COVID-19 Vaccine Hesitancy among Italian University Students: A Cross-Sectional Survey during the First Months of the Vaccination Campaign

Achieving high levels of vaccination coverage against COVID-19 may be hindered by vaccine hesitancy. We quantified over time the prevalence of COVID-19 vaccine hesitancy among university students, investigated its determinants, and analyzed student attitudes, risk perceptions and compliance with preventive measures. The survey was administered online from 1 March to 30 June 2021. A multivariable logistic regression model was built to identify predictors of hesitancy. Overall, we collected 5369 questionnaires that were grouped into three survey periods (March, April-May, and May-June). The response rate ranged from 81.2% to 76.4%, whereas vaccine hesitancy ranged from 22% to 29%. Multivariable analysis showed that April-May participants had higher odds of hesitancy than March respondents. Other positive predictors were being male, not being a healthcare student, having a lower academic level, and not disclosing a political position. Conversely, higher levels of perceived COVID-19 severity, concern for the emergency, confidence in vaccine safety and effectiveness, and self-reported adherence to mask wearing indoors and outdoors were negatively associated with hesitancy. We found that vaccine hesitancy changed over time and in relation to several factors. Strategies aimed at increasing the students' awareness and engagement, restoring confidence in health authorities, and limiting disinformation around the vaccines should be devised.

Automated summary

This study investigated COVID-19 vaccine hesitancy among university students, finding that hesitancy levels changed over time and in relation to various factors. Positive predictors included being male, non-healthcare students, and lower academic levels, while negative predictors included perceived severity of COVID-19, confidence in vaccine safety and effectiveness, and self-reported mask-wearing behavior. Strategies to increase awareness, restore confidence, and combat disinformation should be implemented.