Knowledge gaps and positive attitudes toward adult vaccination among nursing students: A Cross-sectional study
Noelia Rodríguez-Blanco, Nancy Vicente-Alcalde, Cristina Orts-Ruiz, Sergio Montero-Navarro, Cristina Salar-Andreu, Jesús Sánchez-Más, José Luis Duro-Torrijos
Abstract
Background
Vaccination is one of the most effective public-health measures, yet adult coverage in Spain remains suboptimal due to misinformation and hesitancy. Nursing students, as future immunization promoters, play a pivotal role in vaccine recommendations. This study explored knowledge, attitudes, and recommendation practices regarding adult vaccination among undergraduate nursing students.
Introduction
The World Health Organization (WHO) estimates that vaccination prevents approximately 3.5 to 5 million deaths annually from vaccine-preventable diseases worldwide [1]. However, despite the recognized success of vaccines, adult vaccination coverage remains lower than that in children [2,3].
Materials and method
2.1. Study design, setting, period, and sample size
An observational, descriptive, cross-sectional study was conducted among students from the three universities in the province of Alicante (Spain) that offer the Nursing degree: Universidad CEU Cardenal Herrera, Universidad Europea de Valencia, and Universidad de Alicante.
Results
3.1. Demographic data
A total of 562 nursing students responded to the survey, with first-year students being the most represented group and third-year students showing the lowest participation. All received questionnaires were valid. The participant population was predominantly female, single, and only 25.4% reported prior healthcare experience (Table 1).
Discussion
Our findings reveal persistent deficiencies in knowledge of the adult vaccination schedule, with lower awareness in earlier academic years that only partially improves by the final year. These results are consistent with prior studies conducted in Spain, with no substantial improvement observed following the COVID-19 pandemic [20,21].
Acknowledgments
We would like to thank the three Universities in the province of Alicante that offer Nursing degree (Universidad CEU Cardenal Herrera, Universidad Europea de Valencia and Universidad de Alicante) for allowing us access to classrooms to present the study and collect responses.
Citation: Rodríguez-Blanco N, Vicente-Alcalde N, Orts-Ruiz C, Montero-Navarro S, Salar-Andreu C, Sánchez-Más J, et al. (2026) Knowledge gaps and positive attitudes toward adult vaccination among nursing students: A Cross-sectional study. PLoS One 21(5): e0350295. https://doi.org/10.1371/journal.pone.0350295
Editor: Antonio Peña-Fernández, University of Alcala Faculty of Medicine and Health Sciences: Universidad de Alcala Facultad de Medicina y Ciencias de la Salud, SPAIN
Received: January 15, 2026; Accepted: May 12, 2026; Published: May 26, 2026
Copyright: © 2026 Rodríguez-Blanco et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
