Exploring the perceptions of the COVID-19 vaccine among university students in South Africa: A qualitative inquiry into vaccine hesitancy and uptake.

We explored South African university students' perceptions of the COVID-19 vaccine. Twenty-eight students (mean age: 26.2 years; age range 18-43; females = 20, males = 7, other = 1) from a university in the Western Cape participated in semi-structured interviews. Data were thematically analysed using ATLAS.ti (Version 25). Five themes were identified: (1) Between hope and hesitation; (2) Navigating a saturated information ecosystem; (3) Low risk, low priority; (4) Barriers and mandates; and (5) Vaccinating for the greater good: Responsibility and social tension. Findings are discussed in relation to the 5C model of vaccine hesitancy and reveal a nuanced co-existence of hope and mistrust, influenced by concerns about safety, rapid vaccine development, institutional motives, conflicting information, low perceived personal risk, and tensions between collective responsibility and social division. These insights illuminate the complexity of vaccine perceptions among university students and the need for targeted, contextually informed strategies to address hesitancy.