COVID-19 Vaccination Intention Research Articles

Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study

BackgroundMass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context. MethodsUsing a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November–December 2020; N = 657), during (T2: March–May 2021; N = 818), and after (T3: February–March 2022; N = 605) the start of the vaccination campaign in Italy. ResultsResults indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB. ConclusionFindings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.

Covid-19 vaccination intentions and uptake pre- and post-vaccine availability: a cross-sectional comparison of theory of planned behavior, anticipated regret, and optimistic bias

Abstract Aim Vaccination hesitancy threatens herd immunity and reduces the chances of overcoming pandemics such as the recent Covid-19 pandemic. The present investigation looked at psychological predictors of Covid-19 vaccination intention and vaccination uptake. Subject and methods Two representative Norwegian samples (collected in 2020, N = 1003, and 2022, N = 1000) filled in online questionnaires assessing variables of the theory of planned behavior (attitudes, social norms, and perceived behavioral control) as well as optimistic bias and anticipated regret. Results Results showed that these variables could explain 69% of the variance in vaccination intentions and 41% of the variance in vaccination uptake. Significant predictors in both samples include attitudes, social norms within the family, perceived behavioral capability, and higher anticipated regret for not getting vaccinated. Intentions were also predicted by lower anticipated regret for getting vaccinated, and vaccination uptake was additionally predicted by older age and lower perceived behavioral autonomy. Optimistic bias did not predict intentions to get vaccinated or vaccination uptake. Conclusion Interventions designed to increase vaccination uptake should focus on attitudes, norms, perceived behavioral control, anticipated regret, and possibly altruistic motivations.

COVID-19 vaccination intention and vaccine hesitancy among citizens of the Métis Nation of Ontario

ObjectiveThe study objective is to measure the influence of psychological antecedents of vaccination on COVID-19 vaccine intention among citizens of the Métis Nation of Ontario (MNO).MethodsA population-based online survey was implemented by the MNO when COVID-19 vaccines were approved in Canada. Questions included vaccine intention, the short version of the “5C” psychological antecedents of vaccination scale (confidence, complacency, constraint, calculation, collective responsibility), and socio-demographics. Census sampling via the MNO Registry was used achieving a 39% response rate. Descriptive statistics, bivariate analyses, and multinomial logistic regression models (adjusted for sociodemographic variables) were used to analyze the survey data.ResultsThe majority of MNO citizens (70.2%) planned to be vaccinated. As compared with vaccine-hesitant individuals, respondents with vaccine intention were more confident in the safety of COVID-19 vaccines, believed that COVID-19 is severe, were willing to protect others from getting COVID-19, and would research the vaccines (Confident OR = 19.4, 95% CI 15.5–24.2; Complacency OR = 6.21, 95% CI 5.38–7.18; Collective responsibility OR = 9.83, 95% CI 8.24–11.72; Calculation OR = 1.43, 95% CI 1.28–1.59). Finally, respondents with vaccine intention were less likely to let everyday stress prevent them from getting COVID-19 vaccines (OR = 0.47, 95% CI 0.42–0.53) compared to vaccine-hesitant individuals.ConclusionThis research contributes to the knowledge base for Métis health and supported the MNO’s information sharing and educational activities during the COVID-19 vaccines rollout. Future research will examine the relationship between the 5Cs and actual uptake of COVID-19 vaccines among MNO citizens.

COVID-19 Knowledge, Beliefs, and Intention to Get Vaccinated: A Brief Educational Intervention Among Black and Hispanic Populations.

We aimed to determine the effect of a brief educational intervention on COVID-19 vaccine knowledge, beliefs, and vaccination intention in Black and Hispanic communities in Houston, Texas. As part of the Community Engagement Alliance (CEAL) Against COVID-19 Disparities study (2020-2022), 1606 Black and Hispanic adults completed Web-based surveys before and after viewing COVID-19 educational materials. The intervention significantly improved health beliefs and vaccination intention. Disseminating short and ethnically appropriate educational materials is an effective strategy to decrease vaccine hesitancy in minority populations. (Am J Public Health. 2024;114(S1):S82-S86. https://doi.org/10.2105/AJPH.2023.307501).

