Awareness, Coverage, and Barriers to COVID-19 Vaccination among Undergraduate Students in Nigeria




COVID-19 outbreak, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Pandemic declaration, Nigerian government response, Impact on academic institutions, Vaccination program, Vaccination coverage in Nigeria, Factors influencing vaccination, Undergraduate students, Vaccination awareness, Vaccination barriers, Study methodology (Cross-sectional study), Survey design (Google Forms), Sample size determination, Data analysis (IBM SPSS), Demographic data of respondents, COVID-19 knowledge assessment, COVID-19 vaccination coverage assessment, Correlation between knowledge and vaccination coverage, Barriers to COVID-19 vaccination, Recommendations for improving vaccine uptake


Background: With the resumption of physical learning activities across Nigeria's higher education institutions, tertiary-level students, a priority group in the deployment of the COVID-19 vaccines according to the WHO SAGE, face circumstances that necessitate widespread vaccination coverage among them. This study aimed to assess Nigerian undergraduate students' knowledge, coverage, and barriers to COVID-19 vaccination.

Method: A cross-sectional survey of Nigerian undergraduates was conducted in October 2021, using an online questionnaire and a combined simple random and snowballing sampling technique. The questionnaire included sections on respondents' demographic characteristics, COVID-19 vaccine awareness, coverage, barriers, and recommendations. A total of 326 respondents electronically completed and returned the informed consent form along with the questionnaire. The data obtained were analyzed using the statistical package for the social sciences (SPSS) version 25.

Results: The overall awareness of COVID-19 vaccines among the sampled students was high; with 62.3%, 20.9%, and 16.9% having good, average, and poor levels of knowledge respectively. However, a majority of the respondents (81.3%) had not received the vaccines. The most prominent barrier to vaccination was misinformation about vaccine safety (23.6%). Opening vaccination centers on campuses (18.6%), demonstrating vaccine effectiveness and safety (18.7%), and organizing awareness campaigns (17.2%) were the most frequently recommended actions.

Conclusion: Most respondents were aware of the availability and potential benefits of COVID-19 vaccines; however, coverage remained extremely low. Our findings emphasize the importance of addressing vaccination barriers by public health stakeholders to achieve optimal COVID-19 vaccine coverage.


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Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Emergence, transmission, and characteristics of human coronaviruses. J Adv Res. 2020;1(24):91-8.

Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, Ko WC, Hsueh PR. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths. J Microb Immunol Infect. 2020;53(3):404-12.

World Health Organization. WHO SAGE values framework for the allocation and prioritization of COVID-19 vaccination. Available from: Last updated: Sep 30, 2020; cited: Nov 20, 2022.

Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta BioMed. 2020;91(1):157.

Okereke M, Fortune E, Peter AO, Ukor NA, Lucero‐Prisno III DE. Second wave of COVID‐19 in Nigeria: Lessons from the first wave. Int J Health Plan Manag. 2022; 37(2):650-6.

Ebohon O, Obienu AC, Irabor F, Amadin FI, Omoregie ES. Evaluating the impact of COVID-19 pandemic lockdown on education in Nigeria: Insights from teachers and students on virtual/online learning. Bull Natl Res Cent. 2021;45(1):1-1.

Ezeonu CT, Uneke CJ, Ezeonu PO. A Rapid Review of the Reopening of Schools in this COVID‐19 Pandemic? How Ready are We in Nigeria?. Nig J Med 2021;30(1):8-16.

Adebisi YA, Alaran AJ, Bolarinwa OA, Akande-Sholabi W, Lucero-Prisno DE. When it is available, will we take it? Social media users’ perception of hypothetical COVID-19 vaccine in Nigeria. Pan Afr Med J. 2021;38:230.

Effiong FB, Babatunde AO, Dada OE, Enwerem K. Global Transmission of SARS-COV-2 in Schools, Religious Centres and Markets: An Exploratory Review. Int J Health Life Sci. 2021;7(2):e110729.

Wonodi C, Obi-Jeff C, Adewumi F, Keluo-Udeke SC, Gur-Arie R, Krubiner C, et al. Conspiracy theories and misinformation about COVID-19 in Nigeria: Implications for vaccine demand generation communications. Vaccine. 2022;40(13):2114-21.

World Health Organization. WHO coronavirus disease (COVID-19) dashboard. Available from: Last updated: Nov 25, 2022; cited: Nov 25, 2022

World Health Organization. Strategy to achieve global COVID-19 vaccination by mid-2022. Available from: Last updated: Oct 6, 2021; cited: Nov 25, 2022.

