Exploring the perceptions, knowledge, and acceptability of COVID-19 vaccination among health profession students in Calabar Metropolis, Nigeria: a cross-sectional school-based study

Background The COVID-19 pandemic remains a historic global health crisis, yet vaccine hesitancy persists as a significant barrier to recovery. Health profession students, as future frontline providers, are critical influencers of public vaccination behavior. This study assessed the knowledge, perceptions, and acceptability of COVID-19 vaccination among health profession students in Calabar Metropolis, Nigeria. Methodology A school-based cross-sectional study was conducted among 410 students (96.2% response rate) recruited via multistage sampling from five higher education institutions. Data were collected using a pre-tested, 44-item semi-structured questionnaire. Knowledge was graded using Bloom’s cut-off points, while perceptions were categorized based on median Likert scores. Data were analyzed using SPSS version 20, employing Pearson’s Chi-Square (chi^2) to test associations at a 5% significance level. Results The majority of respondents were female (51.9%) and aged 20–24 years (42.1%). Knowledge levels were evenly distributed: 33.2% good, 34.0% moderate, and 32.9% poor. While more than half (55.1%) held positive perceptions regarding the vaccine’s benefits, actual acceptability was critically low; only 7.8% of students had received at least one dose. Major barriers included concerns over side effects and vaccine-related misinformation. Acceptability was significantly associated with good knowledge (p = 0.01), positive perception (p = 0.012), age (p = 0.021), and sex (p = 0.003), with males and older students demonstrating higher uptake. Conclusion Despite demonstrating moderate knowledge and generally positive perceptions, there is a profound “intention-to-action” gap among health profession students in Calabar, evidenced by the extremely low vaccination rate. This discrepancy underscores the need for targeted educational interventions within medical curricula to address specific safety concerns and neutralize misinformation, ensuring future healthcare leaders are prepared to advocate for immunization.