Self-Reported Vaccine Hesitancy among Undergraduates in Two Universities in Nasarawa State, Nigeria

Abstract

Vaccine hesitancy undermines immunization coverage worldwide, yet data on Nigerian university students remain scarce. This study assessed the prevalence and correlates of vaccine hesitancy among undergraduates at the Federal University of Lafia (FULafia) and Nasarawa State University Keffi (NSUK), Nigeria. A cross-sectional survey was conducted; 400 questionnaires were administered and 385 were adequately completed and analyzed (96.3% response rate; 172 FULafia, 213 NSUK). The questionnaire covered vaccination history, self-rated and vaccine-specific hesitancy, reasons for hesitancy, and information sources. Associations were examined using Chi-square/Fisher's exact tests and multivariable logistic regression. Overall, 66.2% (255/385) self-identified as vaccine hesitant. Hesitancy was more prevalent among students in NSUK than in FULafia (75.1% vs 55.2%, p < 0.001), among Muslim than Christian respondents (88.4% vs 44.6%, p < 0.001), and among male than female students (83.1% vs 40.9%, p < 0.001). After adjustment, institution (adjusted odds ratio [aOR] = 2.90, 95% confidence interval [CI] 1.72–4.90), Muslim affiliation (aOR = 4.05, 95% CI 1.81–9.04), and peer/family encouragement to refuse (aOR = 3.68, 95% CI 1.93–7.03) remained independent correlates; the sex effect attenuated. Hesitancy was highest toward COVID-19 (47.0%) and Hepatitis B (39.2%) vaccines; fear of side effects was the leading reason (68.2%). Vaccine hesitancy is highly prevalent among undergraduates in the two Nasarawa State universities studied and is independently associated with institution, religion, and social encouragement to refuse vaccination. Interventions combining transparent safety communication with engagement of religious and peer networks are needed to strengthen vaccine confidence among this population.