The Impact of Proxy Efficacy and Government Trust on the COVID-19 Vaccination Intention of Young People in Macao: A Study Based on the Moderating Effect on Health Belief Modeling

The Impact of Proxy Efficacy and Government Trust on the COVID-19 Vaccination Intention of Young People in Macao: A Study Based on the Moderating Effect on Health Belief Modeling

Parental concerns and vaccine hesitancy against COVID-19 vaccination for children in Greece: A cross-sectional survey

IntroductionParental hesitancy against children’s COVID-19 vaccination remains a challenge globally. Although many studies have explored parental hesitancy, less is known about parental intentions towards COVID-19 vaccination of 6-month to 4-year-old children who were the last age group that became eligible for vaccination and for older children throughout the Omicron predominance period. MethodsWe conducted a nationwide cross-sectional survey from November to December 2022 in Greece. We aimed to explore parental COVID-19 vaccination intentions for their children, reasons against vaccination, and to estimate the association between parents’ intentions and child and parental characteristics and parental attitudes towards COVID-19 vaccination. ResultsOf 431 parents, 243 (56.4 %) had not or did not intend to vaccinate their children against COVID-19. Most parents were vaccinated against COVID-19 (64.7 % no booster; 14.2 % at least one booster). Among parents with children under the age of 5, 13.0 % intended to vaccinate their children against COVID-19, while 47.3 % of parents with children 5 years of age or older reported intention or had already completed vaccination. The most common reasons against COVID-19 vaccination were fear of side effects (32.9 %), perceived short length of clinical trials (29.2 %), and the child having previously contracted COVID-19 (12.0 %). The strongest factors associated with intention or already completed vaccination were parental own vaccination against COVID-19, using a pediatrician or a healthcare professional as the main source of vaccine-related information for their children, agreeing with their pediatrician regarding COVID-19 vaccination, and trusting official healthcare guidelines. Stratified analyses by the two children’s age groups (<5 and 5 to 17) yielded similar estimates. Among parents who had not or did not intend to vaccinate their children, 11.9 % would do so if recommended by a pediatrician. ConclusionsOur findings highlight the need to incentivize healthcare professionals and pediatricians to inform parents about vaccines, clarify misconceptions and address concerns.

코로나19 팬데믹 상황에서 코로나19 백신접종 의도 결정 요인 탐색

This study examined the factors influencing the COVID-19 vaccination intention, considering demographic factors (gender, age group, residential area, political orientation), individual risk perception, optimistic bias, subjective norms, preventive behaviors, and information-seeking behaviors. Data were collected through an online survey from February 9, 2021 to February 14, right before starting the COVID-19 vaccination. The findings are as follows: Age group, residential area, and optimistic bias were identified as factors influencing the COVID-19 vaccination intention. Higher age groups, non-metropolitan residential areas, and lower levels of optimistic bias were associated with the higher COVID-19 vaccination intention. Individual risk perception and subjective norms were found to have no significant effects on the COVID-19 vaccination intention. These findings suggest that the COVID-19 vaccination intention is influenced more by individual attributes than by the perception of risk during a pandemic like COVID-19. The results provide practical implications to design effective vaccination strategies for the future similar pandemic circumstances.

Cultural tightness–looseness and normative social influence in eight Asian countries: Associations of individual and collective norms with vaccination intentions

RationaleCountries worldwide faced the same public health crisis that required promoting the same health behavior—vaccinations—during the COVID-19 pandemic. Thus, scholars have a unique opportunity to test behavioral change theories across countries with different cultural backgrounds. ObjectiveEmploying the extended theory of social normative behavior, this study examines the influence of individual and collective norms on COVID-19 vaccination intention across eight Asian countries. We examine how cultural tightness–looseness, defined as the degree of a culture's emphasis on norms and tolerance of deviant behavior, shapes normative social influence on COVID-19 vaccination intention. MethodsWe conducted a multicountry online survey (N = 2676) of unvaccinated individuals in China, Indonesia, Japan, Malaysia, Singapore, South Korea, Thailand, and Vietnam in May and June 2021, when COVID-19 vaccination mandates had not yet been implemented in those countries. We conducted hierarchical regression analyses with interaction terms for the total sample and then re-categorizied the eight countries as either “tight” (n = 1102) or “loose” (n = 1574) to examine three-way interactions between individual norms, collective norms, and cultural tightness-looseness. ResultsPerceived injunctive norms exerted the strongest impact of all normative factors on vaccination intention. Collective injunctive norms’ influence depended on both perceived injunctive and descriptive norms, which was larger when norms were lower (vs. higher). The interactive pattern between perceived and collective norms was more pronounced in countries with greater cultural tightness. ConclusionOur findings reveal nuanced patterns of how individual and collective social norms influence health behavioral decisions, depending on the degree of cultural tightness–looseness.

