Attitudes Toward COVID-19 Vaccination and Clinical Trials Among Saudi University Students

The implementation of a global COVID-19 vaccination campaign has been one of the most effective interventions in controlling the pandemic. However, vaccine hesitancy remains a major public health challenge, extending to COVID-19 vaccines. This cross-sectional study aimed to assess attitudes toward COVID-19 vaccination and willingness to participate in clinical trials among Saudi university affiliates.

An anonymous online questionnaire was distributed between June 2021 and June 2022 to affiliates of four major universities in Riyadh, Saudi Arabia. Attitudes toward vaccination were assessed using the 12-item Vaccination Attitudes Examination (VAX) scale, while attitudes toward clinical trial participation were evaluated through statements rated on a 5-point Likert scale. Statistical analyses were conducted to determine associations between vaccine acceptance, clinical trial participation, and demographic factors.

A total of 365 respondents participated in the study. The majority were healthcare students, with most in their fourth academic year. Overall, 50.4% of the study sample exhibited vaccine and clinical trial hesitancy. Females exhibited significantly higher vaccine acceptance than males (P = 0.013), though hesitancy rates were only borderline significant between genders (P = 0.063). Healthcare students had significantly higher vaccine acceptance (P < 0.0001) and greater willingness to participate in clinical trials (P < 0.0001) compared to students from science and humanities disciplines. While most participants believed in vaccine safety and effectiveness, many expressed hesitancy regarding the motivations of pharmaceutical companies. Although attitudes toward clinical trials were generally favorable, only 37.8% expressed willingness to participate, and this figure dropped to 32.9% for COVID-19 vaccine trials. Vaccine acceptors were significantly more likely to be willing to participate in clinical trials (P < 0.0001).

Understanding university students' perspectives on vaccination and clinical trials can help shape targeted public health campaigns to address vaccine hesitancy. Future research is needed to explore determinants of vaccine hesitancy and barriers to clinical trial participation in this population.