(CLOSED) Programmatic Interventions to Increase Uptake of Influenza and COVID-19 Vaccination Among Students Attending Institutions of Higher Education (CDC RFA-IP-23-003)

Purpose:

The purpose of this Notice of Funding Opportunity (NOFO) is to conduct research to investigate the following: 1) knowledge and attitudes about influenza and COVID-19 vaccination and mandates among undergraduate students attending Institutes of Higher Education (IHE); 2) barriers and factors associated with likelihood of influenza and COVID-19 vaccine uptake; 3) effectiveness of one or more approaches to increase influenza and COVID-19 vaccination coverage among undergraduate students; and 4) cost assessment of the intervention(s). Students attending IHEs are a population at higher risk for infection with influenza viruses and SARS-CoV-2 due to unique exposures, including living in dormitories, attending in-person classes, and participating in social activities. Staying up to date with annual influenza and COVID-19 vaccines is recommended to reduce risk of infection by these viruses.

Approach:

The recipient of this award should recruit at least 16 institutes of higher education (IHEs), half of which have instituted a mandate for influenza or COVID-19 vaccination and half of which have not instituted a mandate(s). The IHEs selected should have similar key characteristics: 4-year IHE, proportion of students living in on-campus housing, and proportion of students enrolled in in-person classes. The award recipient should work with the selected IHEs to conduct the following activities:

1. The award recipient should conduct a web-based pre-intervention survey to assess knowledge and attitudes about influenza and COVID-19 vaccination among undergraduate students at each IHE. The survey should also assess barriers to, and factors associated with, the likelihood of getting influenza and COVID-19 vaccinations, including, but not limited to, insurance status, recent history of influenza and/or COVID- 19 infection, receipt of either influenza or COVID-19 vaccine in the past, and general attitudes about vaccines and vaccine mandates. The suggested timeline for this activity is the Winter of Year 1.
2. The award recipient should identify appropriate interventions, informed by results of the pre-intervention survey as well as relevant research, and design and implement a program to assess one more intervention to increase undergraduate student influenza and COVID- 19 vaccination coverage in the IHEs with no vaccination mandates in place. Participating IHEs that do not have a mandate should be randomized to control and intervention groups. The suggested timeline for this activity is late Summer/early Fall of Year 2
   1. The award recipient should conduct interviews among administrators, health clinic staff, and student representatives in the IHEs assigned to the intervention arm to assess acceptability and feasibility of the identified intervention(s). Potential interventions could include, but are not limited to, the following:
      1. Educational messaging to increase student knowledge and acceptance of influenza and COVID-19 vaccination.
      2. Free or low-cost influenza and COVID-19 vaccination on campus.
      3. Incentives for influenza and COVID-19 vaccination, such as credit hours, cancellation of on-campus parking fees, free food, gift cards, or t-shirts.
   2. Participating IHEs randomized to control and intervention groups should receive the following:
      1. Control group: Undergraduate students should receive standard of care with no promotional activities.
      2. Intervention group: Undergraduate students should receive one or more intervention(s) selected by the award recipient and informed by survey results, research, and interviews.
3. The award recipient should conduct a web-based post-intervention survey to assess knowledge, attitudes, and history of influenza and COVID-19 vaccination among undergraduate students attending IHEs without mandates after the intervention program has been implemented. The survey will also assess factors associated with likelihood of getting influenza and COVID-19 vaccination among all students as well as acceptabilityand awareness of the intervention(s) among those students attending IHEs randomized to receive the intervention. The suggested timeline for this activity is Winter of Year 3.
4. The award recipient should perform a cost analysis of each implemented intervention. The suggested timeline for this activity is Years 2-3.

Assessment of study outcomes: Intervention effectiveness should be assessed via the pre- and post-intervention surveys by comparing study groups on the following outcomes:

1. Changes in knowledge of, and attitudes towards, influenza and COVID-19 vaccination among undergraduate students attending IHEs.
2. Changes in self-reported influenza and COVID-19 vaccination coverage among undergraduate students.
3. Feasibility and acceptability of the intervention(s) from the undergraduate student perspective among students in the intervention arm.

Budget and Project Period: The estimated total funding (direct and indirect) for the first year (12-month budget period) is $500,000 with individual awards ranging from $400,000 to $500,000 for the first year. The estimated total funding (direct and indirect) for the entire project period is $1,500,000. The project period is anticipated to run from 09/01/2023 to 08/31/2026.