Fear of COVID-19 and Perceived COVID-19 Infectability Supplement Theory of Planned Behavior to Explain Iranians’ Intention to Get COVID-19 Vaccinated

Abstract

One of the most efficient methods to control the high infection rate of the coronavirus disease 2019 (COVID-19) is to have a high coverage of COVID-19 vaccination worldwide. Therefore, it is important to understand individuals’ intention to get COVID-19 vaccinated. The present study applied the Theory of Planned Behavior (TPB) to explain the intention to get COVID-19 vaccinated among a representative sample in Qazvin, Iran. The TPB uses psychological constructs of attitude, subjective norm, and perceived behavioral control to explain an individual’s intention to perform a behavior. Fear and perceived infectability were additionally incorporated into the TPB to explain the intention to get COVID-19 vaccinated. Utilizing multistage stratified cluster sampling, 10,843 participants (4092 males; 37.7%) with a mean age of 35.54 years (SD = 12.00) completed a survey. The survey assessed TPB constructs (including attitude, subjective norm, perceived behavioral control, and intention related to COVID-19 vaccination) together with fear of COVID-19 and perceived COVID-19 infectability. Structural equation modeling (SEM) was performed to examine whether fear of COVID-19, perceived infectability, and the TPB constructs explained individuals’ intention to get COVID-19 vaccinated. The SEM demonstrated satisfactory fit (comparative fit index = 0.970; Tucker-Lewis index = 0.962; root mean square error of approximation = 0.040; standardized root mean square residual = 0.050). Moreover, perceived behavioral control, subjective norm, attitude, and perceived COVID-19 infectability significantly explained individuals’ intention to get COVID-19 vaccinated. Perceived COVID-19 infectability and TPB constructs were all significant mediators in the relationship between fear of COVID-19 and intention to get COVID-19 vaccinated. Incorporating fear of COVID-19 and perceived COVID-19 infectability effectively into the TPB explained Iranians’ intention to get COVID-19 vaccinated. Therefore, Iranians who have a strong belief in Muslim religion may improve their intention to get COVID-19 vaccinated via these constructs.

The Role of Attitudes, Norms, and Efficacy on Shifting COVID-19 Vaccine Intentions: A Longitudinal Study of COVID-19 Vaccination Intentions in New Zealand

“…At both times of the survey, vaccination intentions were self-reported, and it is important to follow-up on actual behaviour, particularly as few studies report intention-behaviour gap [22]. Similarly, other variables of perceived susceptibility and severity from Health Belief Model should be evaluated for a more comprehensive model [1,4,27]. The associations between social norms and vaccine intentions-tested using multinomial logistic models and multiple imputation models-were inconsistent and weak at best.…”

“…For example, the TPB constructs explain about half of variance in intentions but only a minor variance in behaviours in a meta-analysis of TPB to predict nutrition-related behaviours in youth [19]. However, limited number of studies have been conducted using TPB in longitudinal analysis to identify vaccination intention [24,25] and a majority of reports with few exceptions used cross-sectional TPB framework [26][27][28].…”

COVID-19 vaccines and mental distress

“…A growing literature studies the determinants of vaccine hesitancy and willingness to get vaccinated [ 6 – 8 ]. Factors in the willingness to get vaccinated include age [ 9 ], sources of information [ 10 ], fear of COVID-19 [ 11 ] and perceived severity of COVID-19 [ 12 ]. In earlier studies, fear of COVID-19 was associated with increased increased future career anxiety and decreased job satisfaction [ 13 ].…”

Factors affecting Pakistani young adults’ intentions to uptake COVID‐19 vaccination: An extension of the theory of planned behavior

“…Moreover, the TPB can be supplemented by fear of disease and perceived vulnerability in Protection Motivation Theory (PMT), which improves researchers’ understanding of an individual's intention to vaccinate against COVID‐19 (Yahaghi et al., 2021 ). The PMT is a health psychological theory and was developed to explain the cognitive mediation process of behavioral change from the perspective of threat and coping appraisal (Rogers, 1975 ; Rogers & Prentice‐Dunn, 1997 ).…”