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Although numerous studies investigated the predictors of vaccination intention and decision, little is known about the relationship between vaccination and well-being. This study compares the physical and mental health dimensions among vaccinated and unvaccinated people. In a cross-sectional online survey, 706 university students from Poland (mean age of 23 years, 76% of women) participated in this study during the fourth pandemic wave (November-December 2021). Standardized questionnaires with a Likert response scale were included in the survey to measure spirituality, exposure to the COVID-19 pandemic, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, anxiety, depression, and life satisfaction. Consistent with the fuzzy-trace theory, the unvaccinated sample was younger and scored significantly lower than the vaccinated group in exposure to COVID-19, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, and depression, while higher in life satisfaction. The network analysis showed that mental health plays a crucial role in both groups, with the central influence of anxiety and stress on depression and life satisfaction. The message on vaccination to university students should focus on the benefits of vaccination in maintaining the status quo of good health and well-being. Campus prevention programs should primarily aim to reduce anxiety, stress, and negative emotions by teaching students coping strategies, relaxation techniques, and mindfulness.

Background: Research indicates that mental health worsened during the Coronavirus crisis, in particular among women and university students. However, few longitudinal studies have so far investigated the changes in mental health outcomes across three subsequent waves of the COVID-19 pandemic. Therefore, this study aims to examine changes in mental health among university students., Methods: A total of 1,961university students from Poland, at mean age 23.23 years (SD = 3.16, 57.47% of women) were included in this repeated cross-sectional study across three waves of the COVID-19 pandemic: W1 (n = 657), W2 (n = 654), and W3 (n = 650). They completed the online survey with the Generalized Anxiety Disorder (GAD-7), Perceived Stress Scale (PSS-10), General Self-Rated Health (GSRH), and Satisfaction with Life Scale (SWLS), as well as sociodemographic variables., Results: The prevalence of people at high risk of anxiety and perceived stress, poorer physical health, and low life satisfaction changed significantly across three waves of the COVID-19 pandemic. The results of the two-way ANOVA showed that both the wave (W1W2, W1>W3), and genders (menW3, W2>W3), and was significantly worse in women than in men. The level of life satisfaction also decreased significantly in W3 (W1>W3, W2>W3), but did not differ between men and women. High GAD risk was presented two times more frequently among women and people who subjectively assessed their health as poor, three times more likely in participants dissatisfied with their lives, and seven times more probably in persons with high-stress levels., Conclusions: The results of this study consistently indicate (using parametric and non-parametric statistical analysis) that there are significant differences in mental health problems across three waves of the COVID-19 pandemic. It suggests that pandemic waves should be considered in future review studies and meta-analyses. Furthermore, these findings indicate a potential role for prevention and intervention programs aimed at alleviating life satisfaction and subjective assessment of health and improving coping skills to reduce stress and anxiety., (© 2021. The Author(s).)