"Get your flu shot" is advice that many college students ignored in 2009. Findings of a researcher studying the problem highlight the influences of a complex set of interrelated factors, such as students' baseline knowledge, their information seeking, and the credibility of information sources. Students' low response rate is of particular concern because up to November 2009, almost 80 percent of confirmed H1N1 flu cases in the United States occurred in people below age 30.
This fact prompted the Centers for Disease Control and Prevention (CDC) to launch an emergency risk outreach campaign and spurred many college health clinics to offer free vaccine shots. To understand why students ignored the campaign, the researcher surveyed 371 students and discovered that they tended to overestimate how much they knew about the vaccine. Some dubious information about the risks associated with getting the vaccine itself -- not the flu -- were circulated on the social media website youtube.com that complicated efforts to prevent the disease from spreading. Around 30 percent of people in the initial target groups opted in 2009 to receive the vaccine, compared with the 13 percent of the college students sampled in this study.
The research tests a "socio-psychological" approach to how college students process risk information, assessing the role of the complex array of factors related to attitudes and beliefs that shaped students' inaction. The study by University of Buffalo researcher Z. Janet Yang confirms that the approach, the "Risk Information Seeking and Processing" model or RISP, is applicable to public health challenges like choices related to flu vaccination. Her paper, titled "Too Scared or Too Capable? Why Do College Students Stay Away from the H1N1 Vaccine?" appears in the October 2012 issue of Risk Analysis, published by the Society for Risk Analysis.
Because of the high-density living conditions on college campuses, H1N1 spreads rapidly. In 2009, the federal government approved five vaccines, which are readily available and often free to students at their university health clinics, removing those barriers to vaccination. That year, however, "false information about the vaccine's safety was widely spread on social network sites, such as youtube.com, which further contaminated the information environment surrounding H1N1 vaccine" according to Yang. "Even so, the H1N1 influenza was rated as one of the top stories of 2009," citing a major story on the subject in the December 8, 2009, issue of Time Magazine.
Students taking Yang's online survey who deemed the flu vaccine information source as credible sought more information. Getting more information about the vaccine also increased their intention to get the vaccine. This information-seeking response prompted Yang to call on public health experts to design credible health communications with solid information and evidence for support. The researcher says that given the sample size of 317, her results should not be overly generalized or necessarily be applied to all college students.
Yang's study concludes that to promote vaccination and other healthy behaviors in this population may require several changes in health communications approaches. First, studying the target audience's existing perceptions and attitudes to vaccination may help. Second, countering the unwarranted confidence students may have in their knowledge about the flu may be important. Third, illustrating how vaccinations are personally relevant and urgent is critical, as is promoting its social desirability. Yang concludes that an emphasis on the difference between perceived and actual knowledge, studying emotional reactions, improving the accountability of health information and boosting the appeal of receiving a vaccination are critical, particularly as the 2012 flu season starts.
- Z. Janet Yang. Too Scared or Too Capable? Why Do College Students Stay Away from the H1N1 Vaccine? Risk Analysis, 2012; DOI: 10.1111/j.1539-6924.2012.01799.x
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