Attitudes of COVID-19 vaccination among college students: A systematic review and meta-analysis of willingness, associated determinants, and reasons for hesitancy

Geng, Hui; Cao, Kexin; Zhang, Jingbing; Wu, Kusheng; Wang, Geng; Liu, Caixia

doi:10.1080/21645515.2022.2054260

Cited by 25 publications

(84 citation statements)

References 86 publications

(122 reference statements)

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“…To better analyze the underlying preference disparities, we conducted sub-group analysis based on student majors (humanities/social science or non-humanities/social science) and risk tolerance (risk tolerant or risk adverse). Our results support previous online survey studies which reported that there are no statistically significant relationships between student majors and vaccine preferences ( 26 ). Given our academic major data are social science and non-social science, our results do not contribute to the prior findings that medical and nursing students had higher vaccine willingness than other students due to higher knowledge levels and better perception of vaccines ( 28 , 38 ).…”

Section: Discussionsupporting

confidence: 91%

“…In contrast, most mainland Chinese students' COVID-19 vaccination studies, encompassing vaccination acceptance, willingness and hesitancy, mainly used non-DCE online surveys ( 21 – 25 ), reporting similar vaccine hesitancy factors ( 21 – 25 ). In terms of student vaccine heterogeneity, the existing literature suggests that student majors do not contribute to differing vaccination preferences ( 26 ), except for medical or nursing students who exhibit overall higher vaccination willingness ( 27 , 28 ). Two DCE studies identified efficacy, safety, number of doses, origin of vaccine and costs in student vaccination preferences, but for students in Hong Kong ( 29 , 30 ).…”

Section: Introductionmentioning

confidence: 99%

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Student COVID-19 vaccination preferences in China: A discrete choice experiment

Wang

Maitland²,

Wang³

et al. 2022

Front. Public Health

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ObjectiveThis study uses a discrete choice experiment (DCE) questionnaire to investigate student vaccination preferences for both intrinsic and extrinsic attributes.MethodsA two-part DCE questionnaire was distributed to 1,138 students through face-to-face interviews at vaccination centers in Qingdao, China. Conditional logit models were used to understand student preference trade-offs. Mixed logit models (MLM) and sub-group analysis were conducted to understanding student preference heterogeneity.ResultsWe found that students preferred vaccines with fewer side effects (β = 0.845; 95% CI, 0.779–0.911), administered through third level health facilities (β = 0.170; 95% CI, 0.110–0.230), and had at least 1 year duration of protection (β = 0.396; 95% CI, 0.332–0.461. Higher perception of COVID-19 risks (β = 0.492; 95% CI, 0.432–0.552) increased the likelihood of student vaccination uptake. Surprisingly, vaccine effectiveness (60%) and percentages of acquaintances vaccinated (60%) reduced vaccination utility, which points to free-rider problems. In addition, we find that student study majors did not contribute to preference heterogeneity, and the main disparities in preferences were attributed to student risk tolerances.ConclusionBoth intrinsic and extrinsic attributes were influential factors shaping student preferences for COVID-19 vaccines. Our results inform universities and local governments across China on targeting their vaccination programs.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Student COVID-19 vaccination preferences in China: A discrete choice experiment

Wang

Maitland²,

Wang³

et al. 2022

Front. Public Health

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“…Although the results on unwillingness to get vaccinated show that one in five people in Canada does not plan to get vaccinated, systematic reviews from other countries have shown even more unwillingness. 57 , 58 , 59 , 60 A systematic review including 46 independent samples from studies conducted in the United States found that only 61% of people were willing to be vaccinated. 57 Results from three systematic reviews of students from 42 countries (69%), 58 33 low‐ and middle‐income countries (LMICs) (58.5%), 59 and one from 30 countries (66.01%) also found low rates of willingness to be vaccinated.…”

