Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study

Abstract

Background The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. Objective This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. Methods A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. Results The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=−0.71, P<.001), perceived benefits (SSC=0.58, P<.001), agreement with recommendations from authorities (SSC=0.27, P<.001), and agreement with recommendations from friends or family (SSC=0.31, P<.001), was negatively associated with vaccination (SSC=−0.45, P<.001) via vaccine hesitancy (SSC=−0.32, P<.001). Conclusions It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.

Evaluating Rates and Determinants of COVID-19 Vaccine Hesitancy for Adults and Children in the Singapore Population: Strengthening Our Community’s Resilience against Threats from Emerging Infections (SOCRATEs) Cohort

“…A set of multi-item self-report measures were developed with reference to prior research on vaccination to assess the following psychosocial constructs from relevant models such as the health belief model [35][36][37][38][39][40]59,60], the theory of planned behaviour [45,46,61] and social cognitive theory [45][46][47]: perceived risk of COVID-19 (including items involving perceived susceptibility and severity of COVID-19 infection) (5-items); perceived benefits (6-items); COVID-19 vaccination concerns (5-items); trust (3-items); subjective norm (3-items); moral norm (3-items); necessity of the vaccine (2-items). Items were rated on a 5-point Likert scale ranging from 1 indicating 'Strongly agree' to 5 'Strongly disagree'.…”

“…Of particular interest are the potentially modifiable psychological determinants of vaccine hesitancy. Studies that applied Social Cognition Models [45][46][47] in context of COVID-19 vaccination indicate that such intentions and behaviours are reasoned processes that are determined by beliefs such as risk perceptions [22,23,26,28,[30][31][32][33]35,39,48], vaccination attitudes (i.e., benefits [22,26,28,29,31,32,[35][36][37][39][40][41]48], concerns [22,23,27,28,30,[32][33][34][35][36][37]39,41,48], necessity [29,30,33]), social norms [30,36,37], moral norms [22,…”

Direct and Indirect Associations of Media Use With COVID-19 Vaccine Hesitancy in South Korea: Cross-sectional Web-Based Survey

“…In this context, previous studies revealed the influence of individual and group differences on vaccine hesitancy such as perceived risk of COVID-19 infection [18,19], confidence in the capacity of health services to respond to the COVID-19 pandemic [20], and trust in authorities [21,22]. Vaccine-specific issues such as confidence in the efficacy of the vaccines [23][24][25][26], fear of side effects [19,25], and high conspiracy beliefs around the vaccines [27] were also revealed to predict COVID-19 vaccine hesitancy.…”

Factors that influence Puerto Rican's intention to get the COVID-19 vaccine

“…Theoretical models, such as the Health Belief Model, 17 have been used in recent research to help explain attitudes toward the vaccine and vaccine hesitancy for the COVID-19 vaccine during the pandemic. 18. , 19.…”

“…, 21. Perceived barriers and benefits have been found to be associated with vaccine hesitancy and vaccination uptake intention, 18 with barriers decreasing one's intention to receive the COVID 19 vaccine and benefits increasing their vaccination uptake intention. 20 With approximately 57% of the U.S. indicating intention to receive the vaccine and greater hesitancy among Latino Americans than non-Hispanic whites, 22 , 23 it is important to understand what may prevent this population from getting vaccinated.…”