{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:56:50Z","timestamp":1791557810773,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Grants Council of the Hong Kong Special Administrative Region, China","award":["UGC\/FDS24\/B03\/20"],"award-info":[{"award-number":["UGC\/FDS24\/B03\/20"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>In the response to the coronavirus pandemic, much attention has been invested in promoting COVID-19 vaccination. However, the impact of seasonal influenza should not be neglected, particularly during the winter influenza surge. Currently, most influenza vaccination campaigns target at healthcare workers or high-risk population groups, while COVID-19 vaccination programmes are targeting the whole population as a single homogeneous group. There is limited research on the promotion of influenza vaccination for university students who study, live, and socialise in close contact with a large variety of people on campus, resulting in a low vaccination rate among this underserved group. Thus, a vaccination programme tailored for university students should be developed to increase protection against influenza-like illnesses and complications, and to help achieve herd immunity across populations who spread viruses. WHO has advocated the potential value of social marketing in vaccination campaigns and highlighted the need for audience segmentation as a major prerequisite component of intervention design. This study aims to identify distinct and homogeneous groups of university students based on sociodemographic, psychographic, and behavioural attributes to inform interventions. Two-step cluster analysis was applied in a sample size of 530 university students and revealed four segments that demonstrate statistically significant differences in their attitudes, behaviours, intentions, and responses to promotion messages about seasonal influenza and COVID-19 vaccination. The findings provide a detailed understanding of segment characteristics among university students that can be applied to develop an effective social marketing campaign that can motivate influenza vaccination and cross-promote uptake of the COVID-19 vaccine.<\/jats:p>","DOI":"10.3390\/vaccines9121397","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T03:12:56Z","timestamp":1638328376000},"page":"1397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Motivating Seasonal Influenza Vaccination and Cross-Promoting COVID-19 Vaccination: An Audience Segmentation Study among University Students"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-1689","authenticated-orcid":false,"given":"Daisy","family":"Lee","sequence":"first","affiliation":[{"name":"School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2536-3767","authenticated-orcid":false,"given":"Sharyn","family":"Rundle-Thiele","sequence":"additional","affiliation":[{"name":"Social Marketing @ Griffith, Griffith University, Nathan, QLD 4111, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7207-2300","authenticated-orcid":false,"given":"Gabriel","family":"Li","sequence":"additional","affiliation":[{"name":"School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Schmid, P., Rauber, D., Betsch, C., Lidolt, G., and Denker, M.L. (2017). Barriers of influenza vaccination intention and behavior\u2014A systematic review of influenza vaccine hesitancy, 2005\u20132016. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170550"},{"key":"ref_2","unstructured":"WHO (2021, November 22). Coronavirus Disease (COVID-19): Similarities and Differences with Influenza. Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/question-and-answers-hub\/q-a-detail\/coronavirus-disease-covid-19-similarities-and-differences-with-influenza."},{"key":"ref_3","unstructured":"WHO (2012). Vaccines against influenza WHO position paper\u2014November 2012. Wkly. Epidemiol. Rec., 87, 461\u2013476."},{"key":"ref_4","unstructured":"CDC (2021, November 22). Flu Vaccination Coverage, United States, 2019\u20132020 Influenza Season. Available online: https:\/\/doi.org\/1920estimates.htm."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2741","DOI":"10.1016\/j.vaccine.2015.04.064","article-title":"Promoting influenza vaccination: Insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC)","volume":"33","author":"Nowak","year":"2015","journal-title":"Vaccine"},{"key":"ref_6","unstructured":"CDC (2021, November 22). How Flu Spreads, Available online: https:\/\/www.cdc.gov\/flu\/about\/disease\/spread.htm."},{"key":"ref_7","unstructured":"WHO (2021, November 22). Influenza (Seasonal). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/influenza-(seasonal)."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1001\/archpedi.162.12.1113","article-title":"Influenza vaccination among college and university students: Impact on influenzalike illness, health care use, and impaired school performance","volume":"162","author":"Nichol","year":"2008","journal-title":"Arch. Pediatrics Adolesc. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.ajic.2011.03.012","article-title":"How the H1N1 influenza epidemic spread among university students in Japan: Experience from Shinshu University","volume":"40","author":"Uchida","year":"2012","journal-title":"Am. J. Infect. Control"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5982","DOI":"10.1038\/srep05982","article-title":"transmission characteristics of different students during a school outbreak of (H1N1) pdm09 influenza in China, 2009","volume":"4","author":"Wang","year":"2014","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ypmed.2012.02.015","article-title":"The vaccination coverage required to establish herd immunity against influenza viruses","volume":"55","year":"2012","journal-title":"Prev. