The attitude-behavior gap in vaccine acceptance among medical students: A single‑center study

Year 2025, Issue: Advanced Online Publication, 300 - 312

Ufuk Acar , Burcu Beyazgül , İbrahim Koruk

Abstract

Objective: This study aimed to determine medical students’ level of knowledge regarding vaccines, assess the prevalence of vaccine hesitancy, and identify key factors influencing both attitudinal and behavioral acceptance.
Methods: In this single‑center cross‑sectional study (April-May 2023), 305 medical students at Harran University completed a 37‑item interview‑administered questionnaire. Attitudinal and behavioral acceptance (complete acceptance/hesitancy/rejection) were assessed, and predictors of hesitancy were identified via decision‑tree analyses.
Results: Of the participants, 47.2% did not know the infant/childhood vaccination schedule, while 30.5% and 36.7% reported having completed hepatitis B and varicella vaccines, respectively. Attitudinal complete acceptance was 82.0%, whereas behavioral complete acceptance was 9.2% with 69.5% hesitancy, indicating a pronounced attitude–behavior gap. Uptake of recommended vaccines was generally low (25.2-36.7%), highest for varicella (36.7%). Clinical phase students showed higher complete acceptance in both attitude and behavior (p<0.05); formal training on vaccines/immunization and COVID 19 related anxiety were associated with higher attitudinal acceptance (p<0.05 and p<0.01, respectively). Across vaccine types, the most common reason for non vaccination was “never recommended/reminded.” Decision tree models highlighted vaccine related knowledge, personal/family vaccination experiences, and media influences as major
drivers of hesitancy.
Conclusion: Findings underscore a substantial attitude–behavior gap alongside suboptimal uptake. Targeted strategies to bridge knowledge gaps and translate positive attitudes into actual vaccination behavior-particularly addressing knowledge/awareness, experiential factors, and the communication/media environment are essential for reducing hesitancy among future healthcare providers.

Keywords

Vaccination , Vaccine hesitancy , Medical students , Immunization , Public health

Ethical Statement

Ethical approval was obtained from the Harran University Clinical Research Ethics Committee (approval date: 20/02/2023; decision no: HRÜ/23.03.14), and institutional permission was granted by the Dean’s Office of Harran University Faculty of Medicine. All procedures complied with the institutional guidelines for human research and adhered to the principles outlined in the Declaration of Helsinki.

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