Bono SA, Faria de Moura VE, Siau CS, Chen WS, Pengpid S, Hasan MT, et al. Factors affecting COVID-19 vaccine acceptance: an international survey among low-and middle-income countries. Vaccines. 2021;9(5):515.

Mustapha M, Lawal BK, Sha’aban A, Jatau AI, Wada AS, Bala AA, et al. Factors associated with acceptance of COVID-19 vaccine among University health sciences students in Northwest Nigeria. PloS one. 2021;16(11):e0260672.

Uzochukwu IC, Eleje GU, Nwankwo CH, Chukwuma GO, Uzuke CA, Uzochukwu CE, et al. COVID-19 vaccine hesitancy among staff and students in a Nigerian tertiary educational institution. Ther Adv Infect Dis. 2021:20499361211054923.

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Strobe Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Int Med. 2007;147(8):573-7.

World Health Organization. World Health Organization vaccination coverage cluster surveys: reference manual. Available from: Last updated: June 12, 2018; cited: Jan 20, 2022.

Domek GJ, O’Leary ST, Bull S, Bronsert M, Contreras-Roldan IL, Ventura GA, et al. Measuring vaccine hesitancy: Field testing the WHO SAGE Working Group on Vaccine Hesitancy survey tool in Guatemala. Vaccine. 2018;36(35):5273-81.

Adetayo AJ, Sanni BA, Aborisade MO. COVID-19 Vaccine Knowledge, Attitude, and Acceptance among Students in Selected Universities in Nigeria. DSAMJ. 2021;3(4)162-7.

Ekowo OE, Manafa C, Isielu RC, Okoli CM, Chikodi I, Onwuasoanya AF, et al. A cross-sectional regional study looking at the factors responsible for the low COVID-19 vaccination rate in Nigeria. Pan Afr Med J. 2022;41:114.

Njoga EO, Mshelbwala PP, Abah KO, Awoyomi OJ, Wangdi K, Pewan SB, et al. COVID-19 Vaccine Hesitancy and Determinants of Acceptance among Healthcare Workers, Academics and Tertiary Students in Nigeria. Vaccines. 2022;10(4):626.

Kadam P, Bhalerao S. Sample size calculation. Int J Ayurveda Res. 2010;1(1):55-7.

Al-Qerem WA, Jarab AS. COVID-19 vaccination acceptance and its associated factors among a Middle Eastern population. Front Public Health. 2021;9:632914.

Pugliese-Garcia M, Heyerdahl LW, Mwamba C, Nkwemu S, Chilengi R, Demolis R et al. Factors influencing vaccine acceptance and hesitancy in three informal settlements in Lusaka, Zambia. Vaccine. 2018;36(37):5617-24.

Roy DN, Biswas M, Islam E, Azam MS. Potential factors influencing COVID-19 vaccine acceptance and hesitancy: A systematic review. PloS one. 2022;17(3):e0265496.

Abebe H, Shitu S, Mose A. Understanding of COVID-19 vaccine knowledge, attitude, acceptance, and determinants of COVID-19 vaccine acceptance among the adult population in Ethiopia. Infect Drug Resist. 2021;14:2015.

Mahmud S, Mohsin M, Khan IA, Mian AU, Zaman MA. Knowledge, beliefs, attitudes and perceived risk about COVID-19 vaccine and determinants of COVID-19 vaccine acceptance in Bangladesh. PloS one. 2021;16(9):e0257096.

Mohamed NA, Solehan HM, Mohd Rani MD, Ithnin M, CheIsahak CI. Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. Plos one. 2021;16(8):e0256110.

Effiong F, Akanno I, Anosike U, Kayode A, Okon A, Iwendi G, Oke G, Nwobodo M, Uzairue L. Nigeria’s polio elimination playbook: Lessons to strengthening health systems for other eradicable diseases. Glob Biosec. 2021;3(1).

Tagoe ET, Sheikh N, Morton A, Nonvignon J, Sarker AR, Williams L, et al. COVID-19 vaccination in lower-middle income countries: national stakeholder views on challenges, barriers, and potential solutions. Front Public Health. 2021;9:709127.

Duan Y, Shi J, Wang Z, Zhou S, Jin Y, Zheng ZJ. Disparities in COVID-19 vaccination among low-, middle-, and high-income countries: the mediating role of vaccination policy. Vaccines. 2021;9(8):905.

