Abstract

Vaccination appears to be one of the effective strategies to control the COVID-19 pandemic. However, the challenge of vaccine hesitancy may lower the uptake rate and affect overall vaccine efficacy. Being a low-risk group in terms of serious consequences of infection, university students may possess low motivation to get vaccinated. Therefore, an expanded Protection Motivation Theory (PMT) incorporating perceived knowledge, adaptive response, and maladaptive response was proposed to investigate the COVID-19 vaccination intention among Taiwanese university students. University students (n = 924; 575 males; mean age = 25.29 years) completed an online survey during January to February 2021. The proposed expanded PMT model was examined using structural equation modeling (SEM). The results showed that perceived knowledge was significantly associated with coping appraisal (standardized coefficient (β) = 0.820; p < 0.001), and coping appraisal was significantly associated with adaptive response (β = 0.852; p < 0.001), maladaptive response (β = 0.300; p < 0.001) and intention (β = 0.533; p = 0.009). Moreover, maladaptive response (β = −0.173; p = 0.001) but not adaptive response (β = 0.148; p = 0.482) was significantly and negatively associated with intention. The present study’s results demonstrated a positive path between perceived knowledge, coping appraisal, and intention among university students. Therefore, improving knowledge among this population may increase the intention to uptake the vaccine.

Highlights

  • A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and was rapidly transmitted worldwide

  • Regarding the features between students majoring in medicine and those not majoring in medicine, there were significantly more female students and fewer married individuals among those majoring in medicine compared with those not majoring in medicine

  • Significantly moderate associations were identified between perceived knowledge, adaptive response, coping appraisal, and intention (r = 0.477 to 0.618; all p-values < 0.001)

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Summary

Introduction

A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and was rapidly transmitted worldwide. Due to its high contagiousness and mortality rate, the World Health Organization (WHO) had declared it a health-threatening pandemic and named the disease of SARS-CoV-2 infection as coronavirus disease 2019 (COVID-19) [4]. At the time of writing (9 August 2021), more than four million individuals have died [5] and the numbers continue to rise, especially due to faster spreading COVID-19 mutations [6]. Apart from preventive policies to inhibit the spread of the virus (e.g., border controls, city lockdowns, spatial distancing, quarantining, etc.) launched by many governments worldwide, vaccination appears to be one of the most effective strategies to defeat the pandemic [7]. The development of vaccines has been a significant breakthrough [8] and more than three billion doses of vaccines have been administered to date [5]

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