BACKGROUND/OBJECTIVES: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare students and factors shaping these outcomes.

METHODS

A cross-sectional survey was conducted in 2024, using an online self-administered questionnaire completed by 374 medical and nursing students. Descriptive statistics were used to analyze vaccine-related responses, comparing attitudes between healthcare programs and education years. Binomial logistic regression was applied to identify predictors of support for mandatory vaccination, first considering demographic and academic variables, and then adding students' beliefs and common misconceptions.

RESULTS

Medical students showed more positive attitudes toward vaccination than nursing students, with 96.8% of medical students versus 89.4% of nursing students believing vaccines are effective ( = 0.005). Students in advanced years demonstrated stronger belief in vaccine effectiveness ( = 0.038). Additionally, misbeliefs about the measles vaccine causing autism decreased significantly, with most students in higher years rejecting this misconception ( = 0.009). Logistic regression revealed that belief in following the vaccine schedule (OR = 22.71; < 0.001) and confidence in vaccine effectiveness (OR = 10.20; < 0.001) were the strongest predictors of support for mandatory vaccination, with attitudinal factors explaining over half of the variance.

CONCLUSIONS

Healthcare students' attitudes about vaccination influence public health outcomes, as their perspectives reflect experience and beliefs. Targeted vaccine education helps address misconceptions and improve vaccination rates.