Expert advice and mandates help vaccine hesitant students: UTM study
A new study from U of T Mississauga reveals what’s on the minds of vaccine-hesitant university students, and what it will take to convince the undecided to get the jab.
Madeleine Mant, an assistant professor with UTM’s Department of Anthropology, is lead author on a study published in PLOS One. The research assesses attitudes and perceptions about the COVID-19 vaccine amongst Canadian university students, and finds health care providers and higher education institutions have an important role to play in convincing this unique cohort to get the inoculation.
A UNIQUE DEMOGRAPHIC
Launched in March 2020, the study is part of ongoing longitudinal research into the effect of the pandemic on Canadian university students in their early 20s.
Mant notes that this is an important, though sometimes overlooked, group.
Students may fit into the age range of the broader adult population, but they are at a unique point in their lives. Newly out from the family home, many are making personal health decisions for the first time. At the same time, they don’t yet have the life experience or long-held beliefs and biases of those in older age brackets. Students are also well connected to the influences of social media, and are actively developing critical thinking skills through their studies.
“This is a unique demographic group that doesn’t get a lot of attention,” Mant says. “They have underlying illness and health beliefs and experiences, and interactions with media, and consumption habits, all of which are quite different from older adults.”
These factors play into perceptions about the vaccine.
“This study provides specific information about what students are actually worried about,” says Mant.
The study followed participants over the course of the pandemic, allowing researchers to revisit questions with them and track whether they held the same views when the vaccines became available. The next round of interviews will take place this fall.
Through online surveys and personal interviews, the researchers asked participants about their thoughts on the likelihood of contracting COVID-19 and perceived severity of potential illness, anticipation that individuals or loved ones might get sick, and the benefits and barriers to engaging with health behaviours like hand washing, physical distancing and vaccination.
Most respondents showed early willingness to receive the vaccine. Last summer, months before the release of the vaccine, 78 per cent of study participants indicated they would be willing get the vaccine. That number climbed slightly over subsequent months and follow-up interviews.
Respondents reported a variety of personal factors that influenced their feelings on the vaccine. Those in the pro camp cited fear of catching COVID, a wish to protect vulnerable people in their lives, or a desire to return to normal as influencing factors.
Nearly 20 per cent of study respondents reported reservations about the vaccine. Those in the reluctant or undecided category mentioned concerns about the speed at which the vaccine was developed and worries about potential side effects.
“Other students mentioned that there wasn’t a 100 per cent guarantee they would get COVID, or that they had already had COVID with mild symptoms,” Mant says.
The study also assessed what factors might influence vaccine-hesitant students to change their views.
“This isn’t a black or white question,” Mant says. “There are some who will be entrenched anti-vaxxers and who are not interested in any of this information. But from what we’ve seen, there is a group of students who are in the grey zone and need a nudge or a chance to ask a few questions for reassurance.”
EXPERT ADVICE, MANDATES AND SOMEONE TO LISTEN
Student respondents reported that they would be mostly like to be swayed by conversations with healthcare providers, or a mandate to get the vaccine to return to school in person.
“We were interested to see a really strong relationship between a student saying they would be encouraged by their doctor or pharmacist to get it,” Mant says. “They were 76 times more likely to say they would get it than those who didn’t want to listen to a doctor or pharmacist.”
“Healthcare professionals have an active role to play in helping those conversations continue. The data shows us that this relationship is really important.”
Mant says colleges and universities can use this data to guide initiatives to encourage vaccine uptake. Access to health care experts, providing a clear mandate and someone to just listen to student concerns.
“If students are saying they would trust a doctor or pharmacist, we need to ensure they know where to get that information and give them access to university health centres and family doctors,” Mant says.
Students also cited an institutional mandate to vaccinate as a deciding factor. “They said, ‘I’m not interested if I’m doing school online, but I will get it if needed to go back to campus,’” Mant says. “We’re seeing this mandate for certain sports or music programs, but if that’s what it took to get students back on campus, our study shows there would be students who would get vaccinated specifically for that reason.”
“Some folks might not be motivated to get the vaccine until they absolutely have to,” she says, adding that in some cases, they might just need to be told to go and get it. “We should be considering that as a factor.”
Finally, a sympathetic ear may also be effective. Mant notes that some students were swayed simply by their participation in the study.
“One student said that having the chance to talk about it was a major factor in deciding to get the vaccine,” she says. “This was me asking the same standard questions – how are you feeling, what are your worries. They said that just being asked to articulate their worries helped them make a decision.
“It really emphasized to me that conversations have to keep happening. It’s not a matter of giving somebody a pamphlet. It’s asking, calmly and patiently, about what their concerns might be.
“Students in this grey area, who are feeling isolated or left out of the conversation because their worry hasn’t been addressed. It’s important to keep having the conversation.”
“University students’ perspectives, planned uptake, and hesitancy regarding the COVID-19 vaccine: A multi-methods study” is published in PLOS One, and supported by the University of Toronto COVID-19 Action Initiative. The study is co-authored by Mant with Asal Aslemand, assistant professor, teaching stream with UTM’s Department of Mathematical and Computational Sciences, physician Andrew Prine of Groves Memorial Community Hospital in Fergus, Ontario, and resident physician Alyson Holland of the Department of Family Medicine at McMaster University.
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