title: Improvement in attitudes toward influenza vaccination in medical students following an integrated curricular intervention.
abstract: BACKGROUND
  Vaccination of health care workers (HCW) reduces transmission of influenza among patients, yet uptake of vaccination remains low. If vaccination education is integrated into the early medical school curriculum, will student attitudes toward the vaccine change? The objectives of the study were to: (1) Determine influenza vaccination rates among entering medical students; (2) Assess the attitudes toward influenza vaccination; (3) Evaluate the effects of a multifaceted educational intervention on attitudes to vaccination.
  
  
  METHODS
  Entering medical students were surveyed before and after an intervention at the beginning of the influenza season. This intervention provided by an inter-professional team, included education about influenza, importance of vaccination for HCWs, followed by vaccination administration practice, and ended with students vaccinating consenting classmates.
  
  
  RESULTS
  The pre-intervention surveys and intervention were completed by 124 of 125 (99%) students. Pre-intervention survey revealed 60 (48%) of students had been previously vaccinated. Of the vaccinated students 91% had been recommended vaccination by their healthcare provider compared to 43% of non-vaccinated students. More positive attitudes were noted in the vaccinated students compared to non-vaccinated students: importance of vaccination (p<0.01); HCWs should be vaccinated (p<0.01); recommendation of vaccine to family and friends (p<0.01). 97 (78%) students completed post-intervention surveys. Significant improvement in these attitudes was noted post-intervention compared to pre-intervention: importance of vaccination 93% versus 71% (p<0.01); HCWs should be vaccinated 95% versus 83% (p<0.01); recommendation to family and friends 93% versus 73% (p<0.01); comfort with vaccine counseling 92% versus 41%; comfort with vaccine administration 84% versus 22% (p<0.01).
  
  
  CONCLUSIONS
  Educating medical students and promoting the importance of vaccination early in a medical student's career using such an intervention is relatively simple and easily integrated into the curriculum. This intervention was successful in vaccinating all students, and demonstrated a marked positive shift in attitudes toward influenza vaccination.
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI, United States. Electronic address: afonso@oakland.edu.
authors.forename: Nelia
authors.initials: N
authors.lastname: Afonso
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI, United States.
authors.forename: Maurice
authors.initials: M
authors.lastname: Kavanagh
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI, United States.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Swanberg
mesh_terms: D001291:Attitude of Health Personnel; D003479:Curriculum; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control; D013337:Students, Medical / Q000523:psychology*; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines
keywords: Attitudes; Educational intervention; Influenza vaccine; Medical students