Attitudes towards vaccination and HPV vaccine uptake among Croatian university students

BACKGROUND: The attitudes that underlie vaccine hesitancy are important for predicting individuals’ vaccination behaviour but also for developing effective public health interventions. This study aimed to investigate attitudes towards vaccination among Croatian university students and to evaluate its possible association with human papillomavirus (HPV) vaccine uptake in the same population. METHODS: This cross-sectional questionnaire study was conducted from February to May 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, as well as the Vaccination Attitudes Examination Scale (VAX scale) was self-administered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia. The higher scores on the VAX scale reflect more negative attitudes toward vaccination. RESULTS: The study sample included 840 subjects with, a median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females. The median VAX scale score was 39.0 (interquartile range 32.0-46.0). The prevalence of vaccination uptake in the studied population was 20.8%. The more negative attitudes towards vaccination were found in students who studied within the scientific area of the social sciences (p < 0.001), students who had a lower average grade of study (p < 0.001), and students who were not vaccinated against HPV (p < 0.001). CONCLUSIONS: The Croatian university students had rather negative attitudes towards vaccination probably reflected by the observed HPV vaccine uptake in this population. Identifying factors that influence general attitudes towards vaccination in the studied population would enable the design of more adequate public health interventions intended to promote HPV vaccine uptake. KEY MESSAGES: • Croatian university students have shown strong general vaccine hesitancy as well as low HPV vaccine uptake. • Better understanding of the attitudes that underlie vaccine hesitancy is important for developing public health interventions created to increase HPV vaccine uptake among Croatian university students.