What Motivates People to Receive Continuous COVID-19 Vaccine Booster Shots? An Expectation Confirmation Theory Perspective.

Abstract

(1) Background: Abundant evidence has shown that the COVID-19 vaccine booster is highly effective against the Omicron variant. It is of great practical significance to explore the factors influencing the intention to receive COVID-19 booster shots. (2) Methods: We introduced expectation confirmation theory as the basis to construct a model of the factors of the vaccination intention for COVID-19 vaccine boosters. We obtained two batches of questionnaires through Chinese social platforms, with a valid sample size of 572. To test the model, we used SmartPLS3.0 software for empirical analysis. (3) Results: In terms of the characteristics of the vaccine itself, perceived vaccine efficacy and perceived vaccine safety had significant positive effects on expectation confirmation. Regarding vaccination services, perceived vaccination convenience also had a significant positive effect on expectation confirmation. Expectation confirmation positively affected the vaccination intention for the COVID-19 vaccine boosters. Furthermore, the results showed two moderating effects: first, health consciousness negatively moderated the positive effect of perceived vaccine safety on expectation confirmation; second, the time interval since the last dose negatively moderated the positive effect of perceived vaccine efficacy on expectation confirmation. (4) Conclusions: Our research demonstrated that there is an expectation confirmation process for previous COVID-19 vaccines before people consider whether to obtain a booster shot. Perceived vaccine efficacy and perceived vaccine safety remained important factors in receiving COVID-19 booster shots, and our conclusions were consistent with previous literature. In this study, multiple dimensions such as distance and cost were used to measure perceived vaccination convenience. This new variable improve the explanatory power of the convenience of the vaccination service and enrich the variables of the factor model of vaccination intention. In addition, the moderating effects of health consciousness and time interval were found. The findings can provide a theoretical reference for public health institutions to help them understand the formation process of people's intention to receive the COVID-19 vaccine booster.