COVID-19 vaccination attitudes, values, intentions: US parents for their children, September 2021

ObjectivesTo compare vaccine-related attitudes and values of parents of children 2–17 years old to other adults, examine intentions to vaccinate their children, and identify factors associated with intending to vaccinate children. MethodsA nationally representative survey was conducted in September 2021 (just before the EUA for children 5–11 years old) using Ipsos KnowledgePanel, a probability-based web panel. The survey measured COVID-19 vaccination status, intentions, attitudes, values, and trust in public health authorities among US adults. Scale response options to survey items were dichotomized, and cross-tabulations and logistic regressions were performed. ResultsParents had lower odds of reporting being vaccinated against COVID-19 than other adults even after adjusting for associated sociodemographic characteristics such as age (aOR: 0.66; 95 %CI: 0.50–0.87). The most prevalent parental concerns about COVID-19 vaccines included the speed of their development (88 %), potential side effects (78 %), suspicion of government (77 %), and suspicion of pharmaceutical companies (72 %). Fewer than half (42 %) of parents intended to vaccinate their children 5–11 years old, while 38 % were uncertain and 20 % were unlikely to ever vaccinate their children. Vaccinated parents had higher odds than unvaccinated parents of intending to vaccinate their children (OR: 675.51; 95 %CI: 106.46–4286.12). Discussions with healthcare providers who encouraged COVID-19 vaccination were positively associated with intent to vaccinate children (OR: 11.29; 95 %CI: 2.60–49.02). ConclusionsWe found parental vaccination and conversations with providers were positively associated with intent to vaccinate children. Decisions about childhood vaccination need to be supported by healthcare providers and a public health system that makes vaccine access and related information equitable and accessible. Vaccination-related decision making should be guided by healthcare providers and provide information about safety and risk to children.

Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study.

Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine. The association of baseline vaccine hesitancy with vaccination was assessed by the Kaplan-Meier survival analysis. Follow-up analyses tested the importance of other variables predicting vaccination using the Cox proportional hazards model. Older age was associated with shorter time to vaccination (HR = 1.76 [1.37-2.25] 85-year-old versus 65-year-old). Lower education levels (HR = 0.80 [0.69-0.92]), household incomes (HR = 0.84 [0.72-0.98]), and baseline vaccination intention of 'No' (HR = 0.16 [0.11-0.23]) were associated with longer times to vaccination. The most common reasons for not being vaccinated (N = 58) were vaccine safety concerns (n = 33), side effects (n = 28), and vaccine effectiveness (n = 25). Vaccination campaigns that target populations prone to hesitancy and address vaccine safety and effectiveness could be helpful in future vaccination rollouts.

Investigating the role of threat, coping, and sociodemographic factors on COVID-19 vaccination intention

Investigating the role of threat, coping, and sociodemographic factors on COVID-19 vaccination intention

County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.

