Objective: To assess changes in perceptions of COVID-19 worry and perceived severity, changes in COVID-19 vaccination status, and barriers to COVID-19 vaccination among college students. Participants: 2,252 participants were recruited from a personal wellness course across four academic semesters at a large public university. Methods: Participants completed an anonymous online survey. Changes between groups were analyzed to capture changing perceptions and behaviors related to COVID-19. Results: COVID-19 related worry, perceived severity, and vaccination against COVID-19 significantly decreased over time. However, flu vaccination status did not decrease. The top three cited reasons for vaccination hesitation were concerns about side effects, being healthy and young, and at low risk for getting infected. Conclusion: Given the likely endemic nature of COVID-19, it is important for universities to continue to provide health education regarding transmission prevention, promote COVID-19 vaccination, and reduce myths regarding side-effects and risk perception.