COVID-19 vaccine hesitancy and its drivers: An empirical study of the vaccine hesitant group in Malaysia

Abstract

Background Sporadic outbreaks of COVID-19 remain a threat to public healthcare, especially if vaccination levels do not improve. As Malaysia begins its transition into the endemic phase, it is essential to identify the key determinants of COVID-19 vaccination intention amongst the pockets of the population who are still hesitant. Therefore, focusing on a sample of individuals who did not register for the COVID-19 vaccination, the current study integrated two widely used frameworks in the public health domain—the health belief model (HBM) and the theory of reasoned action (TRA)—to examine the inter-relationships of the predictors of vaccination intention amongst these individuals. Methodology Primary data from 117 respondents who did not register for the COVID-19 vaccination were collected using self-administered questionnaires to capture predictors of vaccination intention amongst individuals in a Malaysian context. The partial least squares structural equation modeling (PLS-SEM) technique was used to analyze the data. Results Subjective norms and attitude play key mediating roles between the HBM factors and vaccination intention amongst the unregistered respondents. In particular, subjective norms mediate the relationship between cues to action and vaccination intention, highlighting the significance of important others to influence unregistered individuals who are already exposed to information from mass media and interpersonal discussions regarding vaccines. Trust, perceived susceptibility, and perceived benefits indirectly influence vaccination intention through attitude, indicating that one’s attitude is vital in promoting behavioral change. Conclusion This study showed that the behavioral factors could help understand the reasons for vaccine refusal or acceptance, and shape and improve health interventions, particularly among the vaccine-hesitant group in a developing country. Therefore, policymakers and key stakeholders can develop effective strategies or interventions to encourage vaccination amongst the unvaccinated for future health pandemics by targeting subjective norms and attitude.

COVID-19 vaccine uptake in Skåne county, Sweden, in relation to individual-level and area-level sociodemographic factors: a register-based cross-sectional analysis

“…30 These effects can be on the individual level but also on the area level with influence from family, friends, community members or public health policy makers. 33 From a questionnaire study, the most given reasons to refuse vaccine were being against vaccines in general, concerns about safety/thinking that a vaccine produced in a rush is too dangerous, considering the vaccine useless because of the harmless nature of COVID-19 and a general lack of trust. 32…”

Factors influencing the perception and the willingness to take the COVID-19 vaccine among the working population in Ghana

“…Empirical studies in developed and developing countries have identified several factors influencing the hesitancy, perception and willingness to vaccinate against diseases, such as COVID-19 among others. These factors determining the hesitancy, perception, willingness and decision to vaccinate are gender differences (Vaithilingam et al ., 2023), age (Burke et al ., 2021), educational background (Roy et al ., 2022), family characteristics including household size and the income of the household head (Tan et al ., 2022), sectors and urbanization (Mishi et al ., 2023).…”