Int J Biol Sci 2021; 17(6):1469-1475. doi:10.7150/ijbs.58835 This issue

Research Paper

Attitudes toward COVID-19 vaccines in Chinese college students

Wei Bai, PhD1,2,3#, Hong Cai, PhD1,2,3#, Shou Liu, PhD4#, Huanzhong Liu, PhD5#, Han Qi, MSc6#, Xu Chen, MD6#, Rui Liu, PhD6#, Teris Cheung, PhD7, Zhaohui Su, PhD8, Chee H. Ng, MBBS, MD9✉, Yu-Tao Xiang, MD, PhD1,2,3✉

1. Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
2. Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
3. Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
4. Department of Public Health, Medical College, Qinghai University, Xining, Qinghai province, China
5. Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, China
6. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
7. School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
8. Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
9. Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
# These authors contributed equally to the work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Bai W, Cai H, Liu S, Liu H, Qi H, Chen X, Liu R, Cheung T, Su Z, Ng CH, Xiang YT. Attitudes toward COVID-19 vaccines in Chinese college students. Int J Biol Sci 2021; 17(6):1469-1475. doi:10.7150/ijbs.58835. Available from

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Graphic abstract

Background: Vaccination is an important preventative measure against the coronavirus disease 19 (COVID-19) pandemic. To implement vaccination and immunization programs effectively, it is essential to investigate public attitudes toward COVID-19 vaccines. This study examined the attitudes of Chinese college students toward COVID-19 vaccines and their associated factors. Methods: A cross-sectional study was conducted in college students nationwide from December 27, 2020 to January 18, 2021. Attitudes toward COVID-19 vaccines and acceptance of future vaccination programs were assessed. Results: Totally, 2,881 college students participated in this survey; of them, 76.3% (95% CI: 74.8% - 77.9%) were willing to accept a COVID-19 vaccine in the future. Multiple logistic analysis revealed that students living in urban (OR=1.409, 95% CI: 1.152 - 1.724, p=0.001) and those studying health-related courses (OR=1.581, 95% CI: 1.291 - 1.935, p<0.001) were more likely to have a positive attitude toward COVID-19 vaccines. In addition, those who were worried about being infected with COVID-19 (very much vs no, OR=1.690, 95% CI: 1.212-2.356, p=0.002), heard previously about COVID-19 vaccines (OR=1.659, 95% CI: 1.268-2.170, p<0.001), believed that vaccines are safe (Yes vs No, OR=3.570, 95% CI: 1.825-6.980), thought that vaccines can protect people from being infected with COVID-19 (Yes vs No, OR=1.957, 95% CI: 1.286-2.979, p=0.002), and had encouraged their family and friends to have a vaccine (Yes vs No, OR=17.745, 95% CI: 12.271-25.660, p<0.001) had higher acceptance of COVID-19 vaccination. Conclusions: A high rate of acceptance of COVID-19 vaccines was found among Chinese college students. However, vaccine uptake may be reduced by concerns about vaccine safety and efficacy. Alleviating these concerns and enhancing public confidence in vaccines are crucial for future immunization programs against the COVID-19 pandemic.

Keywords: Coronavirus disease 19, Vaccine, College students, Attitude