Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy
Abstract
1. Introduction
2. Materials and Methods
2.1. Setting and Participants
2.2. Procedures
2.3. Questionnaire
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Respondents
3.2. Attitude towards COVID-19
3.3. Sources of COVID-19 Vaccine Booster Dose Information
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/ (accessed on 23 November 2021).
- Italian Government. Presidency of the Council of Ministers. Ulteriori Disposizioni Attuative del Decreto-Legge 23 Febbraio 2020, n. 6, Recante Misure Urgenti in Materia di Contenimento e Gestione Dell’emergenza Epidemiologica da COVID-19, Applicabili Sull’intero Territorio Nazionale. [Further Implementing Provisions of the Decree-Law 23 February 2020, n. 6, Containing Urgent Measures Regarding the Containment and Management of the Epidemiological Emergency from COVID-19, Applicable throughout the National Territory]. Available online: https://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=73532 (accessed on 12 December 2021).
- Polack, F.; Thomas, S.; Kitchin, N.; Absalon, J.; Gurtman, A.; Lockhart, S.; Perez, J.; Pérez Marc, G.; Moreira, E.; Zerbini, C.; et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N. Engl. J. Med. 2020, 383, 2603–2615. [Google Scholar] [CrossRef] [Scilit]
- Italian Ministry of Health. Approvazione del Piano Strategico Nazionale dei Vaccini per la Prevenzione delle Infezioni da SARS-CoV-2 Costituito dal Documento Recante «Elementi di Preparazione della Strategia Vaccinale», di cui al Decreto 2 Gennaio 2021 Nonché dal Documento Recante «Raccomandazioni ad Interim sui Gruppi Target della Vaccinazione Anti SARS-CoV-2/COVID-19» del 10 Marzo 2021. [Approval of the National Strategic Plan for the Prevention of SARS-CoV-2 Infections and the Implementation of a National Vaccination Campaign with the Document Containing “Elements of Preparation and Implementation of the Vaccination Strategy”, Referred to the Decree of 2 January 2021 as well as the Document Containing “Interim Recommendations on the Target Groups of the SARS-CoV-2/COVID-19 Vaccination Program” of 10 March 2021]. (21A01802) (GU Serie Generale n.72 del 24-03-2021). Available online: https://www.gazzettaufficiale.it/eli/id/2021/03/24/21a01802/sg (accessed on 12 December 2021).
- Italian Ministry of Health. Circolare ministeriale n. 0025121-04/06/2021. Estensione di Indicazione di Utilizzo del Vaccino Comirnaty (BioNTech/Pfizer) per la Fascia di età tra i 12 e i 15 Anni. Aggiornamento Note Informative. [Extension of Indication of Use of the Comirnaty Vaccine (BioNTech/Pfizer) for the Age Group between 12 and 15 years. Information Notes Update]. Available online: https://www.trovanorme.salute.gov.it/norme/renderNormsanPdf?anno=2021&codLeg=80841&parte=1%20&serie=null (accessed on 12 December 2021).
- Ministero della Salute. Circolare ministeriale n. 0053886-25/11/2021. Estensione della Platea Vaccinale Destinataria della Dose “Booster” (di Richiamo) Nell’ambito della Campagna di Vaccinazione anti SARS-CoV-2/COVID-19. [Extension of the Vaccine Audience Receiving the “booster” Dose in the anti-SARS-CoV-2/COVID-19 Vaccination Campaign]. Available online: https://www.trovanorme.salute.gov.it/norme/renderNormsanPdf?anno=2021&codLeg=84077&parte=1%20&serie=null (accessed on 12 December 2021).
- Italian Ministry of Health. Circolare Ministeriale n. 0056429-07/12/2021. Estensione di Indicazione di Utilizzo del Vaccino Comirnaty (BioNTech/Pfizer) per la Fascia di Età 5–11 Anni. [Extension of Indication of Use of the Comirnaty Vaccine (BioNTech/Pfizer) for the Age Group 5–11 Years]. Available online: https://www.trovanorme.salute.gov.it/norme/renderNormsanPdf?anno=2021&codLeg=84353&parte=1%20&serie=null (accessed on 12 December 2021).