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Almalki, M.J., Alotaibi, A.A., Alabdali, S.H., Zaalah, A.A., Maghfuri, M.W., Qirati, N.H., Jandali, Y.M., and Almalki, S.M. (2021). Acceptability of the COVID-19 vaccine and its determinants among university students in Saudi Arabia: A cross-sectional study. Vaccines, 9.","DOI":"10.3390\/vaccines9090943"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s41182-021-00331-1","article-title":"Acceptance of the coronavirus disease-2019 vaccine among medical students in Uganda","volume":"49","author":"Kanyike","year":"2021","journal-title":"Trop. Med. Health"},{"key":"ref_14","unstructured":"WHO (2021, November 22). TIP: Tailoring Immunization Programmes. Available online: https:\/\/www.euro.who.int\/en\/health-topics\/disease-prevention\/vaccines-and-immunization\/publications\/2019\/tip-tailoring-immunization-programmes-2019."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"556","DOI":"10.3390\/vaccines3030556","article-title":"Addressing the vaccine hesitancy continuum: An audience segmentation analysis of American adults who did not receive the 2009 H1N1 vaccine","volume":"3","author":"Ramanadhan","year":"2015","journal-title":"Vaccines"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6785","DOI":"10.1016\/j.vaccine.2020.08.038","article-title":"The continuum of influenza vaccine hesitancy among nursing professionals in Hong Kong","volume":"38","author":"Lau","year":"2020","journal-title":"Vaccine"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dietrich, T., Rundle-Thiele, S., and Kubacki, K. (2017). Segmentation in Social Marketing, Springer.","DOI":"10.1007\/978-981-10-1835-0"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1177\/147059310333004","article-title":"The life trajectory of social marketing: Some implications","volume":"3","author":"Andreasen","year":"2003","journal-title":"Mark. Theory"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1186\/s12889-019-6696-2","article-title":"Learning what our target audiences think and do: Extending segmentation to all four bases","volume":"19","author":"Kitunen","year":"2019","journal-title":"BMC Public Health"},{"key":"ref_20","unstructured":"WHO (2021, November 22). 2013 Guide to Tailoring Immunization Programmes. Available online: http:\/\/www.euro.who.int\/en\/health-topics\/communicable-diseases\/poliomyelitis\/publications\/2013\/2013-guide-to-tailoring-immunization-programmes."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/10410236.2020.1847450","article-title":"Toward more effective public health interventions during the COVID-19 pandemic: Suggesting audience segmentation based on social and media resources","volume":"36","author":"Ihm","year":"2021","journal-title":"Health Commun."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Betsch, C., Schmid, P., Heinemeier, D., Korn, L., Holtmann, C., and B\u00f6hm, R. (2018). Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLoS ONE, 13.","DOI":"10.31234\/osf.io\/ytb7w"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/00913367.1943.10673459","article-title":"The personal involvement inventory: Reduction, revision, and application to advertising","volume":"23","author":"Zaichkowsky","year":"1994","journal-title":"J. Advert."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.3389\/fpsyg.2020.01085","article-title":"Using two-step cluster analysis and latent class cluster analysis to classify the cognitive heterogeneity of cross-diagnostic psychiatric inpatients","volume":"11","author":"Benassi","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"George, D., and Mallery, P. (2019). IBM SPSS Statistics 26 Step by Step: A Simple Guide And Reference, Routledge.","DOI":"10.4324\/9780429056765"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s12160-014-9589-8","article-title":"The clustering of health behaviours in older Australians and its association with physical and psychological status, and sociodemographic indicators","volume":"48","author":"Griffin","year":"2014","journal-title":"Ann. Behav. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1108\/MIP-03-2014-0050","article-title":"Using two-step cluster analysis to identify homogeneous physical activity groups","volume":"33","author":"Kubacki","year":"2015","journal-title":"Mark. Intell. Plan."},{"key":"ref_28","unstructured":"Noru\u0161is, M.J. (2012). IBM SPSS Statistics 19 Statistical Procedures Companion, Prentice Hall."},{"key":"ref_29","unstructured":"WHO (2021, November 18). Fighting Misinformation in the Time of COVID-19, One Click at a Time. Available online: https:\/\/www.who.int\/news-room\/feature-stories\/detail\/fighting-misinformation-in-the-time-of-covid-19-one-click-at-a-time."},{"key":"ref_30","first-page":"10.37016\/mr-2020-38","article-title":"Not just conspiracy theories: Vaccine opponents and proponents add to the COVID-19 \u2018infodemic\u2019on Twitter","volume":"1","author":"Jamison","year":"2020","journal-title":"Harv. Kennedy Sch. Misinformation Rev."},{"key":"ref_31","unstructured":"WHO (2021, November 18). How to Report Misinformation Online. Available online: https:\/\/www.who.int\/campaigns\/connecting-the-world-to-combat-coronavirus\/how-to-report-misinformation-online."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e26933","DOI":"10.2196\/26933","article-title":"Bots and misinformation spread on social media: Implications for COVID-19","volume":"23","author":"Giorgi","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Shams, A.B., Hoque Apu, E., Rahman, A., Sarker Raihan, M.M., Siddika, N., Preo, R.B., Hussein, M.R., Mostari, S., and Kabir, R. (2021). Web search engine misinformation notifier extension (SEMiNExt): A machine learning based approach during COVID-19 Pandemic. Healthcare, 9.","DOI":"10.3390\/healthcare9020156"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/12\/1397\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:35:47Z","timestamp":1760168147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/12\/1397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,25]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["vaccines9121397"],"URL":"https:\/\/doi.org\/10.3390\/vaccines9121397","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,25]]}}}