Knowledge, attitudes, beliefs, and behaviors of university students, faculty, and staff during a meningococcal serogroup B outbreak vaccination program

Abstract

Objectives

During an outbreak of invasive meningococcal B disease on a university campus, we explored the knowledge, attitudes, beliefs, and behaviors of members of the university community in relation to the disease, the vaccine, and the vaccination program.

Design

All students, faculty and staff were invited by email to participate in a 71-item online survey, which was administered after completion of the mass clinics for the first and second doses of a meningococcal B vaccination program.

Results

A total of 404 individuals responded to the survey; 75.7% were students. Knowledge about meningococcal disease and vaccine was generally high; more than 70% correct responses were received on each knowledge question except for one question about the different meningococcal serogroups. Gender (female) and higher knowledge scores were significantly associated with either being immunized or intending to be immunized (p < 0.05). Positive attitudes about immunization, concern about meningococccal infection, a sense of community responsibility, and trust in public health advice also correlated with being vaccinated or intending to be vaccinated (p < 0.05).

Conclusions

A successful mass vaccination program in a Nova Scotia university was associated with high levels of knowledge, positive attitudes toward vaccination, and positive attitudes toward public health recommendations.

Introduction

Since the incorporation of meningococccal C conjugate vaccine (MenC) into the routine infant and adolescent immunization programs, serogroup B is now the most common cause of invasive meningococcal disease (IMD) in Canada [1], [2]. In December 2013, a serogroup B vaccine (4CMenB, Bexsero®, GlaxoSmithKline, Inc., Mississauga, ON) was authorized for use for children and adolescents 2 months through 17 years of age but has not been incorporated into the routine immunization schedule [3]. The 4CMenB vaccine was used to control outbreaks of IMD on two university campuses in the US prior to its licensure [4], [5] and to control a regional outbreak of group B IMD in Saguenay–Lac-Saint-Jean, Quebec, in 2014 [6].

In February 2015, serotype B IMD was identified in two students at a small, residential university in Nova Scotia. The Nova Scotia Department of Health and Wellness implemented a two-dose 4CMenB vaccination program at the university for all students and for faculty and staff with health conditions that would put them at risk. The Canadian Immunization Research Network (CIRN) collaborated with public health and university officials to estimate the frequency of health events (sufficient severity to lead to a visit to a healthcare provider, hospitalization, or interfere with normal activity) associated with the 4CMenB vaccine through an on-line safety survey [7]. CIRN also invited all students, faculty, and staff to participate in a separate, on-line survey to evaluate the knowledge, attitudes, beliefs, and behaviors related to IMD, 4CMenB, and the immunization program. The objective of the study was to identify factors that were associated with positive attitudes about immunization, acceptance of the vaccine, and preferred data sources for receiving information about the disease and vaccine.