- Sallam, M. COVID-19 Vaccine hesitancy worldwide: A concise systematic review of vaccine acceptance rates. Vaccines 2021, 9, 160. [Google Scholar] [CrossRef] [Scilit]
- Yasmin, F.; Najeeb, H.; Moeed, A.; Naeem, U.; Asghar, M.; Chughtai, N.; Yousaf, Z.; Seboka, B.; Ullah, I.; Lin, C.; et al. COVID-19 vaccine hesitancy in the United States: A systematic review. Front. Public Health 2021, 9, 1877. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Rzymski, P.; Poniedziałek, B.; Fal, A. Willingness to receive the booster COVID-19 vaccine dose in Poland. Vaccines 2021, 9, 1286. [Google Scholar] [CrossRef] [Scilit]
- Sugawara, N.; Yasui-Furukori, N.; Fukushima, A.; Shimoda, K. Attitudes of Medical Students toward COVID-19 vaccination: Who is willing to receive a third dose of the vaccine? Vaccines 2021, 9, 1295. [Google Scholar] [CrossRef] [Scilit]
- Pal, S.; Shekhar, R.; Kottewar, S.; Upadhyay, S.; Singh, M.; Pathak, D.; Kapuria, D.; Barrett, E.; Sheikh, A. COVID-19 Vaccine hesitancy and attitude toward booster doses among US healthcare workers. Vaccines 2021, 9, 1358. [Google Scholar] [CrossRef] [Scilit]
- Alhasan, K.; Aljamaan, F.; Temsah, M.; Alshahrani, F.; Bassrawi, R.; Alhaboob, A.; Assiri, R.; Alenezi, S.; Alaraj, A.; Alhomoudi, R.; et al. COVID-19 Delta Variant: Perceptions, worries, and vaccine-booster acceptability among healthcare workers. Healthcare 2021, 9, 1566. [Google Scholar] [CrossRef] [Scilit]
- Yadete, T.; Batra, K.; Netski, D.M.; Antonio, S.; Patros, M.J.; Bester, J.C. Assessing acceptability of COVID-19 vaccine booster dose among adult Americans: A cross-sectional study. Vaccines 2021, 9, 1424. [Google Scholar] [CrossRef] [Scilit]
- Klugar, M.; Riad, A.; Mohanan, L.; Pokorná, A. COVID-19 vaccine booster hesitancy (VBH) of healthcare workers in Czechia: National cross-sectional study. Vaccines 2021, 9, 1437. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Tung, T.; Lin, X.; Chen, Y.; Zhang, M.; Zhu, J. Willingness to receive a booster dose of inactivated coronavirus disease 2019 vaccine in Taizhou, China. Expert Rev. Vaccines 2021. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Di Giuseppe, G.; Pelullo, C.P.; Della Polla, G.; Pavia, M.; Angelillo, I.F. Exploring the willingness to accept SARS-CoV-2 vaccine in a university population in Southern Italy, September to November 2020. Vaccines 2021, 9, 275. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Di Giuseppe, G.; Pelullo, C.P.; Della Polla, G.; Montemurro, M.V.; Napolitano, F.; Pavia, M.; Angelillo, I.F. Surveying willingness toward SARS-CoV-2 vaccination of healthcare workers in Italy. Expert Rev. Vaccines 2021, 20, 881–889. [Google Scholar] [CrossRef] [Scilit]
- Della Polla, G.; Pelullo, C.P.; Di Giuseppe, G.; Angelillo, I.F. Changes in behaviors and attitudes in response to COVID-19 pandemic and vaccination in healthcare workers and university students in Italy. Vaccines 2021, 9, 1276. [Google Scholar] [CrossRef] [Scilit]
- Shapiro, G.; Tatar, O.; Dube, E.; Amsel, R.; Knauper, B.; Naz, A.; Perez, S.; Rosberger, Z. The vaccine hesitancy scale: Psychometric properties and validation. Vaccine 2018, 36, 660–667. [Google Scholar] [CrossRef] [Scilit]
- Stata Corporation. Stata Reference Manual Release 15.1; Stata Corporation: College Station, TX, USA, 2017. [Google Scholar]
