Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study

Abstract Background The mental health problems during the coronavirus disease 2019 (COVID-19) pandemic may have influenced their decision to receive the COVID-19 vaccine among health-related university students, with potential differences across countries. This study elucidated the association betwe...

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Main Authors: Thanawat Khongyot, Amy Takyi, Dympna Siysila Ndzeshang, Karl Gwei Njuwa Fai, Tin Zar Win, Latdavanh Vorlasane, Gibson Omwansa Javes, Satoshi Kaneko, Taeko Moriyasu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Tropical Medicine and Health
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Online Access:https://doi.org/10.1186/s41182-025-00751-3
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author Thanawat Khongyot
Amy Takyi
Dympna Siysila Ndzeshang
Karl Gwei Njuwa Fai
Tin Zar Win
Latdavanh Vorlasane
Gibson Omwansa Javes
Satoshi Kaneko
Taeko Moriyasu
author_facet Thanawat Khongyot
Amy Takyi
Dympna Siysila Ndzeshang
Karl Gwei Njuwa Fai
Tin Zar Win
Latdavanh Vorlasane
Gibson Omwansa Javes
Satoshi Kaneko
Taeko Moriyasu
author_sort Thanawat Khongyot
collection DOAJ
description Abstract Background The mental health problems during the coronavirus disease 2019 (COVID-19) pandemic may have influenced their decision to receive the COVID-19 vaccine among health-related university students, with potential differences across countries. This study elucidated the association between mental health and COVID-19 vaccine hesitancy of health-related university students in Thailand, Laos, and Japan. We additionally examined the other factors that might relate to COVID-19 vaccine hesitancy. Methods The study conducted an online survey from February 4 to 27, 2021, among undergraduate students enrolled in health-related programs at University of Health Sciences (Lao PDR), Walailak University (Thailand), and Nagasaki University (Japan) using a non-probability convenience sampling method. The data were analyzed using multiple logistic regression to identify associations between mental health and self-reported COVID-19 vaccine hesitancy and other potential factors. Results This study analyzed data from 841 students. Japanese students attended hybrid classes (82.45%), while those in Laos and Thailand had entirely online courses. All mental health assessment scores (depression, anxiety, and stress) were higher in Thailand and Laos compared to Japan. Students with very high-stress scores had the highest odds of vaccine hesitancy (aOR 2.67, 95% CI 1.45–4.93). Fear of COVID-19 increased hesitancy, while unbelief in vaccine protection significantly increased it (aOR 2.59, 95% CI 1.86–3.59). Females displayed about two times greater hesitancy (adjusted odds ratio, aOR 2.43, 95% CI 1.68–3.51), which correlated with higher mental health scores. Conclusions We highlighted a significant association between mental health and self-report COVID-19 vaccine hesitancy. Interventions, including tailored support, awareness campaigns, and psychological services, can foster trust and vaccine uptake.
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spelling doaj-art-beb2b190ab924db9b80575c515ea93a12025-08-20T03:08:44ZengBMCTropical Medicine and Health1349-41472025-05-0153111110.1186/s41182-025-00751-3Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center studyThanawat Khongyot0Amy Takyi1Dympna Siysila Ndzeshang2Karl Gwei Njuwa Fai3Tin Zar Win4Latdavanh Vorlasane5Gibson Omwansa Javes6Satoshi Kaneko7Taeko Moriyasu8School of Pharmacy, Walailak UniversityHealth Information OfficerSchool of Tropical Medicine and Global Health, Nagasaki UniversityEpicentre, Médecins Sans FrontièresSchool of Tropical Medicine and Global Health, Nagasaki UniversitySavannakhet Provincial HospitalSchool of Tropical Medicine and Global Health, Nagasaki UniversityInstitute of Tropical Medicine, Nagasaki UniversityOffice for Global Relations, Nagasaki UniversityAbstract Background The mental health problems during the coronavirus disease 2019 (COVID-19) pandemic may have influenced their decision to receive the COVID-19 vaccine among health-related university students, with potential differences across countries. This study elucidated the association between mental health and COVID-19 vaccine hesitancy of health-related university students in Thailand, Laos, and Japan. We additionally examined the other factors that might relate to COVID-19 vaccine hesitancy. Methods The study conducted an online survey from February 4 to 27, 2021, among undergraduate students enrolled in health-related programs at University of Health Sciences (Lao PDR), Walailak University (Thailand), and Nagasaki University (Japan) using a non-probability convenience sampling method. The data were analyzed using multiple logistic regression to identify associations between mental health and self-reported COVID-19 vaccine hesitancy and other potential factors. Results This study analyzed data from 841 students. Japanese students attended hybrid classes (82.45%), while those in Laos and Thailand had entirely online courses. All mental health assessment scores (depression, anxiety, and stress) were higher in Thailand and Laos compared to Japan. Students with very high-stress scores had the highest odds of vaccine hesitancy (aOR 2.67, 95% CI 1.45–4.93). Fear of COVID-19 increased hesitancy, while unbelief in vaccine protection significantly increased it (aOR 2.59, 95% CI 1.86–3.59). Females displayed about two times greater hesitancy (adjusted odds ratio, aOR 2.43, 95% CI 1.68–3.51), which correlated with higher mental health scores. Conclusions We highlighted a significant association between mental health and self-report COVID-19 vaccine hesitancy. Interventions, including tailored support, awareness campaigns, and psychological services, can foster trust and vaccine uptake.https://doi.org/10.1186/s41182-025-00751-3COVID-19 vaccineCoronavirus diseaseMental healthUniversity studentVaccine hesitancy
spellingShingle Thanawat Khongyot
Amy Takyi
Dympna Siysila Ndzeshang
Karl Gwei Njuwa Fai
Tin Zar Win
Latdavanh Vorlasane
Gibson Omwansa Javes
Satoshi Kaneko
Taeko Moriyasu
Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
Tropical Medicine and Health
COVID-19 vaccine
Coronavirus disease
Mental health
University student
Vaccine hesitancy
title Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
title_full Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
title_fullStr Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
title_full_unstemmed Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
title_short Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study
title_sort mental health and covid 19 vaccine hesitancy among health related university students a cross sectional multi center study
topic COVID-19 vaccine
Coronavirus disease
Mental health
University student
Vaccine hesitancy
url https://doi.org/10.1186/s41182-025-00751-3
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