Knowledge of University Students in Health Care Settings on Vaccines and Vaccinations Strategies: Impact Evaluation of a Specific Educational Training Course during the COVID-19 Pandemic Period in Italy

Round 1

Reviewer 1 Report

I would like to thank MDPI and Vaccines for the possibility to review this work.

Authors must indicate a number of key points in order to accept the article:

- What is the student population. We know the sample, but not the general framework.

- Same with residents or postgraduate school of Hygiene and Preventive Medicine.

- In the statistical analysis they should specify whether they have used normality tests.

- This is research, but they do not reflect whether there is a favourable report from an ethics or research committee. This is an essential aspect of any research, even if all anonymity requirements have been met, although the authors insist that "ethical approval was not required". They must justify this aspect with national or international legislation.

- Demographic data on respondents such as gender ratio or age would be missing.

Author Response

We would like to thank the reviewer for his/her comments and suggestions. We reply to referee's comments in attached file. All changes in the manuscript were made using the Track Changes style.

Author Response File: Author Response.docx

Reviewer 2 Report

This manuscript presents the outcome of a training course on vaccination in the curriculum for students in Medicine and Surgery (n=261), students in Pharmacy (n=165), and residents in in Hygiene and Preventive Medicine (23), all at the University of Florence, Italy. This course, described as Elective Teaching Activity (ETA), was a course that could be voluntarily selected by the students as part of their study program. A questionnaire comprising 30 multiple-choice questions: 3 in each of the topics “Knowledge about vaccines”, “COVID-19 vaccines”, “Vaccine development”, “COVID-19 vaccine development, “Quility Control and GMPs”, “Vaccines in community pharmacy”, “Pharmacovigilance of vaccines”, “False myths on vaccines”, ”Italian national immunization plan”, and “HTA”. The course given in the first quarter of 2021 included 16 hours. The analysis was done regarding the increase in knowledge and the reduction in incorrect answers: statistical analysis was conducted by simple parametric tests. The data showed a significant improvement in knowledge and a reduction in incorrect answers.

This is an interesting study demonstrating that a specific 16-hr course on vaccines in the university training of students in medical disciplines leads to improvements in knowledge: this is considered relevant in relation to the increase in vaccine hesitance in society, requiring sufficient training of health professionals in providing information and advice. The text is well written and the conclusions are correct.

There are a few points to be considered in revision:

·        Considering the magnitude of SD values, it is advised to bring numerical data without digits behind the comma

·        Results “Each correct answer was assigned a score, for a total score of 32 points (passing grade 18 points).” It is not clear how 30 questions can result in 32 points. This also regards the number of 32 in the results.

·        Table 2: data on percentual increase in score are given for the average scores before and after the course in a given group. It would be interesting to present this for the scores for individual students, and calculate the average of the percentages calculated for individuals.

·        Table 2 and 3: it is advised to include the numbers of students in a separate column.

·        Table 4 presents data in a different way when compared with those in Tables 2 and 3. This is somewhat confusing. Also this table shows differences with the tables in supplementary information. The authors are advised to present data at the level of individual students, if possible. The corresponding text in the results, presenting the summaries, could easily be implemented in the table. The references in the text to questions are not readable, and could be reduced to only “Question XX”. It is advised to synchronize the descriptors in subsections of table 4 and the tables in the supplementary information and figure 1.

·        Figure 1 is difficult to read. Also, the terminology in the headings differs from that in the tables. This also regards the corresponding text in the results.

·        The abbreviation HTA is not explained.

Author Response

We would like to thank the reviewer for his/her comments and suggestions. We reply to referee's comments in attached file. All changes in the manuscript were made using the Track Changes style.

Author Response File: Author Response.docx