Min Htike Wai Yan, Zhang Muxuan, Wu Zixuan, Zhou Xinyu, Lyu Siran, Kam Yiu-Wing
Division of Natural and Applied Science, Duke Kunshan University, No. 8 Duke Avenue, Kunshan 215316, China.
Vaccines (Basel). 2025 Apr 25;13(5):461. doi: 10.3390/vaccines13050461.
: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine among university students globally. Utilizing the WHO's 3C model, which encompasses confidence, complacency, and convenience, this review seeks to pinpoint the main factors and suggest focused strategies to address them. : Following the PRISMA guidelines, we conducted a systematic search in PubMed, Medline, Web of Science, Scopus, Embase, and Global Health. Eligible studies were cross-sectional, peer-reviewed, and examined COVID-19 vaccine hesitancy among college students. Covidence was used for screening, and data were synthesized narratively using the 3C model. : Sixty-seven studies (n = 88,345 participants) from 25 countries were included in this study. Confidence factors were the most influential, with fear of side effects (87.18%) and doubts about efficacy (72.4%) as primary concerns. Complacency factors included a low perceived risk of infection (34.9%) and a preference for alternative preventive measures (52.3%). Convenience barriers involved financial costs (58.1%) and difficulty accessing vaccination centers (40.3%). Subgroup analyses revealed variations by academic discipline and geographic region, with medical students showing hesitancy despite their health knowledge. : COVID-19 vaccine hesitancy among college students is primarily driven by safety concerns, misinformation, and accessibility barriers. Addressing hesitancy requires transparent risk communication, policy-driven accessibility improvements, and tailored educational interventions. These findings can inform strategies to enhance vaccine uptake among young adults and contribute to broader efforts in pandemic preparedness.
疫苗接种的阻力仍然是实现广泛接种的一个重大挑战，尤其是在大学生群体中，他们在支持公共卫生倡议方面起着关键作用。本系统综述调查了全球大学生中影响其不愿接种新冠疫苗的因素。利用世界卫生组织的3C模型，即信心、自满和便利，本综述旨在找出主要因素并提出针对性策略来解决这些问题。
按照PRISMA指南，我们在PubMed、Medline、科学网、Scopus、Embase和全球健康数据库中进行了系统检索。符合条件的研究为横断面研究、经过同行评审且调查了大学生对新冠疫苗的犹豫态度。使用Covidence进行筛选，并利用3C模型对数据进行叙述性综合分析。
本研究纳入了来自25个国家的67项研究（共88345名参与者）。信心因素最具影响力，主要担忧包括对副作用的恐惧（87.18%）和对有效性的怀疑（72.4%）。自满因素包括感染风险感知较低（34.9%）以及对其他预防措施的偏好（52.3%）。便利障碍包括经济成本（58.1%）和前往疫苗接种中心困难（40.3%）。亚组分析显示，不同学科和地理区域存在差异，医学生尽管具备健康知识也表现出犹豫态度。
大学生对新冠疫苗的犹豫主要由安全担忧、错误信息和可及性障碍驱动。解决犹豫问题需要进行透明的风险沟通、政策驱动改善可及性以及开展针对性的教育干预。这些发现可为提高年轻人疫苗接种率的策略提供参考，并有助于更广泛的大流行防范工作。
