Determining the intention of receiving the influenza vaccine: a cross-sectional survey among international and domestic college students in the USA.

Abstract

Vaccination is the most effective strategy for preventing infectious diseases, yet it is underused in young adults. College students are important targets for the influenza vaccine given this population's low vaccination rates; however, limited research has focused on international college students' vaccination status. This study examined the relationships between the theory of planned behaviour (TPB; attitudes, perceived behavioural control (PBC) and subjective norms) and students' intention of receiving an influenza vaccine. A cross-sectional study was conducted with a convenience sample of 222 domestic students recruited via Amazon Mechanical Turk and 197 international students recruited through the Registrar's Office at a Midwest university. International students had higher levels of PBC, intention and attitudes towards receiving an influenza vaccine compared with domestic students. Being Hispanic (β=-5.33; 95% CI -9.84 to -0.81, p=0.021), up-to-date vaccination status (β=-1.60; 95% CI -2.99 to -0.17, p=0.028) and identifying as smokers (β=-2.94; 95% CI -5.72 to -0.15, p=0.039) significantly lowered college students' intention. Attitudes (international: β=0.14; 95% CI 0.04 to 0.23, p=0.003; domestic: β=0.14; 95% CI 0.07 to 0.22, p<0.001), subjective norms (international: β=0.40; 95% CI 0.29 to 0.51, p<0.001; domestic: β=0.34; 95% CI 0.23 to 0.44 p<0.001), and PBC (international: β=0.09; 95% CI 0.004 to 0.18, p=0.042; domestic: β=0.10; 95% CI 0.01 to 0.19, p=0.019) were significantly associated with both domestic and international students' intention of receiving an influenza vaccine. Findings support the TPB's potential utility to enhance domestic and international college students' influenza vaccination rates.