RESEARCH ARTICLE: Training university students as vaccination champions to promote vaccination in their multiple identities and help address vaccine hesitancy




COVID-19, Hesitancy, Misconception, Myth, Promotion, Vaccination


Introduction: Covid-19 related vaccine hesitancy is a major problem worldwide and it risks delaying the global effort to control the pandemic.  Covid-19 vaccine hesitancy is also higher in certain communities.  Given that prescriber recommendation and community engagement are two effective ways of addressing vaccine hesitancy, training university students to become vaccination champions could be a way of addressing hesitancy, as the champions engage with their communities in their multiple identities. 

Aim: This study aims to assess the impact of a pilot project conducted in the UCL School of Pharmacy that could pave a way of integrating vaccination championing in the pharmacy undergraduate curriculum to address vaccine hesitancy.

Method: Participants completed a pre-workshop questionnaire, attended an online workshop, conducted vaccination-promoting action/s, and provided evidence via a post-workshop questionnaire.

Result: Fifty three students completed the course. The students’ vaccination-promoting actions ranged from speaking with vaccine-hesitant family, friends and customers in the pharmacy, to posting on various social media platforms. Post-workshop showed an increase in the knowledge of participants regarding vaccination and a decrease in the belief of vaccine misconceptions. After attending the workshop, participants were more likely to engage with vaccine-hesitant friends, family, strangers and patients. They were also more likely to receive the Covid-19 vaccine for them and for their children.

Author Biographies

Nusayba Ali, University College London, London, United Kingdom

UCL School of Pharmacy

Diane Ashiru-Oredope , University College London & Public Health England, United Kingdom

UCL School of Pharmacy & Antimicrobial Resistance and Healthcare Associated Infection, National Infection Service

Sudaxshina Murdan, University College London, London, United Kingdom

UCL School of Pharmacy


Aggarwal, A. (2019). Childhood Vaccine Refusal and Hesitancy -Reasons. Indian Journal of Pediatrics, 86(1), 5-6.

APhA. (n.d.). APhA-ASP Operation Immunization. APhA. Retrieved December 2020, from

Bhandari, A., & Wagner, T. (2006). Self-reported utilization of health care services: Improving measurement and accuracy. Medical Care Research and Review, 63(2), 217-235.

Bowers, B.L., Rowe, J.M., & Stafford, R.A. (2020). Using an Algorithm to Assess Vaccination Among Patients Who Attended a Pharmacy Student-Driven Statewide Free Health Screening. Journal of Pharmacy Practice, 33(4), 425-432.

Bushell, M., Frost, J., Deeks, L., Kosari, S., Hussain, Z., & Naunton, M. (2020). Evaluation of Vaccination Training in Pharmacy Curriculum: Preparing Students for Workforce Needs. Pharmacy, 8(3), Article 151.

Church, D., Johnson, S., Raman-Wilms, L., Schneider, E., Waite, N., & Sharpe, J.P. (2016). A literature review of the impact of pharmacy students in immunization initiatives. Canadian Pharmacists Journal, 149(3), 153-165.

Ciliberti, R., Bragazzi, N. L., & Bonsignore, A. (2020). The Implementation of the Professional Role of the Community Pharmacist in the Immunization Practices in Italy to Counteract Vaccine Hesitancy. Pharmacy, 8(3), Article 155.

Dube, E., Gagnon, D., MacDonald, N.E., & Hesitancy, S.W.G. V. (2015). Strategies intended to address vaccine hesitancy: Review of published reviews. Vaccine, 33(34), 4191-4203.

Dube, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. (2013). Vaccine hesitancy An overview. Human Vaccines & Immunotherapeutics, 9(8), 1763-1773.

Eskola, J., Duclos, P., Schuster, M., MacDonald, N.E., & Hesitancy, S.W.G.V. (2015). How to deal with vaccine hesitancy? Vaccine, 33(34), 4215-+.

