Cognitive predictors of vaccine hesitancy and COVID-19 mitigation behaviors in a population representative sample

Abstract

With the continued threat of COVID-19, predictors of vaccination hesitancy and mitigation behaviors are critical to identify. Prior studies have found that cognitive factors are associated with some COVID-19 mitigation behaviors, but few studies employ representative samples and to our knowledge no prior studies have examined cognitive predictors of vaccine hesitancy. The purpose of the present study, conducted among a large national sample of Canadian adults, was to examine associations between cognitive variables (executive function, delay discounting, and temporal orientation) and COVID-19 mitigation behaviors (vaccination, mask wearing, social distancing, and hand hygiene). Findings revealed that individuals with few executive function deficits, limited delay discounting and who adopted a generally future-orientation mindset were more likely to be double-vaccinated and to report performing COVID-19 mitigation behaviors with high consistency. The most reliable findings were for delay discounting and future orientation, with executive function deficits predicting mask wearing and hand hygiene behaviors but not distancing and vaccination. These findings identify candidate mediators and moderators for health communication messages targeting COVID-19 mitigation behaviors and vaccine hesitancy.

Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis

“…Most studies used samples of adults ( N = 26). Sixteen studies addressed vaccine hesitancy (i. e., doubts concerning the reception of a COVID‐19 vaccine) 6 , 7 , 8 , 16 , 17 , 29 , 33 , 34 , 37 , 39 , 44 , 45 , 46 , 47 , 48 , 50 and 14 studies explored vaccine unwillingness (i.e., the likelihood of refusing a COVID‐19 vaccine). 28 , 30 , 32 , 35 , 36 , 38 , 40 , 41 , 42 , 43 , 46 , 49 , 51 , 52 The characteristics of the studies are presented in Table 1 .…”

“…Vaccine hesitancy was reported to be related to several factors including concerns that receiving a vaccine has more risks than benefits, 6 , 29 fear of side effects, 6 , 39 , 47 belief that insufficient research had been conducted on the vaccine, 29 , 47 , 48 mistrust in vaccines, 8 , 39 , 44 insufficient time to reflect on accepting the vaccine, 8 having an incomplete vaccination history, 16 , 29 , 33 believing that COVID‐19 will not affect the person or the people around them, 6 , 16 , 29 , 44 living in rural areas, 50 holding more conservative political views, 6 and poorer executive functions. 34 …”

“…Vaccine hesitancy was reported to be related to several factors including concerns that receiving a vaccine has more risks than benefits, 6,29 fear of side effects, 6,39,47 belief that insufficient research had been conducted on the vaccine, 29,47,48 mistrust in vaccines, 8,39,44 insufficient time to reflect on accepting the vaccine, 8 having an incomplete vaccination history, 16,29,33 believing that COVID-19 will not affect the person or the people around them, 6,16,29,44 living in rural areas, 50 holding more conservative political views, 6 and poorer executive functions. 34 The willingness to accept a vaccine was related to living in an urban area, 28 scepticism of conspiracy theories, 30,38 confidence in the COVID-19 vaccine, 28,30,35,38 previous receipt of other types of vaccines such as the flu shot, 38 belief that there was sufficient information available on the COVID-19 vaccine, 38,43,49 concern that COVID-19 is severe, 30,41 being personally affected by COVID-19, 41 and encouragement by primary physicians or others to receive the vaccine. 41,49…”

COVID‐19 vaccine hesitancy: The synergistic effect of anxiety and proactive coping

“…Proactive coping and anxiety about contracting COVID-19 reflect future-oriented behaviors and cognitions, which may have a role in the adoption of health-related behavior. Recent research showed that people with a future-oriented thinking style were more likely to take the COVID-19 vaccine and engage in precautionary health-related behaviors, such as social distancing and wearing a mask [5]. Proactive coping represents effortful steps to modify or avoid a stressor before it occurs [6].…”

“…Despite efforts to address vaccine skepticism and mistrust by increasing public health messaging focused on vaccine safety, COVID‐19 vaccination rates remain suboptimal in the United States [4]. Repeating scientific evidence to debunk vaccine misinformation and demonstrate vaccine safety and effectiveness may not be enough to change anti‐vaccination attitudes and beliefs [5]. Identifying predictors of vaccine hesitancy may provide alternative avenues for tailoring public health messaging to increase vaccination uptake and encourage people to continue to stay up to date on their vaccines.…”