- Liu, Q.; Qin, C.; Liu, M.; Liu, J. Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: A systematic review and meta-analysis. Infect. Dis. Poverty 2021, 10, 132. [Google Scholar] [CrossRef] [Scilit]
- Zheng, C.; Shao, W.; Chen, X.; Zhang, B.; Wang, G.; Zhang, W. Real-world effectiveness of COVID-19 vaccines: A literature review and meta-analysis. Int. J. Infect. Dis. 2021, 114, 252–260. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Munro, A.; Janani, L.; Cornelius, V.; Aley, P.; Babbage, G.; Baxter, D.; Bula, M.; Cathie, K.; Chatterjee, K.; Dodd, K.; et al. Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): A blinded, multicentre, randomised, controlled, phase 2 trial. Lancet 2021, 398, 2258–2276. [Google Scholar] [CrossRef] [Scilit]
- Bellomo, N.; Bingham, R.; Chaplain, M.A.; Dosi, G.; Forni, G.; Knopoff, D.A.; Lowengrub, J.; Twarock, R.; Virgillito, M.E. A multiscale model of virus pandemic: Heterogeneous interactive entities in a globally connected world. Math. Models Methods Appl. Sci. 2020, 30, 1591–1651. [Google Scholar] [CrossRef] [Scilit]
- Napolitano, F.; Della Polla, G.; Angelillo, I.F. Knowledge, attitudes, and behaviors of parents towards recommended adult vaccinations: An explanatory survey in the geographic area of Naples, Italy. Int. J. Environ. Res. 2019, 16, 2070. [Google Scholar] [CrossRef] [Scilit]
- Pelullo, C.P.; Della Polla, G.; Napolitano, F.; Di Giuseppe, G.; Angelillo, I.F. Healthcare workers’ knowledge, attitudes, and practices about vaccinations: A cross-sectional study in Italy. Vaccines 2020, 8, 148. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Napolitano, F.; Della Polla, G.; Capano, M.; Augimeri, M.; Angelillo, I.F. Vaccinations and chronic diseases: Knowledge, attitudes, and self-reported adherence among patients in Italy. Vaccines 2020, 8, 560. [Google Scholar] [CrossRef] [Scilit]
- Ashkenazi, S.; Livni, G.; Klein, A.; Kremer, N.; Havlin, A.; Berkowitz, O. The relationship between parental source of information and knowledge about measles/measles vaccine and vaccine hesitancy. Vaccine 2020, 38, 7292–7298. [Google Scholar] [CrossRef] [Scilit]
- Kitro, A.; Sirikul, W.; Piankusol, C.; Rirermsoonthorn, P.; Seesen, M.; Wangsan, K.; Assavanopakun, P.; Surawattanasakul, V.; Kosai, A.; Sapbamrer, R. Acceptance, attitude, and factors affecting the intention to accept COVID-19 vaccine among Thai people and expatriates living in Thailand. Vaccine 2021, 39, 7554–7561. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- McLean, C.; Anderson, E. Brave men and timid women? A review of the gender differences in fear and anxiety. Clin. Psychol. Rev. 2009, 29, 496–505. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Rzymski, P.; Zeyland, J.; Poniedziałek, B.; Małecka, I.; Wysocki, J. The perception and attitudes toward COVID-19 vaccines: A cross-sectional study in Poland. Vaccines 2021, 9, 382. [Google Scholar] [CrossRef] [Scilit]
- Murphy, J.; Vallières, F.; Bentall, R.; Shevlin, M.; McBride, O.; Hartman, T.; McKay, R.; Bennett, K.; Mason, L.; Gibson-Miller, J.; et al. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat. Commun. 2021, 12, 29. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Szilagyi, P.; Thomas, K.; Shah, M.; Vizueta, N.; Cui, Y.; Vangala, S.; Kapteyn, A. Likelihood of COVID-19 vaccination by subgroups across the US: Post-election trends and disparities. Hum. Vaccines Immunother. 2021, 17, 3262–3267. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Kessels, R.; Luyten, J.; Tubeuf, S. Willingness to get vaccinated against COVID-19 and attitudes toward vaccination in general. Vaccine 2021, 39, 4716–4722. [Google Scholar] [CrossRef] [Scilit]