Effiong FB, Makata VC, Elebesunu EE, Bassey EE, Salachi KI, Sagide MR, Abdulameed HT, Uwishema O. Prospects of malaria vaccination in Nigeria: anticipated challenges and lessons from previous vaccination campaigns. Annals of Medicine and Surgery. 2022 Sep 1;81:104385.

Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll MD, et al. Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China Vaccines. 2020;8(3):482.

Voo JY, Lean QY, Ming LC, Md. Hanafiah NH, Al-Worafi YM, Ibrahim B. Vaccine Knowledge, Awareness and Hesitancy: A Cross Sectional Survey among Parents Residing at Sandakan District, Sabah. Vaccines. 2021;9(11):1348.

Marzo RR, Sami W, Alam M, Acharya S, Jermsittiparsert K, Songwathana K, et al. Hesitancy in COVID-19 vaccine uptake and its associated factors among the general adult population: a cross-sectional study in six Southeast Asian countries. Trop Med Health. 2022;50(4):1-10.

Lessard D, Ortiz-Paredes D, Park H, Varsaneux O, Worthinton J, Basta NE, MacDonald SE, Lebouche B, Cox J, Ismail SJ, Kronfili N. Barriers and facilitators to covid-19 vaccine acceptability among people incarcerated in Canadian federal prisions: A qualitative study. Vaccine X. 2022;10:100150.

Eastin C, Moore B, Moulton A, et al. Vaccine Acceptance During a Novel Student-led Emergency Department COVID-19 Vaccination Program. West J Emerg Med. 2023;24(3):436-46.

Chengane S, Cheney A, Garth S, Medcalf S. The COVID-19 Response in Nebraska: How Students Answered the Call. Prev Chronic Dis. 2020;17:E81.

Yelsma A, Mitchell M, Filpi G. Establishing and Implementing a University-Based COVID-19 Coalition In: The Health Education Monograph Series. WMU. 2022;39(1):46-50.

Sadoh AE, Okonkwobo C, Nwaneri DU, Ogboghodo BC, Eregiea C, Oviawe O et al. Effect of Peer Education on Knowledge of Human Papillomavirus and Cervical Cancer among Female Adolescent Students in Benin City, Nigeria. Ann Glob Health. 2018;84(1):121-8.

Mary M, Femi RT, Sonika RG, Olaniyi T, and Jalo P, et al. Effects of Peer Education Intervention for Hepatitis B on Level of Knowledge and Beliefs of School Adolescents in Jos,Plateau State Nigeria Nigeria. Acta Sci Nutr Health. 2019;3(1):53-60.

Busari DA, Nwokporo EI. Equity, Access and Utilization of COVID-19 Vaccine in Ebonyi State, Nigeria. J Geovis Spat Anal. 2023;7(24).

Adigwe OP. COVID-19 vaccine hesitancy and willingness to pay: Emergent factors from a cross-sectional study in Nigeria. Vaccine X. 2021;9:100112.

Akinyemi PA, Owoade IA, Fajobi O, Wuraola FO, Elugbaju OT. Determinants of Willingness to Pay for COVID-19 Vaccines among Residents of Osun State, South-West Nigeria. J Com Med Pr Health C. 2021;33(2):1-18.

Couture MC, L’Engle KL, Swathi PA, Regan AK. COVID-19 vaccine coverage among college students following vaccine mandates. J Am Coll Health. 2023;9:1-5.

Smith MJ, Emanuel EJ. Learning from five bad arguments against mandatory vaccination. Vaccine. 2023;41(21):3301-4.

World Health Organizations. COVID-19 and mandatory vaccination: Ethical considerations. nCoV19 2022 Policy brief. Available from: Last updated: May 30, 2022; cited: Oct 28, 2023.

Association Between Vaccination Coverage and Awareness (Knowledge Grading) about COVID-19 and COVID-19 Vaccines Among Respondents.



How to Cite

Effiong, F. B., Hassan, I. A., Olawuyi , D. A., Ogbonna , C. P., Araoye, J. B., Bassey, E. E., Enwerem, K. E., & Adebisi , Y. A. (2023). Awareness, Coverage, and Barriers to COVID-19 Vaccination among Undergraduate Students in Nigeria. International Journal of Medical Students, 11(4), 262–270.



Original Article


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