccine information sources were the internet (66.7%), doctor or healthcare provider (56.5%), family (24.9%), brochures or pamphlets (23.7%), and friend or coworker (14.7%). No students reported social media as a source of online vaccine-related health information. Campaigns could therefore benefit from disseminating information on official web pages. In addition, university students in the UK often live away from home and so re-register with a local health provider. Healthcare providers could, thus, use this opportunity to provide information in consultations and use pamphlets as a tool to offer further information.

According to the researchers, these findings are timely in view of the recent introduction of MenACWY vaccine for 14- to 18-year-olds and for young people up to the age of 25 years attending university for the first time. It is of concern that uptake of the MenACWY vaccine in the first 2 cohorts of 18-year olds offered the vaccine has not exceeded 39%, leaving many young people at risk of these potentially severe infections. The findings provide an indication of where to focus future interventions to raise university students' awareness of the importance of this and other vaccination programmes.