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Bouloukaki I, Christodoulakis A, Patelarou A, Giakoumidakis K, Zografakis-Sfakianakis M, Patelarou E, Tsiligianni I. Factors Influencing COVID-19 Vaccination Hesitancy and Booster Dose Adherence Among University Students: A Cross-Sectional Study in Crete, Greece. Healthcare (Basel) 2025; 13:1115. [PMID: 40427952 PMCID: PMC12110812 DOI: 10.3390/healthcare13101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2025] [Revised: 04/28/2025] [Accepted: 05/09/2025] [Indexed: 05/29/2025] Open
Abstract
Background/Objectives: Vaccination hesitancy remains a global challenge, especially after the COVID-19 pandemic. We aimed to assess the prevalence of hesitancy towards regular COVID-19 vaccinations, including booster doses (additional doses beyond the primary to sustain or improve immunity), among university students and its associated factors. Methods: We conducted a cross-sectional study involving 190 university students from Hellenic Mediterranean University in Crete, Greece. Data were collected through an electronic survey distributed from July to October 2024. The survey included socio-demographic characteristics, health status factors, prior COVID-19 infection and vaccination history (general and for COVID-19), attitudes about COVID-19 vaccination, and the Attitude Towards Adult Vaccination (ATAVAC) scale. Qualitative data were also collected by addressing themes regarding ways to overcome vaccine hesitancy. Results: The study found that 64% of participants expressed hesitancy towards receiving COVID-19 booster doses. Factors contributing to this hesitancy were female gender, current smoking, pregnancy, concerns about vaccine side effects, a lack of confidence in vaccine efficacy, COVID-19 infection history, low perceived susceptibility to infection, and reliance on media information. Additionally, increased trust in the value of adult vaccination, adhering to recommendations of treating physician/scientist opinions, and prior adherence to vaccination were positively associated with regular COVID-19 vaccinations. A thematic analysis of the qualitative data identified four key strategies to overcome student vaccine hesitancy: enhancing health literacy, validating vaccine safety through further research, alleviating pandemic-related fears, and addressing distrust in authorities and opposition to mandatory vaccination. Conclusions: Our findings provide insights into the intricate factors and barriers of COVID-19 vaccination hesitancy among university students, thus emphasizing the need for more targeted interventions.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (I.B.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (I.B.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (A.P.); (K.G.); (M.Z.-S.); (E.P.)
| | - Athina Patelarou
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (A.P.); (K.G.); (M.Z.-S.); (E.P.)
| | - Konstantinos Giakoumidakis
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (A.P.); (K.G.); (M.Z.-S.); (E.P.)
| | - Michail Zografakis-Sfakianakis
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (A.P.); (K.G.); (M.Z.-S.); (E.P.)
| | - Evridiki Patelarou
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (A.P.); (K.G.); (M.Z.-S.); (E.P.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (I.B.); (I.T.)
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 2417 Nicosia, Cyprus
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Giannella L, Grelloni C, Natalini L, Sartini G, Lavezzo F, Cicoli C, Bernardi M, Bordini M, Petrini M, Petrucci J, Terenzi T, Delli Carpini G, Di Giuseppe J, Ciavattini A. The Role of Internet Information on Anti-HPV Vaccines: A Comprehensive Overview of a Double-Edged Sword. Vaccines (Basel) 2025; 13:445. [PMID: 40432056 PMCID: PMC12116087 DOI: 10.3390/vaccines13050445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Revised: 04/09/2025] [Accepted: 04/22/2025] [Indexed: 05/29/2025] Open
Abstract
Cervical cancer (CC) is the only cancer that has the possibility of primary and secondary prevention. Despite this, it is one of the leading causes of cancer death among women, especially in developing countries. The World Health Organization has set the ambitious goal of eliminating CC by 2030 by suggesting specific types of intervention. Unfortunately, to date, we are very far from this goal at a global level, including developed countries. Implementing vaccination coverage among the target population is one of the strategies to be pursued in this area. Achieving this goal should include combating misinformation about the HPV vaccine, which is one of the main reasons for vaccination hesitancy. Such conspiracy theories are prevalent on social media, one of the primary sources of information for adults and adolescents today. In this regard, the Internet plays a significant role in disseminating information about the HPV vaccine, both positively and negatively. The Internet provides easy access to information about the HPV vaccine, including its safety, efficacy, recommended dosing schedule, and potential side effects. It may promote vaccine advocacy and debunking vaccine myths. On the other hand, the Internet may be the place for disseminating misinformation and influencing vaccine decision making. It is a double-edged sword in shaping public discourse and perceptions about the HPV vaccine. This overview aims to assess the literature on this topic in depth to promote evidence-based information, analyze the social channels through which misinformation spreads, and leverage digital health interventions essential for promoting HPV vaccination and reducing the burden of HPV-related diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Andrea Ciavattini
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, Italy; (L.G.); (C.G.); (L.N.); (G.S.); (F.L.); (C.C.); (M.B.); (M.B.); (M.P.); (J.P.); (T.T.); (G.D.C.); (J.D.G.)
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