Abstract
The study aimed to investigate behavioural intentions to receive free and self-paid COVID-19 vaccinations (BICV-F and BICV-SP) among Chinese university students if the vaccine was 80% effective with rare mild side effects, to examine their associations with social media exposures and peer discussions regarding COVID-19 vaccination, and to explore the mediational role of perceived information sufficiency about COVID-19 vaccination. An online anonymous survey (N = 6922) was conducted in November 2020 in five Chinese provinces. Logistic regression and path analysis were adopted. The prevalence of BICV-F and BICV-SP were 78.1% and 57.7%. BICV-F was positively associated with the frequencies of passive social media exposure (adjusted odds ratio (AOR) = 1.32, P < 0.001), active social media interaction (AOR = 1.13, P < 0.001) and peer discussions (AOR = 1.17, P < 0.001). Indirect effects of the three factors on BICV-F via perceived information sufficiency were all significant (P < 0.001). The direct effect of active social media interaction on BICV-F was significantly negative (P < 0.001). Similar associations/mediations were observed for BICV-SP. The COVID-19 vaccination intention of Chinese university students needs improvement. Boosting social media exposures and peer discussions may raise students' perceived information sufficiency and subsequently increase their vaccination intention. Considering the potential negative effect of active social media interaction, caution is needed when using social media to promote COVID-19 vaccination.
Highlights
Immunisation is seen as the most promising measure to end the COVID-19 pandemic [1]
A number of studies conducted across countries (e.g. France, Italy, U.S.A., Canada, Israel, China and Indonesia) have warned that vaccine hesitancy may undermine the success of future COVID-19 vaccination programmes, with the reported prevalence of acceptability or behavioural intention of receiving COVID-19 vaccination ranging from 57.6% to 93.3% [4,5,6,7,8,9,10]
As university students are usually responsive to public health issues and relatively open to new measures [36], they are more likely to be better informed about COVID-19 vaccine development than the general public
Summary
Immunisation is seen as the most promising measure to end the COVID-19 pandemic [1]. Despite the remarkable progress of COVID-19 vaccine development, vaccine hesitancy has raised public health concerns [2]. Social media sometimes convey misinformation and anti-vaccination sentiments, such as conspiracy theories, exaggerated side effects and down-graded vaccine efficacy that may increase vaccine hesitancy [20, 21]. Examples include those cases involving HPV and MMR (measles, mumps and rubella) vaccinations [18, 22]. Univariate logistic regression was conducted to examine the crude associations between the background variables/studied independent variables (i.e. frequency of passive social media exposure, frequency of active social media interaction, frequency of peer discussion, level of perceived information sufficiency) and the two binary dependent variables (i.e. BICV-F and BICV-SP). OR, odds ratio; CI, confidence interval; COVID-19, coronavirus disease 2019. aSimple logistic regression on the binary intention of receiving free/self-paid COVID-19 vaccination was performed for each background variable
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