Knowledge, Attitudes and Practices Regarding COVID-19 and Its Vaccination in a High School Population

The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on education in Mexico, with extended school closures and the shift to distance learning. The absence of an initial vaccine and the general need for evidence on prevention measures within university communities prompted this study.

To assess the knowledge, attitudes, and practices regarding COVID-19 and its vaccination in the high school community (HSC) of the National Autonomous University of Mexico (UNAM) by the third year of the pandemic.

A cross-sectional, 26-question online survey was conducted among UNAM HSC in September 2022. The data were analyzed using multivariate logistic and linear regression models to identify factors associated with vaccination.

A total of 22,000 surveys were collected, 16,789 of which were eligible for analysis. Among these, 16,361 (97.4%) respondents were vaccinated. The primary reason for nonvaccination was the inability to access a vaccine (37.2%). Younger respondents (<18 years) were more likely to be unvaccinated, 10-14 years, (OR: 5.36; 95% CI: 2.12-13.55; p <0.001); and 15-18 years, (OR: 2.77; 95% CI: 1.12-6.82, p = 0.028). Individuals with overweight/obesity (OR: 1.39; 95% CI 1.05-1.85; p = 0.023); immunosuppression (OR: 2.6; 95% CI: 1.56-4.33; p <0.001), and those who considered these conditions as risk factors for COVID-19 were significantly more likely to be unvaccinated. Conversely, those who viewed hypertension as a risk factor OR 0.7 (95% CI 0.53-0.93)) or who were accustomed to face mask use OR 0.28 (95% CI 0.22-0.35), p <0.001) were more likely to be vaccinated.

We found a high acceptance of COVID-19 vaccination at UNAM HSC, which may have contributed to the safer resumption of in-person activities and helped mitigate the impact of subsequent epidemic waves; the reasons for non-vaccination appear addressable through targeted logistical measures and tailored information.