County-level vaccination barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, history of low vaccination) may partially explain COVID-19 vaccination intentions among U.S. adults. This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S. and were associated with willingness to receive the COVID-19 vaccine. In addition, this study assessed whether these associations differed across racial/ethnic groups. This study used data from the REACH-US study, a large online survey of U.S. adults (N = 5,475) completed from January 2021-March 2021. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Ordinal logistic regression estimated associations between race/ethnicity and county-level vaccination barriers and between county-level vaccination barriers and willingness to receive the COVID-19 vaccine. Models adjusted for covariates (age, gender, income, education, political ideology, health insurance, high-risk chronic health condition). Multigroup analysis estimated whether associations between barriers and willingness to receive the COVID-19 vaccine differed across racial/ethnic groups. American Indian/Alaska Native, Black/African American, Hispanic/Latino ELP [English Language Preference (ELP); Spanish Language Preference (SLP)], and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers [Adjusted Odd Ratios (AORs):1.63-3.81]. Higher county-level vaccination barriers were generally associated with less willingness to receive the COVID-19 vaccine, yet associations were attenuated after adjusting for covariates. Trends differed across barriers and racial/ethnic groups. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine (AOR:0.78, 95% CI:0.64-0.94), whereas higher irregular care-seeking behavior was associated with greater willingness to receive the vaccine (AOR:1.20, 95% CI:1.04-1.39). Greater history of low vaccination was associated with less willingness to receive the COVID-19 vaccine among Black/African American adults (AOR:0.55, 95% CI:0.37-0.84), but greater willingness to receive the vaccine among American Indian/Alaska Native and Hispanic/Latino ELP adults (AOR:1.90, 95% CI:1.10-3.28; AOR:1.85, 95% CI:1.14-3.01). Future public health emergency vaccination programs should include planning and coverage efforts that account for structural barriers to preventive healthcare and their intersection with sociodemographic factors. Addressing structural barriers to COVID-19 treatment and preventive services is essential for reducing morbidity and mortality in future infectious disease outbreaks.

Health Belief Model Factors and Personal Characteristics Associated With COVID-19 Vaccination Behaviors in Adults.

Prior studies have mainly examined factors regarding COVID-19 vaccination intentions. This study investigated the factors associated with COVID-19 vaccination behaviors in Korean adults. A total of 620 adults recruited from a survey company between July and August 2021 completed an online survey asking about their personal characteristics, health beliefs, and COVID-19 vaccination status. The collected data were analyzed using descriptive statistics, Pearson's χ2 test, independent-samples t test, and logistic regression analysis. Less than half the participants received COVID-19 vaccinations, whereas 56.3% did not. The full regression model explained 33.3% of the variance in COVID-19 vaccination status. Age older than 60 years, perception of feeling healthy, presence of chronic diseases, past flu shot experiences, and five health belief model factors were significant factors associated with COVID-19 vaccination behaviors. COVID-19 vaccination intention was the most closely related factor (odds ratio, 12.37; 95% confidence interval, 3.54-43.26; P < .001). Vaccinated participants were more likely than unvaccinated to perceive susceptibility to COVID-19 infection, benefits, self-efficacy, moral responsibility, and subjective norms regarding COVID-19 vaccination. Based on the results, vaccinated and unvaccinated individuals showed different attitudes toward COVID-19 infection and vaccination. This study suggests that COVID-19 vaccination intentions lead to actual vaccination behavior.

Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public.

COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.

Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey

IntroductionDespite a high number of recorded COVID-19 infections and deaths in South Africa, COVID-19 vaccine coverage remained low in March 2022, ten months into the national vaccine roll-out. This study provides evidence on the correlates of vaccine intentions, attitudes towards vaccination and opinions about mandates.MethodsWe used data from the second COVID-19 Vaccine Survey (CVACS), a telephone survey conducted February-March 2022 among 3,608 South African adults who self-reported not being vaccinated against COVID-19. The survey instrument was designed in consultation with government, policymakers, and civil society; and segmented the sample into four distinct groups with different vaccine intentions (synonymous with vaccine hesitancy levels). Kruskal-Wallis and Mann-Whitney tests were used to examine the sociodemographic characteristics, attitudes and behaviours associated with the different vaccination intentions groups. Thematic coding of responses to open-ended questions elicited insights on reasons for not being vaccinated and attitudes towards mandates.ResultsIntentions to get vaccinated were greater among individuals with lower socio-economic status (Mann–Whitney Z = -11.3, p < 0.001); those believing the vaccine protects against death (Kruskal–Wallis Χ2 = 494, p < 0.001); and those who perceived themselves at risk of COVID-19-related illness (Χ2 = 126, p < 0.01). Vaccine intentions were lower among individuals who believed that the vaccine causes death (Χ2 = 163, p < 0.001); believed that the vaccine is unsafe for the babies of pregnant/breastfeeding mothers, or the chronically ill (Χ2 = 123, p < 0.01); those not trusting government health information about COVID-19 and the COVID-19 vaccine (Kendall’s τ = -0.41, p < 0.01); and those in opposition to mandates (τ = 0.35, p < 0.001). Only 25% supported mandates, despite 48% thinking mandates would work well, with 54% citing individual rights as their main reason for mandate opposition.ConclusionThe profile of individuals not vaccinated against COVID-19 as of March 2022 varied markedly by self-reported vaccination intentions, underscoring the importance of tailored demand-creation efforts. This paper highlights several factors which differ significantly across these groups. These findings could inform the design of future vaccination campaigns, potentially increasing their likelihood of success. This is an important policy objective given widespread vaccine hesitancy, and further work is required on this topic. Mandates remain an option to increase coverage but need to be carefully considered given extensive opposition.

