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Linking the behavioral immune system to COVID-19 vaccination intention: The mediating role of the need for cognitive closure and vaccine hesitancy.

ABSTRACT: Vaccination has become one of the most effective ways of controlling the spread of COVID-19. Consequently, revealing the evolutionary and cognitive antecedents of COVID-19 vaccine hesitancy and vaccination intention has become crucial. Drawing on the theory of behavioral immune system (BIS), we investigate whether perceived vulnerability to disease (PVD) is associated with vaccination intentions through the need for cognitive closure (NCC) and vaccine hesitancy. The data was collected from 525 adults from Turkey. The structural equation modeling results indicate that of the two dimensions of PVD, germ aversion predicts COVID-19 vaccination intention through sequential mediation of NCC and vaccine hesitancy. Perceived infectability, on the other hand, is directly and positively related to vaccination intention. By showing the mediating role of NCC, our results offer an insight as to why germ aversion translates into vaccine hesitancy, and low vaccination intention. We discuss the potential benefits of considering the roles of BIS and NCC in campaigns and policies targeted at increasing COVID-19 vaccine uptake and suggest implications for such practices.

SUBMITTER: Solak C

PROVIDER: S-EPMC8423810 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Linking the behavioral immune system to COVID-19 vaccination intention: The mediating role of the need for cognitive closure and vaccine hesitancy.

Solak Çağlar Ç Peker-Dural Hilal H Karlıdağ Sercan S Peker Mehmet M

Personality and individual differences 20210908

Vaccination has become one of the most effective ways of controlling the spread of COVID-19. Consequently, revealing the evolutionary and cognitive antecedents of COVID-19 vaccine hesitancy and vaccination intention has become crucial. Drawing on the theory of behavioral immune system (BIS), we investigate whether perceived vulnerability to disease (PVD) is associated with vaccination intentions through the need for cognitive closure (NCC) and vaccine hesitancy. The data was collected from 525 a ...[more]

PMID: 34511678

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Project description:BackgroundA healthy healthcare system requires healthy healthcare workers. Protecting healthcare workers including nurses against COVID-19 is crucial, and vaccination could be a viable future option. However, vaccine hesitancy remains a global challenge. Nurses, as a trustworthy and creditable source of vaccine-related information, may build public confidence in vaccination. Hence, research on vaccine hesitancy among nurses is warranted.ObjectivesThis study estimated nurses' influenza vaccination behaviors and intention to receive COVID-19 vaccine when available, and examined their corresponding 5C psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility). To investigate the impact of COVID-19-related work demands, the mediation effects of work stress on the association between work demands and COVID-19 vaccination intention were also examined.DesignCross-sectional online survey SETTINGS: Nurses were invited to participate via the promotion of a professional nursing organization and by personal referrals during the COVID-19 outbreak in Hong Kong between mid-March and late April 2020.Participants1,205 eligible nurses (mean age = 40.79, SD = 10.47; 90% being female) were included in the analyses.MethodsDemographics, influenza vaccination, intention to have COVID-19 vaccine, the 5C vaccine hesitancy components, work stress and COVID-19-related work demands (insufficient supply of personal protective equipment, involvement in isolation rooms, and unfavorable attitudes towards workplace infection control policies) were reported in the survey.ResultsThe influenza vaccine uptake rate and the proportion intending to take COVID-19 vaccine were 49% and 63%, respectively. Influenza vaccination was associated with working in public hospitals and all 5C constructs (more confidence, more collective responsibility and less complacency, constraints, and calculation), whereas stronger COVID-19 vaccination intention was associated with younger age, more confidence, less complacency and more collective responsibility. COVID-19-related demands were associated with greater work stress, and hence stronger COVID-19 vaccination intention.ConclusionThe potential uptake rate of COVID-19 vaccine among nurses was suboptimal to achieve herd immunity. The 5C constructs were useful in predicting influenza vaccination and, to a lesser extent, the intention to take COVID-19 vaccine. The uncertain attributes such as effectiveness, side effects, and effective duration of the COVID-19 vaccine may contribute to this discrepancy. With less work stress among nurses in the post-pandemic period, the intention to take COVID-19 vaccine will likely drop. The 5C constructs should be infused in vaccination campaigns. While a COVID-19 vaccine could be ready soon, the nursing profession may not be ready to accept it. More research work is needed to boost the uptake rate.Tweetable abstractLess than two-third of nurses intended to take COVID-19 vaccine when available. While a COVID-19 vaccine could be ready soon, nursing profession is not ready to accept it.

