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Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

ABSTRACT: It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p < .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p < .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p < .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.

SUBMITTER: Han Q

PROVIDER: S-EPMC9877847 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

Han Qing Q Zheng Bang B Abakoumkin Georgios G Leander N Pontus NP Stroebe Wolfgang W

Applied psychology. Health and well-being 20221108 3

It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July ...[more]

PMID: 36345695

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Project description:BackgroundIt is imperative to promote behavior/intention of taking up booster COVID-19 vaccination (BI-BV) among people who have ever contracted COVID-19 (PECC). The aims were to investigate the prevalence of BI-BV and its associations with perceived social support. Guided by the stress coping theory, we tested mediators between perceived social support and BI-BV via self-stigma, active coping, and maladaptive emotion regulation (rumination and catastrophizing).MethodsA random population-based telephone survey was conducted among adult PECC having completed the primary series of COVID-19 vaccination prior to the diagnosis; 230 participants were interviewed from June to August 2022 during the fifth (last) major outbreak in Hong Kong. The associations between the independent variables and BI-BV were tested by logistic regression analysis. A structural equation model (SEM) tested the indirect effects of the latent variables of self-stigma, active coping, and maladaptive emotion regulation between the latent variable of perceived social support and BI-BV.ResultsThe prevalence of BI-BV was 62.2%. It was associated with age, marital status, full-time employment, and chronic disease status. The logistic regression analysis found that BI-BV was positively associated with perceived social support (ORc = 1.31, 95% CI: 1.12- 1.54), active coping (ORc = 1.40, 95% CI: 1.10- 1.79), rumination (ORc = 1.75, 95% CI: 1.13- 2.70), and catastrophizing (ORc = 3.12, 95% CI: 1.49- 6.51) and negatively associated with self-stigma (ORc = 0.80, 95% CI: 0.72- 0.88). In the SEM analysis, the positive association between perceived social support and BI-BV was fully mediated: 1) via self-stigma (β = 0.07, 95% CI: 0.03- 0.14), 2) via active coping (β = 0.06, 95% CI: 0.02- 0.12), and 3) via self-stigma and then active coping (β = 0.01, 95% CI: 0.002- 0.04). Two of these indirect paths involved active coping. The indirect paths involving maladaptive emotion regulation were all non-significant.ConclusionsPerceived social support was associated with BI-BV, and was mediated via self-stigma, active coping, and serially self-stigma then active coping but not emotion maladaptation. The data supported the stress cognitive coping model in explaining the association between perceived social support and BI-BV. Interventions promoting BI-BV may consider modifying the observed significant factors. Future longitudinal studies are warranted to confirm the findings.

Project description:ObjectivesThis study aimed to examine the coverage of coronavirus disease 2019 (COVID-19) vaccination and its cognitive determinants among older adults.MethodsA cross-sectional study was conducted using a questionnaire to conduct a survey among 725 Chinese older adults aged 60 years and above in June 2022, 2 months after the mass COVID-19 outbreak in Shanghai, China. The questionnaire covered demographic characteristics, COVID-19 vaccination status, internal risk perception, knowledge, and attitude toward the efficacy and safety of COVID-19 vaccines.ResultsThe vaccination rate was 78.3% among the surveyed individuals. Self-reported reasons for unwillingness to get vaccinated (multiple selections) were "concerns about acute exacerbation of chronic diseases after vaccination (57.3%)" and "concerns regarding vaccine side effects (41.4%)." Compared to the unvaccinated group, the vaccinated group tended to have a higher score in internal risk perception (t = 2.64, P < 0.05), better knowledge of COVID-19 vaccines (t = 5.84, P < 0.05), and a more positive attitude toward the efficacy and safety of COVID-19 vaccines (t = 7.92, P < 0.05). The path analysis showed that the cognitive effect on vaccination behavior is relatively large, followed by the internal risk perception, and then the attitude toward COVID-19 vaccines. The more knowledgeable the participants were about COVID-19 vaccines, the more likely they were to receive the COVID-19 vaccines. In the multivariate logistic regression, the increased coverage of COVID-19 vaccination was associated with reduced age (OR = 0.53 95% CI 0.43-0.66, P < 0.001), being a resident in other places than Shanghai (OR = 0.40, 95% CI 0.17-0.92, P < 0.05), a shorter time of lockdown (OR = 0.33, 95% CI 0.13-0.83, P < 0.05), a history of other vaccines (OR = 2.58, 95% CI 1.45-4.60, P < 0.01), a fewer number of chronic diseases (OR = 0.49, 95% CI 0.38-0.62, P < 0.001), better knowledge about COVID-19 vaccines (OR = 1.60, 95% CI 1.17-2.19, P < 0.01), and a positive attitude toward COVID-19 vaccines (OR = 9.22, 95% CI 4.69-18.09, P < 0.001).ConclusionAcquiring accurate knowledge and developing a positive attitude toward COVID-19 vaccines are important factors associated with COVID-19 vaccination. Disseminating informed information on COVID-19 vaccines and ensuring efficacious communication regarding their efficacy and safety would enhance awareness about COVID-19 vaccination among older adults and consequently boost their vaccination coverage.

Project description:BackgroundHuman behavior is crucial in health outcomes. Particularly, individual behavior is a determinant of the success of measures to overcome critical conditions, such as a pandemic. In addition to intrinsic public health challenges associated with COVID-19, in many countries, some individuals decided not to get vaccinated, streets were crowded, parties were happening, and businesses struggling to survive were partially open, despite lockdown or stay-at-home instructions. These behaviors contrast with the instructions for potential benefits associated with social distancing, use of masks, and vaccination to manage collective and individual risks.ObjectiveConsidering that human behavior is a result of individuals' social and economic conditions, we investigated the social and working characteristics associated with reports of appropriate protective behavior in Brazil.MethodsWe analyzed data from a large web survey of individuals reporting their behavior during the pandemic. We selected 3 common self-care measures: use of protective masks, distancing by at least 1 m when out of the house, and handwashing or use of alcohol, combined with assessment of the social context of respondents. We measured the frequency of the use of these self-protective measures. Using a frequent pattern-mining perspective, we generated association rules from a set of answers to questions that co-occur with at least a given frequency, identifying the pattern of characteristics of the groups divided according to protective behavior reports.ResultsThe rationale was to identify a pool of working and social characteristics that might have better adhesion to behaviors and self-care measures, showing these are more socially determined than previously thought. We identified common patterns of socioeconomic and working determinants of compliance with protective self-care measures. Data mining showed that social determinants might be important to shape behavior in different stages of the pandemic.ConclusionsIdentification of context determinants might be helpful to identify unexpected facilitators and constraints to fully follow public policies. The context of diseases contributes to psychological and physical health outcomes, and context understanding might change the approach to a disease. Hidden social determinants might change protective behavior, and social determinants of protective behavior related to COVID-19 are related to work and economic conditions.Trial registrationNot applicable.

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Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

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Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

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