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.