Project description:In Kenya, community health volunteers link the formal healthcare system to urban and rural communities and advocate for and deliver healthcare interventions to community members. Therefore, understanding their views towards COVID-19 vaccination is critical to the country's successful rollout of mass vaccination. The study aimed to determine vaccination intention and attitudes of community health volunteers and their potential effects on national COVID-19 vaccination rollout in Kenya. This cross-sectional study involved community health volunteers in four counties: Mombasa, Nairobi, Kajiado, and Trans-Nzoia, representing two urban and two rural counties, respectively. COVID-19 vaccination intention among community health volunteers was 81% (95% CI: 0.76-0.85). On individual binary logistic regression level, contextual influence: trust in vaccine manufacturers (adjOR = 2.25, 95% CI: 1.06-4.59; p = 0.030); individual and group influences: trust in the MoH (adjOR = 2.12, 90% CI: 0.92-4.78; p = 0.073); belief in COVID-19 vaccine safety (adjOR = 3.20, 99% CI: 1.56-6.49; p = 0.002), and vaccine safety and issues: risk management by the government (adjOR = 2.46, 99% CI: 1.32-4.56; p = 0.005) and vaccine concerns (adjOR = 0.81, 90% CI: 0.64-1.01; p = 0.064), were significantly associated with vaccination intention. Overall, belief in COVID-19 vaccine safety (adjOR = 2.04, 90% CI: 0.92-4.47 p = 0.076) and risk management by the government (adjOR = 1.86, 90% CI: 0.94-3.65; p = 0.072) were significantly associated with vaccination intention. Overall vaccine hesitancy among community health volunteers in four counties in Kenya was 19% (95% CI: 0.15-0.24), ranging from 10.2-44.6% across the counties. These pockets of higher hesitancy are likely to negatively impact national vaccine rollout and future COVID-19 vaccination campaigns. The determinants of hesitancy arise from contextual, individual and group, and vaccine or vaccination specific concerns, and vary from county to county.

Project description:BackgroundInfluenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake.ObjectiveThis review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.MethodsThirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination.ResultsMost studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups.ConclusionMany different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.

Project description:BackgroundThe advent of an effective novel COVID-19 vaccine could extinguish the current devastating pandemic but the vaccine hesitancy is a hurdle for the public health system, so this study estimated the COVID-19 vaccination intention and hesitancy among the healthcare workers, the priority target group for the COVID-19 vaccination in India.MethodsA web-based cross-sectional survey was conducted among the healthcare workers in Chandigarh, a union territory in North India, using a Snowball sampling technique. A total of 403 healthcare workers participated in the study between 2nd and 25th January 2021. The primary data collected were the intention to get vaccinated against the available COVID-19 vaccine and the concerns regarding the new vaccines. The attitude towards novel COVID-19 vaccine was assessed using developed Vaccine attitude examination scale. These questionnaire, which were delivered via WhatsApp, was filled by the participants over Google forms.ResultsAmong the 403 respondents surveyed, the majority (54.6%) reported they were definitely intended to get vaccinated against COVID-19, however, 7% expressed a resistance for inoculation with COVID-19 vaccination. The perceived susceptibility (aOR = 0.511, CI 0.265-0.987) and severity of COVID-19 infection (aOR = 0.551 CI 0.196-0.704) and not being concerned about the efficacy of new COVID-19 vaccines (aOR = 0.702 CI 1.109-26.55) were found to have the highest significant odds of intention to take the COVID-19 vaccine. The majority (62%) were concerned about the safety of the vaccine, in terms of side-effects, quality control, and doubted efficacy of the vaccine. The mistrust of the benefits of the vaccine is a significant predictor for vaccine hesitancy among the healthcare workers (aOR = 5.205 CI 3.106-8.723).ConclusionTherefore, strategic communication and vaccine-acceptance programs should be formulated in order to combat the prevailing mistrust on the vaccine safety and efficacy and attain effective coverage to gain herd immunity.

