Integrating Health Behavior Theories to Predict COVID-19 Vaccine Acceptance: Differences between Medical Students and Nursing Students

Abstract

Background: This study aimed to explore behavioral-related factors predicting the intention of getting a COVID-19 vaccine among medical and nursing students using an integrative model combining the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Methods: A cross-sectional online survey was conducted among medical and nursing students aged > 18 years in their clinical years in Israel between 27 August and 28 September 2020. Hierarchical logistic regression was used to predict acceptance of a COVID-19 vaccine. Results: A total number of 628 participants completed the survey. Medical students expressed higher intentions of getting vaccinated against COVID-19 than nursing students (88.1% vs. 76.2%, p < 0.01). The integrated model based on HBM and TPB was able to explain 66% of the variance (adjusted R2 = 0.66). Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived susceptibility, benefits, barriers, cues to action, attitude, self-efficacy and anticipated regret. Two interaction effects revealed that male nurses had a higher intention of getting vaccinated than did female nurses and that susceptibility is a predictor of the intention of getting vaccinated only among nurses. Conclusions: This study demonstrates that both models considered (i.e., HBM and TPB) are important for predicting the intention of getting a COVID-19 vaccine among medical and nursing students, and can help better guide intervention programs, based on components from both models. Our findings also highlight the importance of paying attention to a targeted group of female nurses, who expressed low vaccine acceptance.

Attitudes of Medical Students toward COVID-19 Vaccination: Who Is Willing to Receive a Third Dose of the Vaccine?

“…The availability of vaccination, or the percentage of vaccinated students might be associated with vaccination hesitancy. Several studies have shown that medical students express higher intentions to be vaccinated than the general population [24], nonmedical students [25,26], nursing students [27], and dental students [28]. A recent study conducted in Japan showed that 14 to 16% of the younger (15-39 years old) subgroup expressed COVID-19 vaccine hesitancy in terms of their hypothetical intention to be vaccinated and that vaccination intention was associated with several factors, including younger age, female sex, and living alone [29].…”

Vaccine Coverage against Influenza and SARS-CoV-2 in Health Sciences Students during COVID-19 Pandemic in Spain

“…However, lower coverages were also found in other studies conducted in Slovakia and Japan among medical students where the coverages were 71.7% [33] and 89.1% [34], respectively. Perhaps the differences are due to greater reliance on the vaccine over time, the educational environment or differences in the type of vaccine available in each country [35][36][37].…”

COVID-19 Vaccination Compliance and Associated Factors among Medical Students during an Early Phase of Vaccination Rollout—A Survey from Israel

“…Other sources were television, newspapers, politicians, family, radio, and religious or cultural leaders [14]. A study from Israel among medical and nursing students found higher motivation for vaccination in students that were recommended to get vaccinate by their family, friends, colleagues, or supervisors [41].…”