Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis

Abstract Background It is well known that, to be effective, vaccination programs require a high and consistent population uptake. Nevertheless, vaccine coverage is often insufficient. University students occupy a unique position within the broader population: they are highly mobile and socially acti...

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Main Authors: Ilaria Mussetto, Maria Chiara Bernucci, Anna Ewa Kaminska, Claudia Isonne, Antonio Sciurti, Giuseppe Migliara, Erika Renzi, Azzurra Massimi, Carolina Marzuillo, Corrado De Vito, Paolo Villari, Valentina Baccolini
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Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22697-1
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author Ilaria Mussetto
Maria Chiara Bernucci
Anna Ewa Kaminska
Claudia Isonne
Antonio Sciurti
Giuseppe Migliara
Erika Renzi
Azzurra Massimi
Carolina Marzuillo
Corrado De Vito
Paolo Villari
Valentina Baccolini
author_facet Ilaria Mussetto
Maria Chiara Bernucci
Anna Ewa Kaminska
Claudia Isonne
Antonio Sciurti
Giuseppe Migliara
Erika Renzi
Azzurra Massimi
Carolina Marzuillo
Corrado De Vito
Paolo Villari
Valentina Baccolini
author_sort Ilaria Mussetto
collection DOAJ
description Abstract Background It is well known that, to be effective, vaccination programs require a high and consistent population uptake. Nevertheless, vaccine coverage is often insufficient. University students occupy a unique position within the broader population: they are highly mobile and socially active individuals who serve as influential figures among their peers and younger age groups, making them an ideal target for educational campaigns. Methods This review (CRD42022309724) quantified the vaccination intention rates for routine immunizations in university students and systematically examined the determinants of vaccination acceptance. Cross-sectional studies that analyzed vaccination intention for at least one routine immunization using multivariable logistic regression were included. We used random-effects models to calculate the pooled proportions of vaccination intention. Determinants were categorized into contextual factors (such as socio-demographic, economic and cultural factors), individual/group factors (such as knowledge, awareness, peer opinions, infection risk perceptions) and vaccine-specific issues (such as vaccine effectiveness and vaccination policies). Results Thirty-six articles were included: 29 on the human papilloma virus (HPV) vaccine and seven on the influenza vaccine. The pooled proportion of students intending to get vaccinated was 54% (95% CI: 47–60%) for HPV and 43% (95% CI: 26–61%) for influenza. The strongest positive determinants were individual/group factors, such as higher knowledge and awareness, pro-vaccine peer opinions, positive personal experience with vaccinations, and higher risk perception for HPV infection, and higher risk perception for infection and previous vaccination history for influenza. By contrast, contextual influences played a minor role in both vaccinations, while vaccine-specific concerns, particularly about costs and availability, negatively influenced intention for both vaccines. Conclusions Given the suboptimal rates of vaccination intention towards HPV and influenza vaccine that we found, addressing key determinants, such as awareness of infection risks and perception of vaccination benefits, is essential to increase vaccination acceptance in university students and to achieve high vaccination coverage.
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spelling doaj-art-13f9dbb6110144709b52048806d7a47b2025-08-20T03:18:41ZengBMCBMC Public Health1471-24582025-04-0125111810.1186/s12889-025-22697-1Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysisIlaria Mussetto0Maria Chiara Bernucci1Anna Ewa Kaminska2Claudia Isonne3Antonio Sciurti4Giuseppe Migliara5Erika Renzi6Azzurra Massimi7Carolina Marzuillo8Corrado De Vito9Paolo Villari10Valentina Baccolini11Department of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Life Sciences, Health, and Health Professions, Link Campus UniversityDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeDepartment of Public Health and Infectious Diseases, Sapienza University of RomeAbstract Background It is well known that, to be effective, vaccination programs require a high and consistent population uptake. Nevertheless, vaccine coverage is often insufficient. University students occupy a unique position within the broader population: they are highly mobile and socially active individuals who serve as influential figures among their peers and younger age groups, making them an ideal target for educational campaigns. Methods This review (CRD42022309724) quantified the vaccination intention rates for routine immunizations in university students and systematically examined the determinants of vaccination acceptance. Cross-sectional studies that analyzed vaccination intention for at least one routine immunization using multivariable logistic regression were included. We used random-effects models to calculate the pooled proportions of vaccination intention. Determinants were categorized into contextual factors (such as socio-demographic, economic and cultural factors), individual/group factors (such as knowledge, awareness, peer opinions, infection risk perceptions) and vaccine-specific issues (such as vaccine effectiveness and vaccination policies). Results Thirty-six articles were included: 29 on the human papilloma virus (HPV) vaccine and seven on the influenza vaccine. The pooled proportion of students intending to get vaccinated was 54% (95% CI: 47–60%) for HPV and 43% (95% CI: 26–61%) for influenza. The strongest positive determinants were individual/group factors, such as higher knowledge and awareness, pro-vaccine peer opinions, positive personal experience with vaccinations, and higher risk perception for HPV infection, and higher risk perception for infection and previous vaccination history for influenza. By contrast, contextual influences played a minor role in both vaccinations, while vaccine-specific concerns, particularly about costs and availability, negatively influenced intention for both vaccines. Conclusions Given the suboptimal rates of vaccination intention towards HPV and influenza vaccine that we found, addressing key determinants, such as awareness of infection risks and perception of vaccination benefits, is essential to increase vaccination acceptance in university students and to achieve high vaccination coverage.https://doi.org/10.1186/s12889-025-22697-1University studentsRoutine vaccinationsHPVInfluenzaSystematic reviewMeta-analysis
spellingShingle Ilaria Mussetto
Maria Chiara Bernucci
Anna Ewa Kaminska
Claudia Isonne
Antonio Sciurti
Giuseppe Migliara
Erika Renzi
Azzurra Massimi
Carolina Marzuillo
Corrado De Vito
Paolo Villari
Valentina Baccolini
Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
BMC Public Health
University students
Routine vaccinations
HPV
Influenza
Systematic review
Meta-analysis
title Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
title_full Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
title_fullStr Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
title_full_unstemmed Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
title_short Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis
title_sort prevalence and determinants of vaccination intention towards routine immunizations in university students a systematic review and meta analysis
topic University students
Routine vaccinations
HPV
Influenza
Systematic review
Meta-analysis
url https://doi.org/10.1186/s12889-025-22697-1
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