Romanian Medical Students’ Attitude towards and Perceived Knowledge on COVID-19 Vaccination
2. Materials and Methods
3.1. The Study Population
3.2. COVID-19 Infection and Vaccination
3.3. Attitude towards Vaccination
3.4. Perceived Knowledge on COVID-19 Vaccination
3.5. Safety and Efficacy
3.6. Attitude towards Other Vaccines
3.7. Perception towards Vaccine Hesitancy in the General Population
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Questionnaire
- WHO; Shimizu, Y. Vaccines and Immunization. 2019. Available online: https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1 (accessed on 4 June 2021).
- Popescu, C.P.; Marin, A.; Melinte, V.; Gherlan, G.S.; Banicioiu, F.C.; Dogaru, A.; Smadu, S.; Veja, A.M.; Nedu, E.; Stanciu, D.; et al. COVID-19 in a tertiary hospital from Romania: Epidemiology, preparedness and clinical challenges. Travel Med. Infect. Dis. 2020, 35, 101662. [Google Scholar] [CrossRef] [PubMed]
- CNSCBT-COVID-19 Weekly Surveillance Report—Data Reported until 18th of July. Available online: https://www.cnscbt.ro/index.php/analiza-cazuri-confirmate-covid19/2585-raport-saptamanal-episaptamana28-2021/file (accessed on 21 July 2021).
- European Medicines Agency Comirnaty EU Product Information. 2020. Available online: https://www.ema.europa.eu/en/documents/product-information/comirnaty-epar-product-information_ro.pdf (accessed on 4 June 2021).
- National Coordinating Committee for Vaccination Programme against COVID-19-Report of Number of People Vaccinated Against COVID-19 on 20th of July. Available online: https://vaccinare-covid.gov.ro/actualizare-zilnica-20-07-evidenta-persoanelor-vaccinate-impotriva-covid-19/ (accessed on 21 July 2021).
- CNSCBT-COVID-19-Assessment of the Current National Situation and Future Outlook. Available online: https://www.cnscbt.ro/index.php/analiza-cazuri-confirmate-covid19/2584-evaluare-situatie-si-perspectiva-14-07-2021/file (accessed on 21 July 2021).
- Gallup. Wellcome Global Monitor—How Does the World Feel about Science and Health, 2018. Available online: https://wellcome.org/sites/default/files/wellcome-global-monitor-2018.pdf (accessed on 4 June 2021).
- WHO/R. Akbar Ten Threats to Global Health in 2019. Available online: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019 (accessed on 4 June 2021).
- Australian Bureau of Statistics—Sample Size Calculator. Available online: https://www.abs.gov.au/websitedbs/d3310114.nsf/home/sample+size+calculator (accessed on 11 May 2021).
- Szmyd, B.; Bartoszek, A.; Karuga, F.F.; Staniecka, K.; Błaszczyk, M.; Radek, M. Medical Students and SARS-CoV-2 Vaccination: Attitude and Behaviors. Vaccines 2021, 9, 128. [Google Scholar] [CrossRef] [PubMed]
- Jain, J.; Saurabh, S.; Kumar, P.; Verma, M.; Goel, A.; Gupta, M.; Bhardwaj, P.; Raghav, P. COVID-19 vaccine hesitancy among medical students in India. Epidemiol. Infect. 2021, 149, e132. [Google Scholar] [CrossRef] [PubMed]
- Kanyike, A.M.; Olum, R.; Kajjimu, J.; Ojilong, D.; Akech, G.M.; Nassozi, D.R.; Agira, D.; Wamala, N.K.; Asiimwe, A.; Matovu, D.; et al. Acceptance of the coronavirus disease-2019 vaccine among medical students in Uganda. Trop. Med. Health 2021, 49, 37. [Google Scholar] [CrossRef] [PubMed]
- Saied, S.M.; Saied, E.M.; Kabbash, I.A.; Abdo, S.A.E. Vaccine hesitancy: Beliefs and barriers associated with COVID-19 vaccination among Egyptian medical students. J. Med. Virol. 2021, 93, 4280–4291. [Google Scholar] [CrossRef] [PubMed]
- Lucia, V.C.; Kelekar, A.; Afonso, N.M. COVID-19 vaccine hesitancy among medical students. J. Public Health 2020, fdaa230. [Google Scholar] [CrossRef] [PubMed]
- INSCOP Research—Public Perception over Romanians’ Trust in COVID-19 Vaccination. Available online: https://www.inscop.ro/08-februarie-2021-perceptia-publica-asupra-vaccinarii-increderea-romanilor-in-vaccinarea-anti-covid19-capitolul-i/ (accessed on 8 February 2021).
- Statista, J.A. Most Important Reasons for Refusing the Vaccine against COVID-19 in Romania 2020. Available online: https://www.statista.com/statistics/1195987/romania-reasons-for-refusing-the-vaccine-against-covid-19/ (accessed on 13 January 2021).
