Abstract

The purpose of this study was to examine the effect of a vaccine education module (VEM) on college freshmen’s intended vaccination behaviors, vaccine-related perceptions, and vaccine knowledge. Although vaccine requirements for university students are a vital public health strategy, most institutions in the United States do not mandate all recommended immunizations. In today’s environment, where vaccine misinformation and hesitancy remain common, understanding how evidence-based education influences vaccine attitudes is increasingly important. A pre-COVID-19 study showed that a VEM improved students’ vaccine beliefs and intentions; this study assessed these outcomes in a post-COVID-19 context.

A pretest/posttest quasi-experimental design was used. Participants were freshmen enrolled at a large private university in the western United States between September 2024 and June 2025. Students completed a pre-VEM questionnaire, viewed a 10-minute online VEM, and then completed a post-VEM questionnaire. Knowledge checks enhanced engagement. Measures evaluated behavioral intentions, perceptions, and knowledge. Quantitative data were analyzed using descriptive statistics and paired-samples t tests.

A total of 140 freshmen were included. Common pre-VEM concerns were: none (20.7%), cost (20.7%), and uncertainty about which vaccines to receive (18.6%). After the VEM, the most frequent concerns were: none (35%), cost (19.3%), and safety or effectiveness (11.4%). All behavioral intention items showed statistically significant improvement. Students reported increased likelihood of talking with a healthcare provider (pre M=3.54, post M=4.01; t=–6.547, p< .001), reduced likelihood of delaying vaccination (pre M=1.55, post M=1.35; t=3.373, p< .001), and greater likelihood of encouraging others to vaccinate (pre M=2.49, post M=3.06; t=–7.424, p< .001). Effect sizes reflected medium effects for consulting a provider (d=–.553) and encouraging others (d=–.627), and a small effect for reduced intention to delay vaccination (d=.285).

Findings demonstrate meaningful shifts in freshmen students’ concerns, behavioral intentions, and vaccine-related understanding in the post-COVID-19 environment. Brief, targeted education can strengthen vaccine confidence and support proactive vaccination behaviors, with implications for nursing practice, patient education, campus health programming, and public health efforts to increase vaccination coverage among young adults.

Notes

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Description

This study examined the impact of a vaccine education module for college freshmen in the post-COVID-19 era. Statistically significant improvements were found in students’ likelihood of talking with healthcare providers, avoiding vaccination delays, and encouraging others to vaccinate, along with notable shifts in concerns. Findings indicate that short, evidence-based programs can meaningfully strengthen vaccine confidence on college campuses.

Author Details

Karlen E. Luthy, DNP, FNP-C, FAANP, FAAN;

Janelle L. B. Macintosh, PhD*;

Alyssa Vang, SN;

Janessa Johnson, SN*

*List in Sigma event system, but not listed in attached slide deck.

Sigma Membership

Iota Iota

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Public and Community Health, Virtual Learning, Academic-Clinical Partnership, Immunization, College Students, Post-COVID 19 Era

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-30

Click above link to access the slide deck.

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Strengthening Vaccine Confidence Among College Freshmen in the Post-COVID-19 Era

Toronto, Ontario, Canada

The purpose of this study was to examine the effect of a vaccine education module (VEM) on college freshmen’s intended vaccination behaviors, vaccine-related perceptions, and vaccine knowledge. Although vaccine requirements for university students are a vital public health strategy, most institutions in the United States do not mandate all recommended immunizations. In today’s environment, where vaccine misinformation and hesitancy remain common, understanding how evidence-based education influences vaccine attitudes is increasingly important. A pre-COVID-19 study showed that a VEM improved students’ vaccine beliefs and intentions; this study assessed these outcomes in a post-COVID-19 context.

A pretest/posttest quasi-experimental design was used. Participants were freshmen enrolled at a large private university in the western United States between September 2024 and June 2025. Students completed a pre-VEM questionnaire, viewed a 10-minute online VEM, and then completed a post-VEM questionnaire. Knowledge checks enhanced engagement. Measures evaluated behavioral intentions, perceptions, and knowledge. Quantitative data were analyzed using descriptive statistics and paired-samples t tests.

A total of 140 freshmen were included. Common pre-VEM concerns were: none (20.7%), cost (20.7%), and uncertainty about which vaccines to receive (18.6%). After the VEM, the most frequent concerns were: none (35%), cost (19.3%), and safety or effectiveness (11.4%). All behavioral intention items showed statistically significant improvement. Students reported increased likelihood of talking with a healthcare provider (pre M=3.54, post M=4.01; t=–6.547, p< .001), reduced likelihood of delaying vaccination (pre M=1.55, post M=1.35; t=3.373, p< .001), and greater likelihood of encouraging others to vaccinate (pre M=2.49, post M=3.06; t=–7.424, p< .001). Effect sizes reflected medium effects for consulting a provider (d=–.553) and encouraging others (d=–.627), and a small effect for reduced intention to delay vaccination (d=.285).

Findings demonstrate meaningful shifts in freshmen students’ concerns, behavioral intentions, and vaccine-related understanding in the post-COVID-19 environment. Brief, targeted education can strengthen vaccine confidence and support proactive vaccination behaviors, with implications for nursing practice, patient education, campus health programming, and public health efforts to increase vaccination coverage among young adults.