Understanding vaccine knowledge,attitudes, and decision-making through college student interviews

Abstract

Objective: We aimed to explore knowledge, attitudes, and beliefs about vaccines required for college-entry and vaccine-related behaviors among college students. Participants: Thirty-three full-time undergraduate students, ≥ 18 years old, enrolled at public (2) and private (3) colleges and universities in metropolitan Philadelphia in fall 2016. Methods: We conducted semistructured interviews, which were double-coded with 5,015 comments overall and 99.3% intercoder reliability (κ?=?0.779) using NVivo 11 software. Results: Six key themes emerged: (1) low knowledge about vaccines and requirements; (2) mixed attitudes about required vs. recommended vaccines; (3) high trust in medical professionals; (4) low perceived risk for vaccine-preventable disease outbreaks; (5) substantial parental influence on students’ decision-making; and (6) low utilization of Student Health Services. Conclusions: This study revealed lack of knowledge about and low prioritization of vaccination despite overall positive attitudes towards vaccines. Prematriculation education of college students is critical to increasing vaccine knowledge and use.     

Meningococcal serogroup B outbreak response University of Wisconsin-Madison

A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. Objective: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. Methods: We assembled the team leaders to write this case report. Results: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. Conclusion: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.     

Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Too Scared or Too Capable? Why Do College Students Stay Away from the H1N1 Vaccine?

Although college students were among the populations that had the highest frequency of infection for H1N1 influenza, only 8% of them received H1N1 vaccine this past flu season nationwide. During the peak of this pandemic, information about H1N1 vaccine was widely available. However, knowledge test and behavioral data indicated that most college students were not equipped with basic facts about H1N1 and the H1N1 vaccine. To investigate socio‐psychological factors that might have deterred this high‐risk population from learning about and getting the H1N1 vaccine, this study tested the utility of a risk information seeking model in addressing this health communication problem. Data collected from an online survey of 371 college students showed that respondents seemed to overestimate how much they knew about the vaccine. Risk information seeking, however, positively influenced their intentions to get the vaccine. Results suggested that to communicate effectively to this population, it is important to emphasize the difference between perceived knowledge and actual knowledge, monitor emotional responses to potential risks, and promote getting flu vaccination as a socially desirable behavior.     

Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge,Attitudes, and Beliefs Among Injecting Drug Users in Viet Nam

ABSTRACT

In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of those affected by the HIV/AIDS epidemic in Viet Nam, two focus groups (n = 18) were conducted among this population to identify potential barriers and incentives for HIV vaccination. Most were willing to be vaccinated if an HIV vaccine were available. Although there were some concerns about side effects, financial costs, and stigmatization, the benefits were seen to outweigh the risks. The findings may help governments better understand the potential demand for this type of vaccine and design social marketing campaigns for post-trial HIV vaccine dissemination in order to maximize potential uptake of an HIV vaccine.     

The Special Historical Section of the Journal of American College Health

Abstract

Objective: To identify human papillomavirus (HPV) infection and HPV vaccine–related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

A modified false discovery rate multiple-comparisons procedure for discrete data, applied to human immunodeficiency virus genetics

Summary.  To help to design vaccines for acquired immune deficiency syndrome that protect broadly against many genetic variants of the human immunodeficiency virus, the mutation rates at 118 positions in HIV amino-acid sequences of subtype C versus those of subtype B were compared. The false discovery rate (FDR) multiple-comparisons procedure can be used to determine statistical significance. When the test statistics have discrete distributions, the FDR procedure can be made more powerful by a simple modification. The paper develops a modified FDR procedure for discrete data and applies it to the human immunodeficiency virus data. The new procedure detects 15 positions with significantly different mutation rates compared with 11 that are detected by the original FDR method. Simulations delineate conditions under which the modified FDR procedure confers large gains in power over the original technique. In general FDR adjustment methods can be improved for discrete data by incorporating the modification proposed.     

Direct and Indirect Causal Effects via Potential Outcomes*

Abstract. The use of the concept of ‘direct’ versus ‘indirect’ causal effects is common, not only in statistics but also in many areas of social and economic sciences. The related terms of ‘biomarkers’ and ‘surrogates’ are common in pharmacological and biomedical sciences. Sometimes this concept is represented by graphical displays of various kinds. The view here is that there is a great deal of imprecise discussion surrounding this topic and, moreover, that the most straightforward way to clarify the situation is by using potential outcomes to define causal effects. In particular, I suggest that the use of principal stratification is key to understanding the meaning of direct and indirect causal effects. A current study of anthrax vaccine will be used to illustrate ideas.     

Estimation of Stratified Mark‐Specific Proportional Hazards Models with Missing Marks

Abstract. An objective of randomized placebo‐controlled preventive HIV vaccine efficacy trials is to assess the relationship between the vaccine effect to prevent infection and the genetic distance of the exposing HIV to the HIV strain represented in the vaccine construct. Motivated by this objective, recently a mark‐specific proportional hazards (PH) model with a continuum of competing risks has been studied, where the genetic distance of the transmitting strain is the continuous ‘mark’ defined and observable only in failures. A high percentage of genetic marks of interest may be missing for a variety of reasons, predominantly because rapid evolution of HIV sequences after transmission before a blood sample is drawn from which HIV sequences are measured. This research investigates the stratified mark‐specific PH model with missing marks where the baseline functions may vary with strata. We develop two consistent estimation approaches, the first based on the inverse probability weighted complete‐case (IPW) technique, and the second based on augmenting the IPW estimator by incorporating auxiliary information predictive of the mark. We investigate the asymptotic properties and finite‐sample performance of the two estimators, and show that the augmented IPW estimator, which satisfies a double robustness property, is more efficient.