- Miko, D.; Costache, C.; Colosi, H.A.; Neculicioiu, V.; Colosi, I.A. Qualitative Assessment of Vaccine Hesitancy in Romania. Medicina 2019, 55, 282. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Montagni, I.; Ouazzani-Touhami, K.; Mebarki, A.; Texier, N.; Schück, S.; Tzourio, C. The CONFINS group, Acceptance of a Covid-19 vaccine is associated with ability to detect fake news and health literacy. J. Public Health 2021, fdab028. [Google Scholar] [CrossRef]
- Freeman, D.; Loe, B.S.; Yu, L.M.; Freeman, J.; Chadwick, A.; Vaccari, C.; Shanyinde, M.; Harris, V.; Waite, F.; Rosebrock, L.; et al. Effects of different types of written vaccination information on COVID-19 vaccine hesitancy in the UK (OCEANS-III): A single-blind, parallel-group, randomised controlled trial. Lancet Public Health 2021, 6, e416–e427. [Google Scholar] [CrossRef]
- Hildreth, J.; Alcendor, D.J. Targeting COVID-19 Vaccine Hesitancy in Minority Populations in the US: Implications for Herd Immunity. Vaccines 2021, 9, 489. [Google Scholar] [CrossRef] [PubMed]
- Freeman, D.; Lambe, S.; Yu, L.; Freeman, J.; Chadwick, A.; Vaccari, C.; Waite, F.; Rosebrock, L.; Petit, A.; Vanderslott, S.; et al. Injection fears and COVID-19 vaccine hesitancy. Psychol. Med. 2021, 1–24. [Google Scholar] [CrossRef] [PubMed]
|Factors||Overall Respondents (n = 1581)||Pro-Vaccine Group (n = 1399)||Undecided Group (n = 123)||Vaccine Resistant Group (n = 59)||p-Value|
|Midwifery and Nursery||44||2.8%||34||2.4%||7||5.7%||3||5.1%|
|Trust efficacy of COVID-19 vaccines|
|Trust safety of COVID-19 vaccines|
|Opinion: COVID-19 vaccines were developed too fast|
|Neither agree nor disagree||397||25.1%||358||25.6%||32||26.0%||7||11.9%|
|mRNA knowledge self-assessment|
|A lot and can easily explain to others||515||32.6%||478||34.2%||24||19.5%||13||22.0%||<0.001|
|A lot, but find it hard to explain to others||452||28.6%||409||29.2%||29||23.6%||14||23.7%|
|Intermediate amount of knowledge||514||32.5%||442||31.6%||48||39.0%||24||40.7%|
|Little knowledge on the subject||78||4.9%||55||3.9%||16||13.0%||7||11.9%|
|Too little or no knowledge at all||22||1.4%||15||1.1%||6||4.9%||1||1.7%|
|Concern over possible allergic or adverse reaction|
|Neither agree nor disagree||377||23.8%||332||23.7%||33||26.8%||12||20.3%|
|Concern over possible long-term adverse reaction|
|Neither agree nor disagree||330||20.9%||313||22.4%||13||10.6%||4||6.8%|
|Full immunization as per national scheme|
|I don′t know||275||17.4%||230||16.4%||31||25.2%||14||23.7%|
|Opinion: it is necessary to be immunized as per national scheme|
|As future parent: vaccination acceptance|
|As future medical care provider: vaccination recommendation|
|Vaccinated against the flu this season?|
|General Theme||Cited Opinion|
|Information and knowledge||“[…] not even the pro-vaccine side can be efficient in informing the greater public, if they do not adjust the information to the average level of understanding.”|
|“The anti-science propaganda started from the misunderstanding, or lack of understanding, regarding notions of basic biology and physiology.”|
|“Many public figures without any medical training have stepped forward on social media and spread their opinions containing wrong or misunderstood medical information, thus confusing the public.”|
|“There is a general ignorance regarding health issues among common people, “If it does not hurt, it does not need to be treated.”|
|“(…) due to unauthorized sources of information, people have doubts over the content of the vaccine itself, some unreliable media outlets even suggesting they might contain foreign tracking devices, while at the same time placing emphasis on trusting plant-based medicine.”|
|Emotional response||“(…) the feeling of being overwhelmed by such a massive event—a pandemic—lead to people using reluctance as a coping mechanism.”|
|“I have felt personally affected by articles with fake information or conspiracy theories; however illogical they may be, it suffices if they allow for the feeling of restlessness and mistrust to collectively appear.”|
|“As far as the long-term adverse reaction theories go, there is still a number of people who believe and fear that the vaccine is the source of future neoplasms or fertilty issues.”|
|“The reluctance comes from the fact that there are insufficient studies proving long-term efficiency of the vaccine; therefore, people believe they are going to need boosters every three months or so.”|
|“There are still doubts regarding whether the vaccine lowers the transmisibility of the virus, when the vaccinated person is infected or exposed.”|
|“(…) the fact that most people feel disappointed by our national medical system and thus easily reach the conclusion that the national immunization campaign is driven by other purposes than simply vaccinating men and women.”|
|“People believe that the vaccine is still being tested on the general population, due to its hasty development.”|
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Bălan, A.; Bejan, I.; Bonciu, S.; Eni, C.E.; Ruță, S. Romanian Medical Students’ Attitude towards and Perceived Knowledge on COVID-19 Vaccination. Vaccines 2021, 9, 854. https://doi.org/10.3390/vaccines9080854
Bălan A, Bejan I, Bonciu S, Eni CE, Ruță S. Romanian Medical Students’ Attitude towards and Perceived Knowledge on COVID-19 Vaccination. Vaccines. 2021; 9(8):854. https://doi.org/10.3390/vaccines9080854Chicago/Turabian Style
Bălan, Ana, Ioana Bejan, Simona Bonciu, Cristina Elena Eni, and Simona Ruță. 2021. "Romanian Medical Students’ Attitude towards and Perceived Knowledge on COVID-19 Vaccination" Vaccines 9, no. 8: 854. https://doi.org/10.3390/vaccines9080854