Facciola, A., Visalli, G., Orlando, A., Bertuccio, M. P., Spataro, P., Squeri, R., Picerno, I., Di Pietro, A. (2019). Vaccine hesitancy: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal. Journal of Public Health Research, 8(1), 13-18, Article 1436.

Forster, A.S., Rockliffe, L., Chorley, A.J., Marlow, L.A.V., Bedford, H., Smith, S.G., & Waller, J. (2017). Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research. Journal of Epidemiology and Community Health, 71(6), 544-549.

Goldman, R.D., Yan, T.D., Seiler, M., Cotanda, C.P., Brown, J. C., Klein, E.J., Hoeffe, J., Gelernter, R., Hall, E.J., Davis, L.A., Griffiths, A.M., Mater, A., Manzano, S., Gualco, G., Shimizu, N., Hurt, L.T., Ahmed, S., Hansen, M., Sheridan, D., Ali, S., Thompson, C.G., Gaucher, N., Staubli, G. (2020). Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey. Vaccine, 38(48), 7668-7673.

Gust, D.A., Darling, N., Kennedy, A., & Schwartz, B. (2008). Parents with doubts about vaccines: Which vaccines and reasons why. Pediatrics, 122(4), 718-725.

Hanson, K.E., Koch, B., Bonner, K., McRee, A.-L., & Basta, N. E. (2018). National Trends in Parental Human Papillomavirus Vaccination Intentions and Reasons for Hesitancy, 2010-2015. Clinical Infectious Diseases, 67(7), 1018-1026.

Jarrett, C., Wilson, R., O'Leary, M., Eckersberger, E., Larson, H. J., & Hesitancy, S.W.G.V. (2015). Strategies for addressing vaccine hesitancy - A systematic review. Vaccine, 33(34), 4180-4190.

Jones, S., Cortina Borja, M., & Bedford, H. (2020). "I think meningitis is a virus, while septicaemia might be caused by bacteria." A study of vaccination views, disease awareness and MenACWY and MMR uptake among freshers at a London university. International journal of adolescent medicine and health.

Kwok, K.O., Li, K.-K., Wei, W.I., Tang, A., Wong, S.Y.S., & Lee, S.S. (2021). Editor's Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. International journal of nursing studies, 114, 103854-103854.

Lane, S., MacDonald, N.E., Marti, M., & Dumolard, L. (2018). Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015-2017. Vaccine, 36(26), 3861-3867.

Larson, H.J., Jarrett, C., Eckersberger, E., Smith, D.M.D., & Paterson, P. (2014). Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007-2012. Vaccine, 32(19), 2150-2159.

Lazarus, J.V., Ratzan, S.C., Palayew, A., Gostin, L.O., Larson, H. J., Rabin, K., Kimball, S., El-Mohandes, A. (2020). A global survey of potential acceptance of a COVID-19 vaccine. Nature Medicine.

Leask, J., Willaby, H.W., & Kaufman, J. (2014). The big picture in addressing vaccine hesitancy. Human Vaccines & Immunotherapeutics, 10(9), 2600-2602.

Lee, L., Peterson, G.M., Naunton, M., Jackson, S., & Bushell, M. (2020). Protecting the Herd: Why Pharmacists Matter in Mass Vaccination. Pharmacy (Basel, Switzerland), 8(4).

Lisenby, K.M., Patel, K.N., & Uichanco, M.T. (2019). The Role of Pharmacists in Addressing Vaccine Hesitancy and the Measles Outbreak. Journal of Pharmacy Practice, Article 0897190019895437.

Luyten, J., Bruyneel, L., & van Hoek, A.J. (2019). Assessing vaccine hesitancy in the UK population using a generalized vaccine hesitancy survey instrument. Vaccine, 37(18), 2494-2501.

MacDonald, N.E., & Hesitancy, S.W.G.V. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161-4164.

Marlow, L.A.V. (2011). HPV vaccination among ethnic minorities in the UK: knowledge, acceptability and attitudes. British Journal of Cancer, 105(4), 486-492.

