Allison Coleman,David Geffen School of Medicine at UCLA,Los Angeles,CA,Deborah Lehman,David Geffen School of Medicine at UCLA,Los Angeles,CA,Anju Relan,DGSOM at UCLA,Los Angeles,CA
Background: Vaccinations have dramatically reduced childhood morbidity and mortality, but parental support for vaccination is not universal, leading to outbreaks of vaccine-preventable diseases (VPDs). Attitudes and beliefs about vaccinations vacillate as reflected in popular media and scholarly publications. Medical students’ attitudes regarding vaccines are unstudied.
Objective: To assess students’ attitudes and knowledge regarding vaccines and VPDs to inform a case-based, interactive curriculum.
Methods: We administered an IRB-approved, voluntary online survey to rising third year medical students at our institution to assess, 1. Knowledge and attitudes about vaccines and VPDs, 2. Confidence in discussing vaccines with families, and 3. Resources used to gather reliable information. A 5-point Likert scale measured attitude and perceptions of competence in communicating about vaccines. True-false-unsure questions tested knowledge and misconceptions about vaccines and VPDs.
Results: 90/190 (47%) of students responded to the survey. There was strong support for the recommended vaccine schedule, with
82% of respondents disagreeing that this schedule exposes infants and children to an excessive immunologic burden. 93% of students expressed support for mandatory immunization requirements for kindergarten entry. However, there was some variability in attitudes, with 20% of students agreeing that an alternate or delayed vaccine schedule is acceptable.
Specific knowledge about vaccination schedule, contraindications, and VPDs was low, with only 22% of students answering 75% or more of the knowledge-based questions correctly. Some specific misconceptions emerged. 32% of students incorrectly believed that a vaccine series must be restarted if significant time has elapsed since initiation of the series, and 31% of students believed that pertussis is more likely to cause serious complications in an adult rather than a child. 61% of students agreed or strongly agreed feeling competent to discuss vaccines with families. However, feeling of competence was not significantly correlated with total score on the knowledge-based questions (p=0.10).
81% of students listed medical school curriculum as one of the top three most important influences on their vaccine-related attitudes. 68% of students listed electronic information resources as one of their top three most important resources for seeking knowledge about vaccines.
Discussion: Students are generally supportive of the recommended vaccine schedule, but express some variability in their beliefs. The reported importance of medical school curriculum in influencing student attitudes and the extensive use of electronic resources for obtaining vaccine-related information was prescriptive. Medical schools have a responsibility to provide a structured curriculum emphasizing the importance of vaccines and to educate students about where to find vetted, evidence-based resources. This can be addressed with a robust case-based curriculum, including information questioning common misconceptions. Students’ knowledge scores and vaccine attitudes informed our development of an objective curriculum. A comprehensive needs assessment survey is useful in providing critical information for developing a targeted curriculum.