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Factors Affecting Vaccine-seeking Behavior among Graduating Students of the Allied Health

Science Courses

Aubrey Artienda, Darius Bautista, Mellicent Bolislis, Marianne Cantor, Kathleen Galam, Lerma Bhelle

Iglesia, ReizaMillado, Catherine Novela, Rovienne Ortiz, Tristan Palafox

School of Medicine, Saint Louis University

Abstract

The simple act of vaccination has lessened the occurrence of some diseases that used to affect the

majority of a certain population. However, not all vaccines are given as standard interventions, this

makes the individual in a sense, a consumer of vaccines.Vaccine-seeking behaviour can be defined as

the public's general attitudes in regards to demands for vaccines. The factors described in this study

could affect consumers' and physicians' use of vaccines. Immunization program planners might improve

the effectiveness of their effort by considering these factors before implementing their programs.In this

study, the cross-sectional research method was utilized. The study was conducted in the School of

Nursing and School of Natural Sciences, Saint Louis University, Baguio City, Benguet, Philippines. The

study population included graduating students from the different schools of allied health science courses

from Saint Louis University namely the School of Nursing and School of Natural Sciences with the

exception of BS Biology.A questionnaire assessing the various factors that can contribute to a persons

vaccine-seeking behavior was created. Three hundred thirty questionnaires were floated; among which

277 were statistically treated. Results show that the most common reason motivating one to undergo

vaccination is the threat of increasing incidence of a disease (81.9%) and media (23.1%) is the factor

that least motivates them. From the results and discussion of the study we can conclude that factors that

most affect vaccine seeking behaviour of allied health science courses are similar to those previously

identified by other studies. Results show the presence of both physical and psychological discomforts

during vaccination, both of which contribute to the overall experience of an individual.
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INTRODUCTION

Background of the Study

Disease is most often equated with high expenses. It is reasonable to think that the emergence of

new diseases subsequently spurned the need for new preventive interventions against disease. Vaccines

are an important part of this movement.1

The simple act of vaccination has eradicated or at the very least

lessened the occurrence of some diseases that used to affect and devastate the majority of a certain

population. However, not all vaccines are given as standard interventions. Most are upon the discretion

of the individual, one can make a choice to undergo vaccination of a certain disease. This makes the

individual in a sense, a consumer of vaccines.

2

Vaccine-seeking behaviour can be defined as the public's general attitudes in regards to demands

for vaccines. Investigations to determine what affects the public's demand for vaccines began in the

1950s. Rosenstock and associates used the findings of six studies to help explain why people were not

seeking vaccination against poliomyelitis. 3 He was available to identify the following factors such as the

perceived degree of specific diseases and benefits of vaccination, beliefs regarding the safety and

efficacy of a particular vaccine, and the convenience of being vaccinated.

The factors described in this study could affect consumers' and physicians' use of vaccines.

Immunization program planners might improve the effectiveness of their effort by considering these

factors before implementing their programs. Specifically, this study could provide concrete information

about the vaccine-seeking behavior of graduating students in allied health science courses that would aid

in improving immunization plans among these courses. As future workers of the health care system,

they are at a higher risk of exposure to vaccine-preventable diseases than the general population.

The result of this study gives ideas on what consumers consider important when availing

vaccinations. More importantly, it can also help future physicians in forming vaccination programs for


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appropriate populations.

Rosenstocks study shows that Consumers Vaccine-Seeking Behavior can be divided into two

major categories: (a) personal readiness factors, which measure the persons willingness, and (b)

situational factors. The first major category was further divided into subclasses namely: perceived

personal susceptibility to a particular disease, perceived seriousness of the disease, and perceived safety

and efficacy of the vaccine. The second category, on the other hand, includes social pressure and

convenience of vaccination.4

Objectives of the Study

The objectives of the study are to determine: the vaccine seeking behavior of allied health

science courses and if there is an association between the vaccine seeking behavior and the following

variables:

-individuals past experiences with immunizations

- individuals beliefin the vulnerability to a disease

- individuals belief in the safety and efficacy of vaccines

- the influence of media

- endorsement by other people (friends, family)

- perceived affordability of vaccine

-physicians recommendation

- perceived increase in the incidence of a disease


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METHODS

Study Design

In this study the cross-sectional research method was utilized. This method was used to gather

information about the prevalence of a certain condition. The outcome of the study represented the

populations vaccine-seeking behaviour while the exposures were the various factors that could affect it.

Setting

The study was conducted in the School of Nursing and School of Natural Sciences, Saint Louis

University, Baguio City, Benguet, Philippines.

Participants

The study population included graduating students from the different schools of allied health

science courses from Saint Louis University namely the School of Nursing and School of Natural

Sciences with the exception of BS Biology. The researchers chose this population because students of

the allied health sciences are expected to be adequately informedon vaccination. BS Biology is not

considered an allied health science course.

Variables

Vaccine-seeking behaviour is the dependent variable. The factors affecting the vaccine-

seeking behaviour are the independent variables.
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Data Sources and Management

The study began by conducting a literature study on vaccines and vaccine-seeking behaviors. A

questionnaire assessing the various factors that can contribute to a persons vaccine-seeking behavior

was created. This included an introduction to the questionnaire and an informed consent form.

The questionnaire was presented for approval to two known professionals in public health

namely, Dr. Nelson Hora and Dr. Zorayda Clavio. The questionnaires were floated via clustered random

sampling.

The places where the questionnaires were floated were randomly picked using conventional draw

lots method. The School of Nursing has 15 sections from Section A to O. The chosen sections randomly

picked were B, C, G, J and O. The School of Natural Sciences has three allied health courses.

