Date of Award

Spring 2020

Degree Type


Director of Thesis

Mohammed Quasem

Second Reader

Melissa Nolan, Ph.D., MPH


Background: Undergraduate students are at an increased risk for developing respiratory infections as a result of the proximity in which they live, study, and eat. Despite being a target population for the Centers for Disease Control and Prevention’s yearly flu vaccine, several studies of undergraduate populations have found vaccine uptake to be much lower than other at-risk populations. This study aims to understand how perceptions about influenza and the influenza vaccine affect University of South Carolina undergraduate students’ vaccine behavior. Methods: A cross-sectional study was completed using survey data from 165 undergraduate students at the University of South Carolina. The survey was developed according to the Health Belief Model, which has been used often in peer-reviewed literature to understand how perceptions, modifying factors, and cues to action affect an individual’s health behavior. Results: 87.3% of respondents reported receiving a flu shot at least once in their life. Past history of flu diagnosis (OR 11.11, 95% CI [3.03 to 61.76]), perceived benefits (OR 8.09, 95% CI [1.06 to 50.19]) and recommendation for the yearly vaccine (OR 11.30, 95% [CI 3.34 to 40.91]) from a health care provider were significantly associated with receiving the flu shot. Past history of flu diagnosis was also significantly associated with perceived susceptibility (OR 2.31, 95% [CI 1.00 to 1.06]), suggesting personal experience heightens students’ perceived risk of contracting influenza. Conclusion: This pilot study suggests clinicians' recommendations for influenza vaccine and targeted campus-specific education and promotion are potential cues to action for undergraduate student bodies. These findings warrant larger studies among representative samples of various student subpopulations to further refine and validate effective influenza vaccine uptake among this important high-risk group.

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