- Valckx, S.; Crèvecoeur, J.; Verelst, F.; Vranckx, M.; Hendrickx, G.; Hens, N.; Van Damme, P.; Pepermans, K.; Beutels, P.; Neyens, T. Individual factors influencing COVID-19 vaccine acceptance in between and during pandemic waves (July–December 2020). Vaccine 2021, 40, 151–161. [Google Scholar] [CrossRef] [Scilit]
| Characteristics | N | % | ||
|---|---|---|---|---|
| Age, Years | 32.1 ± 15.9 (19–76) * | |||
| Gender | ||||
| Female | 353 | 57.4 | ||
| Male | 262 | 42.6 | ||
| Marital status | ||||
| Unmarried/Separated/Divorced/Widowed | 476 | 77.4 | ||
| Married/Cohabited with a partner | 139 | 22.6 | ||
| Education level | ||||
| High school degree or less | 426 | 69.3 | ||
| Baccalaureate/Graduate degree | 189 | 30.7 | ||
| Number of children in home | ||||
| 0 | 511 | 83.1 | ||
| ≥1 | 104 | 16.9 | ||
| Number of cohabitants | ||||
| 0 | 32 | 5.2 | ||
| 1–3 | 417 | 67.8 | ||
| >3 | 166 | 27 | ||
| Role | ||||
| Student | 437 | 71.1 | ||
| Other | 178 | 28.9 | ||
| Having at least a chronic medical condition | ||||
| No | 542 | 88.1 | ||
| Yes | 73 | 11.9 | ||
| Having been infected with SARS-CoV-2 | ||||
| No | 556 | 90.4 | ||
| Yes | 59 | 9.6 | ||
| Having friends or family members who were diagnosed with COVID-19 | ||||
| No | 63 | 10.2 | ||
| Yes | 552 | 89.8 | ||
| Self-rated global health status | 8.3 ± 1.3 (1–10) * | |||
| Self-rated health status after the first dose of the COVID-19 vaccination | 8.1 ± 1.5 (1–10) * | |||
| Self-rated health status after the second dose of the COVID-19 vaccination | 8.1 ± 1.5 (1–10) * | |||
| Variable | Coeff. | SE | t | p |
|---|---|---|---|---|
| Model 1. Perceived risk of being infected by SARS-CoV-2 F (4, 610) = 13.93, p < 0.0001, R2 = 8.37%, adjusted R2 = 7.77% | ||||
| Female | 1.23 | 0.18 | 6.62 | <0.001 |
| Number of cohabitants | ||||
| 0 | −0.99 | 0.41 | −2.39 | 0.017 |
| 1–3 | 1.00 * | |||
| >3 | −0.27 | 0.2 | −1.33 | 0.186 |
| No need for additional information regarding the booster dose of the COVID-19 vaccine | 0.31 | 0.18 | 1.68 | 0.093 |
| OR | SE | 95%CI | p | |
| Model 2. Willingness to receive the booster dose of the COVID-19 vaccine Log likelihood = −233.34, χ2 = 38.26 (7 df), p < 0.0001 | ||||
| No need for additional information regarding the booster dose of the COVID-19 vaccine | 0.46 | 0.11 | 0.28–0.74 | 0.002 |
| Higher self-rated health status after the second dose of COVID-19 vaccination | 1.22 | 0.08 | 1.07–1.40 | 0.003 |
| Having received information regarding the booster dose of the COVID-19 vaccine from official government organization | 1.68 | 0.41 | 1.03–2.73 | 0.034 |
| Older | 1.03 | 0.01 | 1.01–1.07 | 0.042 |
| Having friends or family members who were diagnosed with COVID-19 | 2.00 | 0.68 | 1.02–3.92 | 0.043 |
| Having at least a chronic medical condition | 1.66 | 0.75 | 0.68–4.04 | 0.258 |
| Student | 0.63 | 0.32 | 0.23–1.71 | 0.372 |
| Model 3. Booster dose COVID-19 vaccine hesitancy Log likelihood = −310.68, χ2 = 66.43 (8 df), p < 0.0001 | ||||
