Individual and Contextual Determinants of Flu Vaccination Adherence: A University Nudge Intervention

Abstract

Introduction: The University of Salerno has implemented a nudge intervention with the aim of promoting vaccine adherence among employees of academia and identifying individual and contextual determinants that influence adherence. Method: A purpose-built questionnaire was used during the reference period of October–December 2022 in order to assess levels of state anxiety (STAI-Y1), perceived stress (PSS-10), and public sentiments, which influence vaccination behavior, with consequences for the whole population (VCI). Results: Analysis of the results revealed a difference in mean scores on the PSS: those who have always adhered to the vaccination campaign compared to those who have never been vaccinated perceived higher levels of stress (12.01 vs. 11.33; F = 4.744, p = 0.031); furthermore, there was a relationship between the presence/absence of pathologies and VCI (F = 3,93; df = 1; p = 0.04). Conclusions: The University of Salerno’s nudge intervention made its employees more responsible for protecting the health of the academic community and encouraged good adherence to the flu vaccination campaign. University employees, equipped with high cultural tools, sought information primarily from institutional sources indicated by the university during the free vaccination campaign at the university’s vaccine center.

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“…Vaccination adherence is generally defined as receiving a vaccination according to the vaccine’s label-recommended dose schedule [ 8 ]; it is a behaviour resulting from a decision-making process influenced by various determinants [ 9 ]. Within healthcare settings and among HCWs, vaccination adherence can exhibit notable differences [ 10 , 11 ].…”

Anti-Herpes Zoster Vaccination of Fragile Patients in Hospital Setting: A Nudge Intervention in Italy

“…Type 2 nudges are capable of activating both automatic response systems and reflective thinking that subsequently shapes behavior [23][24][25][26][27][28][29][30][31][32]. It can create persistent behavioral change using psychological mechanisms such as memory of past utility, self-perception, and repetition.…”

“…In general, the following variables are important indicators in anti-HZ vaccine adherence: age over 50 years, level of health literacy, female gender, higher income and education level, location in specific geographic areas, pre-existing conditions, health perception, and ability to correctly perceive disease risk [9,32,37,41]. Individual determinants include cognitions, beliefs, and thought processes within which vaccine adherence behaviors are constructed, as well as prior knowledge, experiences, and beliefs [38,42] and also the perception of one's own health status and the perception of being able to respond to stressful life events [37,38].…”

“…Regarding contextual variables, vaccination adherence can also be influenced by vaccination campaigns and the information sources chosen by individuals [21,39,42,47]. Therefore, when communication is inadequate, it can negatively influence vaccine adherence and contribute to vaccine hesitancy [32]. Communication can become counterproductive if it is not adapted to literacy levels, even considering the growing skepticism perpetuated by the spread of misinformation through social media.…”