COVID-19 vaccine acceptance, hesitancy and resistancy among university students in France

Clinical Investigation Center, CHU Rouen, Normandie University, Rouen, France, CHU Rouen, Normandie University, Rouen, France, Rouen University Hospital, Normandie University, Rouen, FranceIntroduction. Young adults, specifically college students, are at risk of being infected with COVID-19 and transmitting the infection to others owing to their sense of invulnerability and can be a source of transmission to at-risk populations and could be the public acceptance of a new vaccine for COVID-19 developed within a short period remains uncertain despite the forthcoming availability. The objectives were to explore, among university students, the level of COVID-19 vaccine acceptance, hesitancy and resistancy and to determine the motivations and barriers, and the reasons that may change student vaccination decision making. Material and methods. An online cross-sectional study was conducted among students of a French university in January 2021 with questions about the intention to be vaccinated against COVID-19, the motivations and the barriers: ”Do you intend to be vaccinated against COVID-19 (when it is possible for you to do so)?” with the choice answers of: “Yes, absolutely”; “Yes, probably”; “No, probably not”; “No, certainly not” and “I don’t know”. Students reported the motivations or the reasons of hesitations with several possible answers. Results. A total of 3089 students were included, with a mean of age of 20.3 (SD=1.9). A total of 3089 students were included, with a mean of age of 20.3 (SD=1.9), and 71.4% were female. The self-estimated knowledge of conventional vaccines and COVID-19 vaccines was 5.9/10 (2.3) and 4.9/10 (2.3), respectively. Confidence in the efficacy and safety of conventional vaccines (excluding COVID-19 vaccines) was 8.0/10 (2.3) and 7.7/10 (2.3), respectively. To the question on the intention to vaccinate against the COVID-19, 58.0% of students reported that they would choose to have a vaccination, 17.0% reported that they would not and 25.0% were not sure. The main motivation for vaccine acceptance were “I don't want to transmit COVID-19 to others”, the main barrier for vaccine resistance or hesitancy were “I prefer to wait until I have more experience with these new vaccines”. Age, female gender, being in first three years of study, studied sciences courses and neither sciences nor healthcare courses were significantly associated with a higher risk of vaccine hesitancy or resistancy. Self-estimated knowledge of conventional vaccines and COVID-19 vaccines, and confidence in efficiency and safety of conventional vaccination were associated with a lower risk of vaccine hesitancy or resistancy. Conclusions. Our study shows that, in January 2021, before students have the opportunity to be vaccinated against COVID-19 in France, more than half of the students were vaccine acceptance, a quarter were hesitant, and one in five students were resistant. It is relevant to disseminate evidence-based interventions to promote COVID-19 vaccine acceptability for college students, especially for the students in neither sciences nor healthcare, as college students will soon be eligible to receive a COVID-19 vaccine. Preventive university medicine, campus-based student organizations, and college students could be consider designing educational programs and messaging that promotes behavioral confidence among college students to receive the COVID-19 vaccine