Section: Discussionmentioning

confidence: 99%

“… 57 , 58 , 59 , 60 A systematic review including 46 independent samples from studies conducted in the United States found that only 61% of people were willing to be vaccinated. 57 Results from three systematic reviews of students from 42 countries (69%), 58 33 low‐ and middle‐income countries (LMICs) (58.5%), 59 and one from 30 countries (66.01%) also found low rates of willingness to be vaccinated. Interestingly, the rate of vaccine hesitancy is higher in Canada (41.8%) compared with the rate observed in LMICs (38.2%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis

Cénat

Noorishad

Farahi

et al. 2022

Journal of Medical Virology

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This systematic review and meta‐analysis examined the prevalence and factors associated with vaccine hesitancy and vaccine unwillingness in Canada. Eleven databases were searched in March 2022. The pooled prevalence of coronavirus disease 2019 (COVID‐19) vaccine hesitancy and unwillingness was estimated. Subgroup analyses and meta‐regressions were performed. Out of 667 studies screened, 86 full‐text articles were reviewed, and 30 were included in the systematic review. Twenty‐four articles were included in the meta‐analysis; 12 for the pooled prevalence of vaccine hesitancy (42.3% [95% CI, 33.7%–51.0%]) and 12 for vaccine unwillingness (20.1% [95% CI, 15.2%−24.9%]). Vaccine hesitancy was higher in females (18.3% [95% CI, 12.4%−24.2%]) than males (13.9% [95% CI, 9.0%−18.8%]), and in rural (16.3% [95% CI, 12.9%−19.7%]) versus urban areas (14.1% [95%CI, 9.9%−18.3%]). Vaccine unwillingness was higher in females (19.9% [95% CI, 11.0%−24.8%]) compared with males (13.6% [95% CI, 8.0%−19.2%]), non‐White individuals (21.7% [95% CI, 16.2%−27.3%]) than White individuals (14.8% [95% CI, 11.0%−18.5%]), and secondary or less (24.2% [95% CI, 18.8%−29.6%]) versus postsecondary education (15.9% [95% CI, 11.6%−20.2%]). Factors related to racial disparities, gender, education level, and age are discussed.

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“…Previous research suggests that students with higher levels of COVID-19-related knowledge also had a higher vaccination intention. 27 , 29 We conclude that obtaining adequate information regarding COVID-19-related topics is a key component of having a better general understanding of the complexity of the pandemic and of political decisions made during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 94%

Determinants of vaccination behavior among university students 20 months after the COVID-19 outbreak: Results of the COVID-19 German Student Well-being Study (C19 GSWS)

Trümmler

Heumann

Helmer

et al. 2022

Human Vaccines & Immunotherapeutics

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Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of COVID-19 related complications compared to the general population in Germany. However, little is known about the other determinants of COVID-19 vaccination behavior for the population of German university students. This study aimed to investigate determinants of vaccination behavior in this population. The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities from October 27 th to November 14 th , 2021, via an online survey (n=7,267). Multiple logistic regressions were calculated to examine associations of psychological antecedents of vaccination (5Cs: confidence, complacency, constraints, calculation, collective responsibility), Critical Health Literacy in a Pandemic (CHL-P), and additional determinants (previous infection, trust in the health care system, feeling informed about the COVID-19 vaccine) and vaccination status (not vaccinated vs. fully vaccinated). All 5Cs were associated with reporting to be vaccinated, except for complacency. Regarding the CHL-P, students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had higher odds for reporting being vaccinated (OR=3.02; 95% CI: 2.26-4.04). Students who felt well informed about the COVID-19 vaccines were also more likely to report being fully vaccinated (OR=2.20; 95% CI: 1.51-3.21). Due to our finding that the 5Cs are associated with vaccination status among university students, we recommend that the different components of the 5Cs should be considered in future vaccination campaigns implemented in the university context.

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Attitudes of COVID-19 vaccination among college students: A systematic review and meta-analysis of willingness, associated determinants, and reasons for hesitancy

Cited by 25 publications

References 86 publications

Student COVID-19 vaccination preferences in China: A discrete choice experiment

Student COVID-19 vaccination preferences in China: A discrete choice experiment

Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis

Determinants of vaccination behavior among university students 20 months after the COVID-19 outbreak: Results of the COVID-19 German Student Well-being Study (C19 GSWS)

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