Cross-Sectional Study of University Students’ Attitudes to ‘On Campus’ Delivery of COVID-19, MenACWY and MMR Vaccines and Future-Proofing Vaccine Roll-Out Strategies

  1. Adam Webb
  2. Mayuri Gogoi
  3. Sarah Weidman
  4. Katherine Woolf
  5. Maria Zavala
  6. Shamez N. Ladhani
  7. Manish Pareek
  8. Lieve Gies
  9. Christopher D. Bayliss

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Abstract

University students are a critical group for vaccination programmes against COVID-19, meningococcal disease (MenACWY) and measles, mumps and rubella (MMR). We aimed to evaluate risk factors for vaccine hesitancy and views about on-campus vaccine delivery among university students. Data were obtained through a cross-sectional anonymous online questionnaire study of undergraduate students in June 2021 and analysed by univariate and multivariate tests to detect associations. Complete data were obtained from 827 participants (7.6% response-rate). Self-reporting of COVID-19 vaccine status indicated uptake by two-thirds (64%; 527/827), willing for 23% (194/827), refusal by 5% (40/827) and uncertain results for 8% (66/827). Hesitancy for COVID-19 vaccines was 5% (40/761). COVID-19 vaccine hesitancy was associated with Black ethnicity (aOR, 7.01, 95% CI, 1.8–27.3) and concerns about vaccine side-effects (aOR, 1.72; 95% CI, 1.23–2.39). Uncertainty about vaccine status was frequently observed for MMR (11%) and MenACWY (26%) vaccines. Campus-associated COVID-19 vaccine campaigns were favoured by UK-based students (definitely, 45%; somewhat, 16%) and UK-based international students (definitely, 62%; somewhat, 12%). Limitations of this study were use of use of a cross-sectional approach, self-selection of the response cohort, slight biases in the demographics and a strict definition of vaccine hesitancy. Vaccine hesitancy and uncertainty about vaccine status are concerns for effective vaccine programmes. Extending capabilities of digital platforms for accessing vaccine information and sector-wide implementation of on-campus vaccine delivery are strategies for improving vaccine uptake among students. Future studies of vaccine hesitancy among students should aim to extend our observations to student populations in a wider range of university settings and with broader definitions of vaccine hesitancy.

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  1. Version published to 10.3390/vaccines10081287
  2. ScreenIT

    SciScore for 10.1101/2022.02.07.22270394: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: De-identified survey responses were analysed using R version 4.0.3 with the tidyverse (data handling), jsonlite 1.7.1 (data extraction), ggplot2 3.32 (general graphing), gtsummary 1.4.2 (tabulation), UpSetR 1.4.0 (graphing of sets) and likert 1.3.5 (graphing of likert-style responses) packages [25-31].
    ggplot2
    suggested: (ggplot2, RRID:SCR_014601)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The subsequent evidence of uptake rates of >90% in an ONS study of UK university students [32] indicates that, despite the caveats (see below), our study was a reasonable predictor of student attitudes to vaccines. Intriguingly, we also found that 93% (37/40) of the COVID-19 vaccine hesitant individuals reported having had at least one of the MMR and MenACWY vaccines with 50% (20/40) having had both; this would suggest that these individuals are specifically concerned about the COVID-19 vaccines or that vaccine hesitancy has developed during their transition to adulthood. Determinants of vaccine hesitancy among university students: A key concern for vaccination programmes has been to identify groups of individuals with lower levels of vaccine uptake. Our univariable analysis indicated that ethnicity was strongly linked to vaccine hesitancy, with the multivariable analysis further linking this hesitancy to the black ethnic group within the wider university student population. As these findings were based on small numbers of vaccine-hesitant individuals, we examined the VAX scores for all individuals of each ethnic group and found that both the Asian and Black ethnic groups had significantly lower average scores than the White ethnic group indicating a general trend towards hesitancy among the minority ethnic groups (Figure 1). Other studies have also found evidence of vaccine hesitancy associated with ethnicity [33-36] and specifically with students of black ethnicity [36]. He...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2022.02.07.22270394 on medRxiv