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Assessment of Influenza A (H1N1) Vaccination among Health Sciences Students in Northeast Brazil: A Cross-Sectional Study

Author(s): Adriana Ramos Leite Matalobos, Luiza Ramos Leite Matalobos, Carlos Tomaz

Introduction: Influenza is a respiratory disease with high transmission capability that disseminates easily in seasonal epidemics, characterizing its global distribution. Vaccination is the most effective means of preventing the disease and morbidity, as it reduces the risk of horizontal transmission. Although research has explored influenza vaccination uptake in US and in Europe among college students and health care workers, there is a dearth of research in understanding influenza vaccination uptake and attitudes toward the vaccine among college students of the health sciences in Brazil.

Objective: The aim of this study was to evaluate the adherence to H1N1 vaccination campaigns among college students of health sciences in a private university in Brazil and to investigate the levels of knowledge, attitudes toward influenza vaccination and to identify the factors associated with reported seasonal influenza shots.

Materials and Methods: A cross-sectional study was performed among 353 students of five majors of health sciences - namely: Biomedicine, Nursing, Medicine, Psychology and Dentistry, at the University CEUMA, Campus Imperatriz - Maranhão, northeast of Brazil. Data collection (between July and August 2021) was performed using an online platform (Google Forms) questionnaire consisting of 15 multiple-choice questions to identify age, sex, marital status, housing conditions, undergraduate course, knowledge about the H1N1 vaccine and the reasons for its acceptance or refusal.

Results: Over 75% of the respondents were under the age of 24. Seventytwo percent declared themselves to be female; 62% white or Caucasian; 74% were medical students; 81% responded that they live with up to 4 people; 53% have health insurance, while 47% use public health services. Only 52% of students reported they had been immunized against H1N1, although 77% strongly agree with the vaccine’s efficacy. Of the participants who reported receiving the vaccine, the majority were medical students with health insurance. There was found to be an association between the variables “having health insurance” and “receiving the vaccine for H1N1”. When asked if they were informed or encouraged to receive the H1N1 vaccine, 31.16% reported having received encouragement from parents, relatives, or friends, while 18.13% reported not having received any guidance. Our findings indicate some barriers to the acceptance of influenza vaccination. These factors can be classified as: the attitude toward influenza vaccination among participants; and promotion, education, and information about the H1N1 vaccination.

Conclusions: Results demonstrated that only a half of students surveyed (52%) reported receipt of the seasonal H1N1 influenza vaccine. The low uptake results, when compared to the Brazilian population at large, are concerning, particularly considering that the students are majoring in health sciences. Our study has shown that knowledge alone may not be enough to increase adherence; attitudes about the value and risk, as well as misperceptions, may play a significant role. This indicates the need for targeted interventions within health sciences programs in universities. Students should be alerted they are role models to be followed by the rest of the general population. Maximizing seasonal influenza vaccination uptake in this population by addressing attitudes, barriers, and misperceptions may not only help improve vaccination rates in health sciences students, but also in the communities served by these prospective health professionals.

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