| Need of additional information regarding the booster dose of the COVID-19 vaccine | 2.29 | 0.46 | 1.54–3.41 | <0.001 |
| Not having friends or family members who were diagnosed with COVID-19 | 0.35 | 0.10 | 0.20–0.63 | <0.001 |
| Not having received information regarding the booster dose of the COVID-19 vaccine from official government organization | 0.49 | 0.10 | 0.32–0.73 | 0.001 |
| Lower self-rated health status after the second dose of COVID-19 vaccination | 0.82 | 0.07 | 0.69–0.98 | 0.032 |
| Married/cohabited with a partner | 1.48 | 0.35 | 0.92–2.37 | 0.102 |
| Number of cohabitants | ||||
| 0 | 1.62 | 0.69 | 0.70–3.77 | 0.255 |
| 1–3 | 1.00 * | |||
| >3 | 1.40 | 0.32 | 0.89–2.21 | 0.136 |
| Lower self-rated health status after the first dose of COVID-19 vaccination | 0.90 | 0.08 | 0.76–1.07 | 0.265 |
| Item | Participants’ Response | N | % |
|---|---|---|---|
| The booster dose of COVID-19 vaccine is important for my health | Disagree | 14 | 2.2 |
| Not sure | 76 | 12.4 | |
| Agree | 525 | 85.4 | |
| The booster dose of COVID-19 vaccine is efficacy | Disagree | 10 | 1.6 |
| Not sure | 151 | 24.5 | |
| Agree | 454 | 73.9 | |
| It’s important getting the booster dose of COVID-19 vaccine to protect you and those around you | Disagree | 13 | 2.1 |
| Not sure | 54 | 8.8 | |
| Agree | 548 | 89.1 | |
| The booster dose of COVID-19 vaccine is useful | Disagree | 12 | 1.9 |
| Not sure | 91 | 14.8 | |
| Agree | 512 | 83.3 | |
| The booster dose of COVID-19 is more dangerous than the first and the second dose | Disagree | 327 | 53.2 |
| Not sure | 242 | 39.3 | |
| Agree | 46 | 7.5 | |
| The information I receive from the Ministry of Health on the booster dose of the COVID-19 vaccine is reliable | Disagree | 27 | 4.4 |
| Not sure | 142 | 23.1 | |
| Agree | 446 | 72.5 | |
| Getting the booster dose of the COVID-19 vaccine is an effective strategy to protect me from the disease | Disagree | 14 | 2.3 |
| Not sure | 92 | 14.9 | |
| Agree | 509 | 82.8 | |
| I follow my doctor’s advice about the booster dose of the COVID-19 vaccine | Disagree | 20 | 3.2 |
| Not sure | 86 | 14 | |
| Agree | 509 | 82.8 | |
| I am worried about a serious side effect after getting the booster dose of the COVID-19 vaccine | Disagree | 272 | 44.2 |
| Not sure | 183 | 29.7 | |
| Agree | 160 | 26.1 | |
| I don’t need the booster dose of the COVID-19 vaccine | Disagree | 447 | 72.7 |
| Not sure | 133 | 21.6 | |
| Agree | 35 | 5.7 |
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Folcarelli, L.; Miraglia del Giudice, G.; Corea, F.; Angelillo, I.F. Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy. Vaccines 2022, 10, 146. https://doi.org/10.3390/vaccines10020146
Folcarelli L, Miraglia del Giudice G, Corea F, Angelillo IF. Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy. Vaccines. 2022; 10(2):146. https://doi.org/10.3390/vaccines10020146
Chicago/Turabian StyleFolcarelli, Lucio, Grazia Miraglia del Giudice, Francesco Corea, and Italo F. Angelillo. 2022. "Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy" Vaccines 10, no. 2: 146. https://doi.org/10.3390/vaccines10020146
APA StyleFolcarelli, L., Miraglia del Giudice, G., Corea, F., & Angelillo, I. F. (2022). Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy. Vaccines, 10(2), 146. https://doi.org/10.3390/vaccines10020146

