Abstract
Background: COVID-19 vaccine acceptance by the nurses of the
future is important to increase the population immunity.
Aim: This study aimed to determine the attitudes and concerns
of nursing students towards the coronavirus disease-2019 (COVID-19)
vaccine, their willingness to be vaccinated, and the factors affecting
their willingness in the second wave of the COVID-19 pandemic.
Method : This cross-sectional study was conducted between
February 1, 2021, to March 30, 2021, using an online questionnaire in
498 nursing students in Turkey.
Results: While 64.5% of nursing students had the intention to
be vaccinated against COVID-19, 35.5% had no intention to be vaccinated
(29.3% hesitant and 6.2% unwilling). Students expressed their
attitudes and concerns on the lack of COVID-19 vaccine information
(65.7%), its effectiveness (41.6%), safety (45.8%), and side effects
(50.8%). Students did not intend to be vaccinated due to insufficient
trust in the vaccine effectiveness (84%), the continuous COVID-19
mutation, vaccines side effects (68.9%), and not trusting the supplied
vaccine (55.4%). Students’ high education level, high family income
perception, previous vaccine rejection, family members with COVID-19
infection, COVID-19 information from official institutions, trusting
health professionals’ COVID-19 explanations, and attitudes and concerns
toward vaccines for their intention to be vaccinated are the affecting
factors (p < 0.05).
Conclusions: Nursing students are known to be future healthcare
professionals and play a decisive role in counseling individuals in the
community on the risks of COVID-19 and the benefits of the vaccine.
Therefore, focusing on training that is aimed at increasing vaccine
knowledge, eliminating their negative attitudes and concerns, and
building confidence in vaccines is necessary.
Keywords: COVID-19; vaccine; hesitancy; intention; concerns;
nursing student.
INTRODUCTION
The World Health Organization (WHO) declared a pandemic on March 11,
2020, due to the emergence of the coronavirus disease-2019 (COVID-19) in
December 2019 in Wuhan, China. On the same day, the first official case
in Turkey was confirmed. The COVID-19 pandemic has
caused a public health crisis and socially, economically, and
psychosocially affected the public social distancing, movement
restrictions, public health measures (hygiene, face mask, and social
distance), and social and economic measures have been taken against the
pandemic. These measures were intended to play an important role in
halting the spread of the pandemic while allowing a large part of the
population to acquire natural immunity against the virus[2, 3]. These measures were also aimed to control
the transmission until vaccines were readily available to the
population. Vaccines have been proven to be the most successful and
highly effective public health interventions to control and eradicate
vaccine-preventable diseases, as well as reduce and prevent serious
disability or death due to infectious diseases [2, 4,
5]. However, for a safe and effective vaccination program to reach
optimum effectiveness, high intake rates
by the population are required[6-8].
The concept of “vaccine hesitancy” is defined as the delay or refusal
to accept the vaccination despite the availability of vaccination
services and has been recognized as “one of the top 10 threats to
global health” by the WHO. Vaccine reluctance remains a limiting factor
in the global efforts to control the current pandemic with its adverse
health and socioeconomic consequences [9, 10].
Healthcare providers (HCPs) are considered the most reliable source of
information on vaccines and are expected to be aware of vaccination
risks and benefits. Surprisingly, vaccine hesitancy has been confirmed
among healthcare professionals (medical doctors, nurses, dentists, etc.)
Studies showed that the rate of vaccine acceptance among nurses is low.
A study conducted with HCPs (physicians, nurses, dentists, pharmacists,
and health personnel) in Turkey revealed that approximately 84.6% of
HCPs and 66.5% of nurses were willing to accept the COVID-19 vaccine
when available [11]. Similarly, Hong Kong and
Israel studies revealed that 63% and 61% of working nurses showed
their willingness to be vaccinated against COVID-19, respectively.
Another study that was conducted among nursing students from seven
European countries (Greece, Albania, Spain, Cyprus, Italy, Czech
Republic, and Kosovo) reported that 44 % of participants would accept a
safe and effective COVID-19 vaccine.
Main concerns that were described in previous studies included vaccine
efficacy and safety, possible side effects, misinformation, religious
beliefs, and personal freedom violations. These concerns have been also
reinforced by different conspiracy theories that predominantly circulate
on social media [13, 14]. The pandemic poses a
great risk to HCPs who are often in direct contact with infected
patients. Immunization would be vital to protect HCPs and control
hospital-acquired transmission. HCPs have a key role in helping the
public to overcome their vaccination doubts and concerns[2, 10, 13, 15]. Thus, as future
HCPs, understanding and increased
acceptance among nursing students toward the COVID-19 vaccine to manage
the pandemic, both now and in the future, is very important[9]. Vaccination acceptance by nursing students
does not only protect them against the virus but is also a source of
information on public immunization [9, 10].Existing vaccine hesitancy studies among healthcare nursing students are
very rare.
Therefore, this study aimed to determine the attitudes and concerns of
nursing students toward the COVID-19 vaccine, their willingness to be
vaccinated, and the factors that affect their willingness in the second
wave of the COVID-19 pandemic.