Marlow, L.A.V., Wardle, J., & Waller, J. (2009). Attitudes to HPV vaccination among ethnic minority mothers in the UK An exploratory qualitative study. Human Vaccines, 5(2), 105-110.

McRee, A.-L., Gilkey, M.B., & Dempsey, A.F. (2014). HPV Vaccine Hesitancy: Findings From a Statewide Survey of Health Care Providers. Journal of Pediatric Health Care, 28(6), 541-549.

Nowak, G.J., Gellin, B.G., MacDonald, N.E., Butler, R., & Hesitancy, S.W.G.V. (2015). Addressing vaccine hesitancy: The potential value of commercial and social marketing principles and practices. Vaccine, 33(34), 4204-4211.

Oscarsson, M.G., Dahlberg, A., & Tyden, T. (2011). Midwives at youth clinics attitude to HPV vaccination and their role in cervical cancer prevention. Sexual & Reproductive Healthcare, 2(4), 137-142.

Palamenghi, L., Barello, S., Boccia, S., & Graffigna, G. (2020). Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy. European journal of epidemiology.

Paterson, P., Chantler, T., & Larson, H. J. (2018). Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England. Vaccine, 36(36), 5397-5401.

Picchio, C.A., Carrasco, M.G., Sague-Vilavella, M., & Rius, C. (2019). Knowledge, attitudes and beliefs about vaccination in primary healthcare workers involved in the administration of systematic childhood vaccines, Barcelona, 2016/17. Eurosurveillance, 24(6), 20-29, Article 1800117.

Pogue, K., Jensen, J.L., Stancil, C.K., Ferguson, D.G., Hughes, S.J., Mello, E.J., Burgess, R., Berges, K.B., Quaye, A., Poole, B.D. (2020). Influences on Attitudes Regarding Potential COVID-19 Vaccination in the United States. Vaccines, 8(4), Article 582.

Poudel, A., Lau, E.T.L., Deldot, M., Campbell, C., Waite, N.M., & Nissen, L.M. (2019). Pharmacist role in vaccination: Evidence and challenges. Vaccine, 37(40), 5939-5945.

Prescott, W.A., & Bernhardi, C. (2019). Immunization Education in US Pharmacy Colleges and Schools. American Journal of Pharmaceutical Education, 83(5), Article 6765.

Puri, N., Coomes, E.A., Haghbayan, H., & Gunaratne, K. (2020). Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases. Human Vaccines & Immunotherapeutics.

Royal Society for Public health Vision, Voice and Practice. (2018). Moving The needle: Promoting vaccination uptake across the life course. Available at:

Swaney, S.E., & Burns, S. (2019). Exploring reasons for vaccine-hesitancy among higher-SES parents in Perth, Western Australia. Health Promotion Journal of Australia, 30(2), 143-152.

Taylor, S., Landry, C.A., Paluszek, M.M., Groenewoud, R., Rachor, G.S., & Asmundson, G.J.G. (2020). A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2. Frontiers in Psychology, 11, Article 575950.

Verger, P., Fressard, L., Collange, F., Gautier, A., Jestin, C., Launay, O., Raude, J., Pulcini, C., Peretti-Watel, P. (2015). Vaccine Hesitancy Among General Practitioners and Its Determinants During Controversies: A National Cross-sectional Survey in France. Ebiomedicine, 2(8), 891-897.

World Health Organization (WHO) (2014). Report of the SAGE Working Group on Vaccine Hesitancy. Available at:

Yaqub, O., Castle-Clarke, S., Sevdalis, N., & Chataway, J. (2014). Attitudes to vaccination: A critical review. Social Science & Medicine, 112, 1-11.




How to Cite

Ali, N., Ashiru-Oredope , D., & Murdan, S. (2021). RESEARCH ARTICLE: Training university students as vaccination champions to promote vaccination in their multiple identities and help address vaccine hesitancy . Pharmacy Education, 21, p. 407–419.



Research Article