title: E-health use, vaccination knowledge and perception of own risk: drivers of vaccination uptake in medical students.
abstract: OBJECTIVE
  was to improve understanding of mechanisms contributing to healthcare personnel's (HCP) reluctance to get vaccinated against seasonal influenza. We assessed the role of several drivers: vaccination knowledge, vaccination recommendations and the role of the Internet (so-called e-health) in creating vaccination knowledge. The key mechanism under consideration was the perceived own risk (regarding disease and the vaccine).
  
  
  METHODS
  310 medical students at the Frankfurt University Hospital answered an anonymous questionnaire assessing risk perceptions, intentions to get vaccinated, knowledge, preferences regarding information sources for personal health decisions and search-terms that they would use in a Google-search directed at seasonal influenza vaccination.
  
  
  RESULTS
  The key driver of vaccination intentions was the perceived own risk (of contracting influenza and of suffering from vaccine adverse events). The recommendation to get vaccinated was a significant, yet weaker predictor. As an indirect driver we identified one's knowledge concerning vaccination. 32% of the knowledge questions were answered incorrectly or as don't know. 64% of the students were e-health users; therefore, additional information search via the Internet was likely. An analysis of the websites obtained by googling the search-terms provided by the students revealed 30% commercial e-health websites, 11% anti-vaccination websites and 10% public health websites. Explicit searches for vaccination risks led to fewer public health websites than searches without risk as a search term. Content analysis of the first three websites obtained revealed correct information regarding the questions of whether the doses of vaccine additives were dangerous, whether chronic diseases are triggered by vaccines and whether vaccines promote allergies in 58%, 53% and 34% of the websites, respectively. These questions were especially related to own risk, which strongly predicted intentions. Correct information on vaccination recommendations were provided on 85% of the websites.
  
  
  CONCLUSIONS
  Concentrating on the key drivers in early medical education (own risk of contracting influenza, vaccine safety, vaccination recommendation) promises to be a successful combination to increase vaccination uptake in HCP.
authors.affiliation: Center for Empirical Research in Economics andBehavioral Sciences, University of Erfurt, Germany. cornelia.betsch@uni-erfurt.de
authors.forename: Cornelia
authors.initials: C
authors.lastname: Betsch
authors.forename: Sabine
authors.initials: S
authors.lastname: Wicker
mesh_terms: D004501:Education, Medical / Q000379:methods; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D013337:Students, Medical; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines