Application of the 5C model in understanding adult vaccine hesitancy among medical students: a cross-sectional study
Abstract
Background: Adult vaccination is an important component of preventive health care, but vaccine hesitancy can limit uptake even when vaccines are available. Medical students represent future health professionals and may influence vaccination decisions in the community. The 5C model provides a multidimensional framework encompassing confidence, complacency, constraints, calculation, and collective responsibility. Methods: A cross-sectional study was conducted among undergraduate medical students in a tertiary-care teaching institution, Puducherry. A total of 386 medical students from first year through internship were included. Data were collected using a self-administered, pre-tested structured questionnaire containing sociodemographic variables and assessment of adult vaccine hesitancy and the five dimensions of the 5C model. Data were analyzed using IBM SPSS. Categorical variables were expressed as frequency and percentage, and associations were assessed using Pearson's chi-square test. Pearson's correlation coefficient was used to assess correlations between the five 5C dimensions. Results: Among 386 participants, 216 (56.0%) were classified as vaccine hesitant and 170 (44.0%) as non-hesitant. Age and religion were not significantly associated with vaccine hesitancy (p=0.851 and p=0.495, respectively). Significant associations were observed with gender (p<0.001) and year of study (p<0.001). The five 5C dimensions demonstrated statistically significant positive correlations with one another. Correlation coefficients ranged from 0.581 between calculation and collective responsibility to 0.699 between confidence and calculation (all p<0.001). Conclusions: Adult vaccine hesitancy was prevalent among the medical students studied. Gender and year of study were significantly associated with hesitancy, while the five psychological antecedents measured by the 5C model demonstrated significant interrelationships.