Why Do Women Report Lower Intentions to Get Vaccinated against COVID-19? the Mediating Role of Variables from the TPB and HBM

Abstract

Background: Although the intention to get vaccinated against COVID-19 has globally increased in the last months, the proportion of people intending to be vaccinated is still low in some groups. A recent meta-analysis showed that women report a lower intention to get vaccinated. Purpose: To examine the intention to get vaccinated using predictors from the 5C Model of Vaccination Attitudes, the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM) and to analyze the extent to which gender differences in vaccination intention are mediated by these variables. Methods: Between August and November 2020, an online survey was delivered to 1428 participants in the UK and Germany (mean age = 40.6; 57% women), assessing socio-demographic and health factors, general vaccination attitudes, TBP and HBM variables and COVID-19 vaccination intention. Results: Vaccination intentions were high and did not differ by country or survey period. Predictors of intention with highest explanatory power in a relative weight analysis were confidence, collective responsibility (5C) perceived behavioral control, social norms, attitudes (especially negative affect & TPB cognitions) and perceived benefits (HBM). Women reported lower intention, although the effect size was small. The relationship between gender and intention was fully mediated by perceived behavioral control, subjective norm and negative affect. Conclusions: Messages promoting women’s sense of autonomy and control over the decision to get vaccinated, approval from significant others and reassurance that getting vaccinated will not be associated with fear or other negative feelings could be used to reduce potential gender inequalities in vaccine uptake.