Graduating students of Medical Laboratory Science were distributed in different clinical laboratories in

Baguio City, namely SLU Hospital of the sacred Heart Clinical Laboratory, Baguio Health Department

Clinical Laboratory, and three SLU Clinical Laboratories located at Rizal Building rooms R-100

(Clinical Microscopy, Microbiology and Histopathology Sections) and R-400 (Blood Bank and Serology

Sections); and Adenauer Building room A-110 (Hematology and Clinical Chemistry sections). Chosen

laboratories for Medical Laboratory Science course were SLU-HSH Clinical Laboratory, R-400 Clinical

Laboratory and A-110 Clinical Laboratory. Graduating students of Radiologic Technology has two

internship laboratories: one in SLU-HSH Radiology Department and one in Baguio General Hospital

Radiology Department. The chosen laboratory for Radiologic Technology was SLU-HSH Radiology

Department. Pharmacy has three block sections for graduating students, namely Blocks A, B and C.

Chosen block section where the questionnaires were floated for graduating Pharmacy students was

Block A.


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Approval letter to conduct research signed by the deans of School of Nursing and School of

Natural Sciences were presented to the staff in-charge from the different clinical laboratories before the

questionnaires were floated. Three hundred thirty questionnaires were floated; among which 277 were

statistically treated. Two hundred fifty questionnaires, 50 per selected section, were floated in the School

of Nursing while 80 questionnaires, 15-20 per laboratory or block section, were floated in the School of

Natural Sciences.

Excluded in the final tally of questionnaires were the following:

Respondents who answered no in item 1 asking if they were vaccinated in the past 5years;

Respondents who have at least one item unanswered.

Respondents who have vague or inconsistent answers (e.g. checked yes to item 1 but answeredIf no, why?)

Out of the final 277 samples, 205 came from the School of Nursing and 72 came from the

College of Natural Sciences. Statistical analysis of the results was undertaken. Finally, the researchers

wrote a report combining their understanding of the relevant theory and previous research with the

results of their empirical research.

Bias

Cluster random sampling minimized selection bias. Participants are randomized in research so

that bias does not weaken the study results. Bias consists of human choices, beliefs or any other factors

besides those being studied that can affect a clinical trial's results. If physicians or participants

themselves choose the group, assignments might be personally influenced and therefore unevenly

slanted toward one side or the other.


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Study Size

The sample size was based on the population of graduating students from both the School of

Natural Sciences and School of Nursing. From the total population the sample size was computed

statistically. The samples were gathered through Cluster Random Sampling method.

The School of Natural Sciences has 247 graduating students while the school of Nursing has 731

resulting to a total population size (N) of 978. The hypothesized percentage frequency of the outcome

factor in the population was 50%. Confidence limits were set at 5%. A confidence level of 95% resulted

in a sample size of 277. Allied courses included from the School of Natural Sciences were BS Medical

Laboratory Science, BS Radiologic Technology and BS Pharmacy. BS Biology course was excluded

from the study, as it is not an allied health course.

Quantitative Variable

From a total study population of 978, the School of Natural Sciences had 247 graduating students

while the school of Nursing had 731. From this, the sample size of 277 total samples was computed

using Open Epi 2.3.1. Two hundred five out of the 277 were students from the School of Nursing and 72

respondents were students from the School of Natural Sciences. The 72 respondents from the School of

Natural Sciences included graduating students from allied health courses, namely BS Pharmacy, BS

Medical Laboratory Science, and BS Radiologic Technology. The 205 Nursing respondents were from

five block sections of Nursing. The 72 respondents from the Natural Sciences were taken from 3 MLS

Laboratories, 1 Radio Technology laboratory and 1 Pharmacy block section.

Statistical Method

Percentages were used to show the frequency distribution of the following:


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The distribution of respondents according to gender and school; The vaccines received by the respondents in the past five years; The distribution of respondents according to whether they experienced discomfort when they

were given vaccines;

The distribution of different feelings of discomfort experienced by the respondents when givenvaccines

The distribution of respondents whether they want to be vaccinated despite they discomfort; The distribution of respondents according to their perception of various vaccines in relation to:

- Their belief in vulnerability from disease

- Safety of various vaccines

- Efficacy of various vaccines

The distribution of respondents according to their motivation in receiving various vaccines.A statistician, Mr. Jaime Ballena IV, was employed by the researchers to analyze and interpret

the data. Pearson's chi-squared was used to assess two types of comparison: tests of goodness of fit and

tests of independence. A test of goodness of fit establishes whether or not an observed frequency

distribution differs from a theoretical distribution. A test of independence assesses whether paired

observations on two variables, expressed in a contingency table, are independent of each other.5

The researchers determined whether the feeling of discomfort when given vaccines was

significantly associated with school using Pearsons Chi-square test. Moreover, the Pearsons Chi-

square test was utilized to determine if there was an association between the decision of the respondents

to be vaccinated again despite discomfort and school.
http://en.wikipedia.org/wiki/Goodness_of_fithttp://en.wikipedia.org/wiki/Independence_(probability_theory)http://en.wikipedia.org/wiki/Frequency_distributionhttp://en.wikipedia.org/wiki/Frequency_distributionhttp://en.wikipedia.org/wiki/Contingency_tablehttp://en.wikipedia.org/wiki/Contingency_tablehttp://en.wikipedia.org/wiki/Frequency_distributionhttp://en.wikipedia.org/wiki/Frequency_distributionhttp://en.wikipedia.org/wiki/Independence_(probability_theory)http://en.wikipedia.org/wiki/Goodness_of_fit

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