Hesitant Minds in Vulnerable Times: COVID-19 Vaccine Hesitancy Among University Students in Ukraine

Abstract

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemo graphic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (re sistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher con straints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was posi tively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and foster ing collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings.