Freshman Flu Vaccination Behavior and Intention During a Nonpandemic Season

Objective. To examine predictors of flu vaccination and vaccination intention among college freshmen during a nonpandemic influenza season using the health belief model (HBM). Participants. A total of 184 college freshmen at a single institution participated in a mixed-mode (paper or online) survey in October-November 2015. Method. Flu vaccination and intention to vaccinate were predicted using binomial logistic regression on HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and availability), prior flu vaccination history, family and peer reference behaviors, and demographics. Results. Overall, 31.5% of participants received the seasonal flu vaccine by mid-November, and 25% intended to receive it. In full models, history of past flu vaccination (adjusted odds ratio [aOR] = 7.90; 95% confidence interval [CI] = 2.55-24.49) was significant for vaccination while availability (aOR = 2.00; 95% CI = 1.32-3.01) and family intention (aOR = 250.59; 95% CI = 3.77 to >999) were positively associated with intent to vaccinate. Significant confounding by past behavior and family intentions existed for both outcomes. Conclusions. Past flu vaccination behavior and family member intentions to vaccinate were better predictors of annual flu vaccination behavior and intention than HBM constructs among college freshmen. College campuses may enhance flu vaccine coverage by highlighting benefits and availability to students and families.