Predicting intention to receive COVID-19 vaccine among the general population using the health belief model and the theory of planned behavior model

Liora Shmueli

doi:10.1186/s12889-021-10816-7

Abstract

BackgroundThis study aim to explore the intentions, motivators and barriers of the general public to vaccinate against COVID-19, using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model.MethodsAn online survey was conducted among Israeli adults aged 18 years and older from May 24 to June 24, 2020. The survey included socio-demographic and health-related questions, questions related to HBM and TPB dimensions, and intention to receive a COVID-19 vaccine. Associations between questionnaire variables and COVID-19 vaccination intention were assessed by univariate and multivariate analyses.ResultsEighty percent of 398 eligible respondents stated their willingness to receive COVID-19 vaccine. A unified model including HBM and TPB predictor variables as well as demographic and health-related factors, proved to be a powerful predictor of intention to receive COVID-19 vaccine, explaining 78% of the variance (adjusted R squared = 0.78). Men (OR = 4.35, 95% CI 1.58–11.93), educated respondents (OR = 3.54, 95% CI 1.44–8.67) and respondents who had received the seasonal influenza vaccine in the previous year (OR = 3.31, 95% CI 1.22–9.00) stated higher intention to receive COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived benefits of COVID-19 vaccine (OR = 4.49, 95% CI 2.79–7.22), of perceived severity of COVID-19 infection (OR = 2.36, 95% CI 1.58–3.51) and of cues to action (OR = 1.99, 95% CI 1.38–2.87), according to HBM, and if they reported higher levels of subjective norms (OR = 3.04, 95% CI 2.15–4.30) and self-efficacy (OR = 2.05, 95% CI 1.54–2.72) according to TPB. Although half of the respondents reported they had not received influenza vaccine last year, 40% of them intended to receive influenza vaccine in the coming winter and 66% of them intended to receive COVID-19 vaccine.ConclusionsProviding data on the public perspective and predicting intention for COVID-19 vaccination using HBM and TPB is important for health policy makers and healthcare providers and can help better guide compliance as the COVID-19 vaccine becomes available to the public.

Highlights

This study aim to explore the intentions, motivators and barriers of the general public to vaccinate against COVID-19, using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model
The present study examined the intentions of the general public to receive a future COVID-19 vaccine, and investigated various sociodemographic, health-related and behavioral predictors for these intentions based on the combined use of the HBM and TPB models
This result is consistent with the findings of Dror et al, who showed a vaccine acceptance rate of 75% in the entire Israeli population [9], and are similar to those of Reiter et al [8], who found that 69% of participants in the United States were willing to receive a COVID-19 vaccine, and to those of Wong et al [26] showing that 48% of participants definitely intend to receive the vaccine, in addition to the 30% who probably intend to receive the vaccine

Summary

Introduction

This study aim to explore the intentions, motivators and barriers of the general public to vaccinate against COVID-19, using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model. At the time of conducting this study (June 2020), no vaccine to COVID-19 has become available yet, and such vaccines were estimated to become available only at the end of 2021 [2]. Sooner than expected, in December 2020, the U.S Food and Drug Administration (FDA) authorized a vaccine to COVID-19 by Pfizer-BioNTech [3]. This authorization was quickly followed by authorizations to other vaccines by Moderna, AstraZeneca/Oxford and Jansen. After the first vaccine became available, mass vaccination campaigns against COVID-19 were initiated around the world. In Israel, which was among the first countries to initiate such a campaign, more than 49% of people have received at least the first dose by the end of February 2021 [4]

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Results

Discussion

Conclusion