An outbreak of a novel strain of influenza (H1N1) reached pandemic status in spring of 2009. The first batches of a vaccine for the new H1N1 strain were released in October of 2009 [
1]. We had the unique opportunity to study students’ risk perceptions in a university setting during this period of extensive media coverage and heightened vigilance due to the H1N1 pandemic. College students are more susceptible to the H1N1 virus due to close living conditions in residence halls [
2], social contact in and out of the classroom [
3-
5], and the fact that younger people are more likely to get the H1N1 flu [
1,
6]. While vaccination is an effective strategy to reduce influenza cases [
7], influenza vaccination rates prior to the pandemic were typically low among college students [
8].
Vaccinations against influenza are effective. Vaccination is associated with significant reductions in doctor visits, better school performance, and less days of missed class/work for college students [
7]. Thus, immunization provides the best preventative strategy against the influenza virus [
1,
9]. Despite this, even the most effective vaccine is ineffective if people are not willing to get themselves vaccinated [
10]. Unfortunately, the general public is distrustful of pandemic flu vaccines [
11].
Multiple studies have shown that a motivation for flu vaccine refusal of a novel flu vaccine is fear of side effects [
12-
15]. Many people also believe that the vaccination will not be effective [
12,
14,
16] or that the novel vaccines have not received adequate testing [
13,
15] and may be harmful and weaken the immune system [
16]. Still others are unconcerned about the flu and simply do not want the vaccine [
12,
14]. Vaccine acceptance is generally driven by self-perceived risk; if people feel that they are low risk, they are unlikely to receive flu vaccinations [
17]. By contrast, people who are receptive to flu vaccinations are likely to be so because they want protection for themselves and their families [
12-
14] and flu vaccine acceptance is correlated with beliefs about vaccine effectiveness and safety [
15,
16]. In addition, flu vaccination acceptance is increased when one has been advised to by a doctor or other health authority [
2,
13,
14,
18]. Demographic variables are also related to vaccination acceptance, with older age and chronic illness being predictors [
7,
10,
12,
14,
18,
19].
College students are at particular risk for H1N1 influenza. During a pandemic, universities are threatened by the possibility of rapid influenza transmission because of their large young adult population and close social contact [
1,
4,
5]. Students living in on-campus residences are at even higher risk of becoming ill due to close proximity living conditions [
2]. Data based on laboratory-confirmed cases of H1N1 flu suggest higher infection rates in younger age groups [
6], and people under the age of 25 were one of the key groups recommended by the CDC to receive the 2009 H1N1 vaccine [
1].
In the present study, we surveyed undergraduate college students on their perceptions of their H1N1 flu risk and their attitudes regarding vaccinations. Given the heightened media activity during the H1N1 pandemic of 2009, we wished to determine rates of likelihood to receive vaccinations and major reasons for vaccine refusal in this at risk group.
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