title: Determinants of students' willingness to accept a measles-mumps-rubella booster vaccination during a mumps outbreak: a cross-sectional study.
abstract: BACKGROUND
  Despite high vaccination coverage, a mumps outbreak that affected mainly vaccinated university students and their contacts took place in the Netherlands in the period 2009-2012. We presented university students with a hypothetical case in which we offered them a measles, mumps, and rubella (MMR) booster vaccination to control the mumps outbreak. The aim of this study was to get insight into the determinants of university students' willingness to accept this vaccination.
  
  
  METHODS
  A questionnaire containing 38 items was developed for the purpose of assessing students' willingness and the psychosocial and social demographic determinants influencing their willingness to accept an MMR booster vaccination. In addition, we explored how organisational characteristics influenced the willingness to be vaccinated. Data were collected at six Dutch universities; a total of 790 students from various faculties were invited to participate. This was a convenience sampling procedure.
  
  
  RESULTS
  687 university students participated (response rate 87.0%) and 60.4% of the participants said they would be willing accept the hypothetical MMR booster vaccination. The perceived seriousness of mumps (OR 6.1) was the most important predictor of willingness to accept vaccination. Students who expected the MMR vaccination to be effective and to prevent individual illness and who believed their own vaccination would help stop the epidemic were more likely to be willing than others. The students were more willing to accept vaccination when they perceived that the social norms of significant others and the government favoured vaccination. Organisational characteristics, such as offering vaccination cost free and offering it at the university site, increased students' willingness.
  
  
  CONCLUSIONS
  During a mumps outbreak, university students were generally willing to accept a hypothetical MMR booster vaccination. Risk perception, outcome expectations, perceived social norms, and organisational characteristics should be taken into account in the planning of any vaccination campaign for university students during an outbreak of an infectious disease.
authors.affiliation: Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, P.O. Box 9101, 117, 6500 HB, Nijmegen, The Netherlands. Hanneke.Donkers@radboudumc.nl.|Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Hanneke.Donkers@radboudumc.nl.
authors.forename: Hanna W
authors.initials: HW
authors.lastname: Donkers
authors.affiliation: Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, P.O. Box 9101, 117, 6500 HB, Nijmegen, The Netherlands. Jeannine.Hautvast@radboudumc.nl.|Public Health Service of Gelderland-Zuid, Nijmegen, The Netherlands. Jeannine.Hautvast@radboudumc.nl.
authors.forename: Jeannine L A
authors.initials: JL
authors.lastname: Hautvast
authors.affiliation: Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Reinier.Akkermans@radboudumc.nl.
authors.forename: Reinier P
authors.initials: RP
authors.lastname: Akkermans
authors.affiliation: Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Corien.Swaan@rivm.nl.
authors.forename: Corien M
authors.initials: CM
authors.lastname: Swaan
authors.affiliation: Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, P.O. Box 9101, 117, 6500 HB, Nijmegen, The Netherlands. Hruijs@ggdgelderlandzuid.nl.|Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Hruijs@ggdgelderlandzuid.nl.
authors.forename: Wilhelmina L M
authors.initials: WL
authors.lastname: Ruijs
authors.affiliation: Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, P.O. Box 9101, 117, 6500 HB, Nijmegen, The Netherlands. Marlies.Hulscher@radboudumc.nl.|Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Marlies.Hulscher@radboudumc.nl.
authors.forename: Marlies E J L
authors.initials: ME
authors.lastname: Hulscher
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007117:Immunization, Secondary; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D009107:Mumps / Q000453:epidemiology / Q000517:prevention & control*; D009426:Netherlands / Q000453:epidemiology; D012409:Rubella / Q000453:epidemiology / Q000517:prevention & control*; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014495:Universities; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D022542:Measles-Mumps-Rubella Vaccine