Project description:RationaleVaccines save lives. Despite the undisputed value of vaccination, vaccine hesitancy continues to be a major global challenge, particularly throughout the COVID-19 global pandemic. Since vaccination decisions are counter-intuitive and cognitively demanding, we propose that vaccine hesitancy is associated with executive function-a group of high-level cognitive skills including attentional control, working memory, inhibition, self-regulation, cognitive flexibility, and strategic planning.ObjectiveWe set out to test (i) whether vaccine hesitancy is driven by individual differences in executive function beyond established socio-demographic factors (e.g., education, political orientation, gender, ethnicity, age, religiosity) and depressed mood, and (ii) whether this relationship is exacerbated by situational stress.MethodsTwo studies were conducted with U.S. residents. Using a cross-sectional design, Study 1 examined the associations between executive function, socio-demographic factors, COVID-19 conspiracy beliefs, trust in health authorities, and COVID-19 vaccine hesitancy. Using an experimental design, Study 2 focused solely on unvaccinated individuals and tested the interactive effect of executive function and stress on willingness to receive a COVID-19 vaccine. We used ordinal logistic regressions to analyze the data.ResultsIndividual differences in executive function predicted participants' COVID-19 conspiracy beliefs, trust in health authorities, and their willingness to vaccinate against COVID-19. Importantly, the unique contribution of executive function to vaccine hesitancy could not be explained by socio-demographic factors or depressed mood. Furthermore, Study 2 revealed that weaker executive function had detrimental effects on COVID-19 vaccine acceptance and trust in health authorities mainly under heightened stress.ConclusionsIndividual differences in executive function and situational stress jointly impact COVID-19 vaccination decisions and need to be considered together when designing health communications aimed at reducing COVID-19 vaccine hesitancy. Interventions that lower stress and promote trust have the potential to increase vaccine acceptance, especially for individuals with weaker executive function.

Project description:In Austria, data on vaccine hesitancy is scarce. Available studies suggest around 1-11% of parents refuse vaccination, while many more are hesitant and consider refraining from some but not all of the recommended vaccinations. However, the key drivers for vaccine hesitancy in Austria are largely unknown. To learn more about vaccination coverage, attitude towards and knowledge around immunization as well as views on mandatory vaccination, we conducted a survey in a rural Austrian lay population including adults and children. Two paper-based questionnaires, one for adults 16 years or older and one for children aged 6-15 years, were developed, then sent to all houses of a rural community in Austria as well as handed out at the local primary and middle school, respectively. Self-reported coverage rates of children and adults were found to be low. Within the surveyed population 3% of children had never been or do not get vaccinated. More than half (57%) of the survey participants had a positive attitude towards vaccines, 21% were without reserves, 16% were found skeptical and 5% had a generally negative attitude. Knowledge about immunization in general was poor. Younger adults and people with secondary education appear to be most skeptical and negative towards vaccination. Children's attitudes were closely linked to those of their parents. The major concern around vaccination in adults was fear of side effects. In adults, 54.2% support mandatory vaccination for Health Care Workers and 20.7% are against it. 39% of adults and 37% of children wanted more information on vaccination, preferably provided by physicians. Knowledge about disease prevention by vaccination should be improved and children could also benefit from an early age-appropriate vaccine education to strengthen health literacy. Physicians are the most trusted source of health information. Medical doctors should be aware of their very important role in transmitting trusted health information. This should include an up-to-date education in communicable disease prevention and immunization during their whole medical career. Furthermore, the curricula of health-care workers may need to be improved and harmonized concerning prevention and vaccination.

Dataset Information

Linking the behavioral immune system to COVID-19 vaccination intention: The mediating role of the need for cognitive closure and vaccine hesitancy.

Publications

Linking the behavioral immune system to COVID-19 vaccination intention: The mediating role of the need for cognitive closure and vaccine hesitancy.

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