COVID-19 vaccine hesitancy among Italian university students: Insights from history to shape the future

Vaccination is considered the most effective measure to protect people from severe illness due to COVID-19. However, vaccine hesitancy (VH) remains a public health challenge. This cross-sectional study aimed to assess COVID-19 vaccine uptake and acceptance among Italian university students (aged 18-29 years), to identify key factors influencing these outcomes, and to provide insights for public health interventions. Data were collected between the 1^st and the 14^th of April 2021 through an online, anonymous, self-administered questionnaire that was used to gather socio-demographic characteristics, knowledge, fears, and beliefs concerning the COVID-19 vaccine, and vaccination-related behaviors. The study population consisted of 1025 students. Only 34.9% of students correctly answered all vaccine-related questions in the general knowledge about vaccines and COVID-19 vaccine section of the questionnaire. A significant number of students expressed fear of contracting COVID-19 (68%), were concerned about the vaccine's safety (34.2%), and preferred natural immunity (22.1%). Nevertheless, most (93.8%) students who had not received the vaccine expressed a willingness to do so. Social responsibility was one of the main drivers of the intention to be vaccinated (82.4%). Concerns about potential side effects (70%) and vaccine effectiveness (50%), and lack of information (50%) were the main reason for not getting vaccinated. The survey provided valuable information useful to bridge the gap between vaccination intention and behavior and to design tailored intervention addressed to young adults across the southern part of the country.