Using behavioral theory to understand partisan differences in COVID-19 vaccination and booster intentions.

In 2020, the Food and Drug Administration granted emergency use authorization for two COVID-19 vaccines. Two years later, the Centers for Disease Control and Prevention estimated that more than 250 million individuals had received at least one dose of the vaccine. Despite the large numbers of individuals vaccinated against COVID-19, partisan differences surrounding the COVID-19 vaccine emerged, creating a potential challenge for health communications aimed at increasing vaccine uptake. A better understanding of partisan differences in attitudes and intentions towards vaccination may help guide public health strategies aimed at increasing vaccine uptake. To determine whether a commonly used theory of behavioral intentions used to craft public health messages explains partisan differences in intentions. Data were drawn from a national panel of US adults and collected between February 21, 2022, and March 3, 2022, using an online survey (n = 1845). Among respondents identifying as either Democrat or Republican (n = 1466), path analysis models were estimated to test whether partisan differences in vaccination or booster intentions were explained by the theoretical constructs of protection motivation theory (PMT). PMT accounted for approximately half of the covariate-adjusted mean difference in COVID-19 vaccination intentions between Democrats and Republicans, and nearly all the mean difference in booster intentions. Party affiliation indirectly affected intentions via its association with perceived susceptibility to COVID-19, vaccine/booster efficacy, and perceived costs of getting a COVID-19 vaccine or booster dose. Compared with Democrats, Republicans may be less likely to get vaccinated or receive a booster dose because of beliefs that they are less susceptible to COVID-19, that the vaccine is less effective, and that vaccination comes with disadvantages. Theories of behavioral intentions can help to identify the underlying theoretical determinants driving behavioral differences between political groups.

A randomized controlled trial of an information intervention to bolster COVID-19 vaccination intention among people with purity concerns.

Previous literature has indicated a strong negative correlation between the moral foundation of purity/sanctity and vaccination rates. The current research investigated how purity concerns impact COVID-19 vaccination hesitancy and tested an information intervention to bolster vaccination intention among people with purity concerns. Study 1 surveyed 566 Republicans and Republican-leaning Independents in the United States. Study 2 was a between-subject-designed survey experiment that investigated the impact of three statements on the COVID-19 vaccination attitudes and intentions of 637 Republicans and Republican-leaning Independents. Statement 1 argued that vaccines are not impure from a scientific perspective; Statement 2 made the same argument with quotes from the Bible; and Statement 3 was a control statement. Study 1 established a significant correlation between the existence of vaccination history and purity as a moral foundation. Study 2 found that among those with no COVID-19 vaccination history, statements arguing that vaccines are not impure from either a scientific perspective or a religious perspective improved attitudes toward vaccination and intention to get vaccinated. Purity concerns can be leveraged as a way to bolster vaccination rates, especially among conservatives. However, the impurity perception only mediated the causal relationship between the treatment and the attitude toward vaccines (but not the actual intention), suggesting that changes in the actual vaccination behavior are subject to factors other than purity concerns. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Current health care experiences, medical trust, and COVID-19 vaccination intention and uptake in Black and White Americans.

