Vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland: a national study

Background Vaccine hesitancy remains a major challenge among healthcare workers whose recommendations strongly influence vaccine uptake. Evidence suggests that nurses and midwives exhibit greater hesitancy than physicians, often due to training gaps. In Switzerland, little is known about vaccine confidence among nursing and midwifery students, despite their future role as frontline providers. This study aimed to fill this gap by examining vaccine confidence, HPV vaccine recommendation, and perceptions of vaccination-related training in this population. Methods We conducted a national, cross-sectional online survey (September 2023 – June 2024) among undergraduate nursing and midwifery students enrolled at Swiss Universities of Applied Sciences. Vaccine confidence was assessed using the Vaccine Confidence Index™ (VCI). Multivariable logistic regression analyses were performed to identify determinants of vaccine confidence and recommendation. Results Of 444 respondents (70.7% nursing, 29.3% midwifery), 16.2% expressed having doubts about vaccines in general; 28.6% about HPV vaccine and 10.6% were reluctant or uncertain to recommend HPV vaccine. A high vaccine confidence was strongly associated with HPV vaccination (OR = 4.05, 95% CI: 2.30–7.21 for general; OR = 5.46, 95% CI: 3.35–9.04 for HPV), male gender (OR = 4.66, 95% CI: 1.48–20.85 for general), and lack of complementary and alternative medicine (CAM) interest (OR = 3.39, 95% CI: 1.36–10.32 for general). Italian-speaking students reported higher HPV vaccine confidence (OR = 3.29, 95% CI: 1.37–8.10) and felt the most positive about their training (40.7%). CAM interest was high (79.7%). Among final-year students ( N = 138), major training gaps were reported, with 50.7% considering their education was inadequate on vaccine safety, 62.3% on the approval process, and 63.8% on communication with hesitant patients. Conclusions Vaccine confidence among Swiss nursing and midwifery students is generally high but persistent doubts – particularly about HPV and safety – and major training gaps highlight the need to strengthen curricula to ensure future professionals can act as trusted advocates for vaccination.