Background University students are at particular risk of invasive meningococcal disease (IMD). Group W, an aggressive strain, is increasing in prevalence and the high case-fatality rate is concerning. Adolescents have been offered the MenACWY vaccine since 2015. National uptake has been low, leaving students vulnerable to infection. Objectives To investigate MenACWY uptake, knowledge of IMD and attitudes towards vaccination among UCL first-year students. Methods A mixed methods approach was used, involving a questionnaire (n=144) and follow-up interviews (n=13). Students were asked for demographic details and questions including vaccination status, awareness of the vaccine, other vaccination history and knowledge of IMD, which was assessed through true/false/unsure statements. Interviews explored these issues in more detail as well as their suggestions for making vaccination more accessible for students. Results MenACWY uptake was 84%, with more socioeconomically disadvantaged students being less likely to be vaccinated (aOR=0.117, p=0.006). Most students thought vaccines were safe and important. Students with above average knowledge were more likely to be vaccinated (OR=3.057, p=0.019). Vaccination views were positive and knowledge level was moderate to high. Reasons for non-vaccination included illness, laziness, forgetfulness and difficulty with GP access. Of concern, many students believed that the vaccine prevents any cause of meningitis. Conclusion High vaccine uptake is essential to protect students. Uptake at University College London is higher than at other universities in previous studies. This research highlights several areas requiring further study and has implications for university vaccination policy.

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