This large-sample study of three Chinese societies—Mainland China, Taiwan, and Hong Kong—demonstrates the importance of media exposure for people’s vaccination intentions during the COVID-19 pandemic. By employing two constructs (i.e., perceived susceptibility and severity) in the health belief model (HBM), the study identifies significant indirect effects of media exposure on individuals’ vaccination intention in all three Chinese societies. That said, media trust negatively moderated the path from perceived severity to vaccination intention in Mainland China and Taiwan. In these two societies, the higher an individual’s trust in media, the less influence of perceived severity on his/her vaccination intention. It suggests that the level of trust in media is a contextual factor in explaining individuals’ decision-making on health issues. Generally, the combination of the HBM and media trust has been proven to be useful for understanding individuals’ vaccination intentions. These findings provide practical considerations for governmental agencies, public institutions, and health campaign designers to promote vaccination in the pandemic.

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This study uses longitudinal data to profile psychological characteristics of COVID-19 vaccine advocates, resisters, and converts. We conducted a two-wave longitudinal survey (Nwave1 = 3190, Nwave2 = 2193) in Hong Kong using stratified quota sampling. Among those who completed both survey waves, 458 (30.5%) were classified as vaccine advocates, 295 (19.7%) were vaccine resisters, and 621 (41.4%) were vaccine converts (who shifted away from hesitancy). Compared to advocates, resisters were more likely to be female, those without children, between 40 and 49 years old, democratic voters, and those with poor health. Highly educated individuals, non-democrats, and those in good health were more likely to convert from hesitancy to acceptance. Public trust in authorities and confidence in vaccine were the primary factors related to vaccine uptake. Those who were more confident in vaccine, those who increased in information consumption and risk perceptions towards the pandemic, and those who decreased in their trust of health professionals were more likely to convert. Our study complements the emerging global picture of COVID-19 vaccine acceptance by focusing on changes in vaccine hesitancy during the pandemic.

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Scholars and communications practitioners worldwide have sought novel resilience models amid heightened rates of psychological distress caused by the COVID-19 pandemic. We examined perceived life satisfaction as a determinant of resilience. Additionally, we investigated the assumption that perceived pandemic severity at the country/region level moderates structural relationships within our risk–resilience model. Analyzing more than 34,000 valid samples from 15 countries/regions, we found that (1) perceived life satisfaction alleviated psychological distress across all 15 countries/regions; and (2) country/region-level pandemic severity moderated the relationships among COVID-19 symptom experience, perceived life satisfaction, and psychological distress. The effects of COVID-19 symptom experience and perceived life satisfaction on psychological distress were conditional. We discuss possible mechanisms behind our findings and provide practical implications for mitigating psychological distress during public health crises.