The COVID-19 pandemic spotlighted Black Americans' inequitable health care experiences. Across two studies, we tested the associations between health care experiences, historical knowledge of medical mistreatment, medical trust, and COVID-19 vaccination intention and uptake in Black and White Americans. We hypothesized that Black Americans' worse current health care experiences (rather than historical knowledge) and lower medical trust would be associated with lower COVID-19 vaccination intention (Study 1) and that feeling less cared for by their personal physician would be associated with Black Americans' lower medical trust (Study 2). In convenience (Study 1, December 2020) and nationally representative samples (Study 2, March-April 2021), participants completed online surveys. In Study 1 (N = 297), Black (relative to White) Americans reported lower vaccination intention (Cohen's d = -.55, p < .001) and lower medical trust (Cohen's d = -.72, p < .001). Additionally, less positive health care experiences among Black participants (Cohen's d = -.33, p = .022) were associated with less medical trust and in turn lower vaccination intention. Tuskegee Study knowledge was not associated with vaccination intention or medical trust. Study 2 (N = 12,757) data revealed no statistically significant racial differences in COVID-19 vaccination receipt or intention. Black (relative to White) Americans reported feeling less cared for by their personal physician (Cohen's d = -.44, p < .001), which was associated with lower medical trust (Cohen's d = -.51, p < .001). Findings highlight factors that may contribute to Black Americans' vaccination hesitancy and medical trust. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vaccination intention and uptake within the Black community in Appalachia.

Black communities have disproportionately experienced adverse health effects from the COVID-19 pandemic while simultaneously having less vaccination access and decreased vaccine utilization. As such, predictors of vaccination uptake within Black communities are a public health imperative. Black Americans from socio-geographic regions associated with health inequities (e.g., Appalachia), including vaccination disparities, represent an intersection of racial, economic, and ethnic social identities. To better understand the preventive health needs of Black communities in Appalachia and elsewhere, this study examined psychosocial predictors of vaccination intention or behavior. Adults (n = 336) identifying as Black or African American from West Virginia indicated demographics, reported COVID-19 vaccination intention, flu vaccination uptake, and human papillomavirus (HPV) vaccination uptake, and completed assessments of vaccine hesitancy, medical mistrust, and racial discrimination. Hierarchical logistic regression modeling examined potential associations between psychosocial predictors and each vaccine type. Results showed variation in significant predictors across the vaccines of focus. Racial discrimination (OR = 0.64) and medical mistrust (OR = 0.93) were negatively associated with COVID-19 vaccination intention. Vaccine confidence was positively associated with COVID-19 vaccination intention (OR = 2.17) and HPV vaccination uptake (OR = 1.77). Total household income was the only predictor associated with flu vaccination uptake (OR = 1.12). These findings suggest that social interventions targeting racial discrimination in healthcare may significantly help address vaccination disparities in rural Black communities. Moreover, results emphasize unique aspects of vaccination behavior in the Black community within Appalachia that may generalize to other Black communities living in rural regions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario: A qualitative study

BackgroundThe burden of the current COVID-19 pandemic is not shared equally in Canadian society, with Indigenous Peoples being disproportionately affected. Moreover, there is a lack of research pertaining to vaccination behaviour in Métis communities. This Métis-specific and Métis-led qualitative study endeavours to understand COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario (MNO). MethodsData was collected via one-on-one interviews. Participants were recruited via the MNO’s existing social media channels. Participants filled out a screening survey indicating their intention to vaccinate against COVID-19 as yes, no, or unsure. Sixteen participants (9 yes, 3 unsure, 4 no) were interviewed. Interviews averaged 30 min, and the questions and probes were developed in collaboration with the MNO. The interviewer received Métis-specific cultural safety training. Interviews were transcribed verbatim and uploaded to NVivo 12. ResultsA deductive analysis using the Social Ecological Model framework (SEM) for vaccine behaviour and two blinded coders was used to understand the data. An additional factor, COVID-19 public health measures, was added to the framework to better capture the experiences of participants during the COVID-19 pandemic. Overall, the factors with the greatest number of coded references included Vaccine roll-out and availability, Organization of the public into priority groups, Public discourse, Interpersonal influences, Interface with health professionals, Knowledge state, Trust, and Vaccine risk perception. Bandwagoning (following others’ behaviour) and Freeloading (perceiving enough people have been vaccinated), both factors of the SEM, were not discussed. Yes, no, and unsure participant groups were compared to understand the influences of each factor based on COVID-19 vaccination intention. ConclusionsMNO citizens COVID-19 vaccine behaviour was negatively and positively influenced by a number of factors. This information will allow the MNO and public health units to better tailor their messaging for COVID-19 vaccine uptake campaigns and future pandemic emergencies.