Predicting Vaccination Intention against COVID-19 Using Theory of Planned Behavior: A Systematic Review and Meta-Analysis

Abstract

This study systematically analyzed the literature using the theory of planned behavior (TPB) as a theoretical framework to examine the influence of its constructs on vaccination intention against COVID-19. Quantitative studies were searched in PubMed, CINAHL, Web of Science, and Google Scholar following the PRISMA guidelines. The average rate of COVID-19 vaccination intention was 73.19%, ranging from 31% to 88.86%. Attitude had the strongest association with vaccination intention (r+ = 0.487, 95% CI: 0.368–0.590), followed by subjective norms (r+ = 0.409, 95% CI: 0.300–0.507), and perceived behavioral control (r+ = 0.286, 95% CI: 0.198–0.369). Subgroup analyses showed that the pooled effect sizes of TPB constructs on vaccination intention varied across geographic regions and study populations. Attitude had large effect sizes in Asia, Europe, and Oceania, especially among the adult general population, parents, and patients. Subjective norms had large effect sizes in Asia and Oceania, especially among parents and patients. Perceived behavioral control was the most dominant predictor of vaccination acceptance in Africa among patients. These findings suggest that TPB provides a useful framework for predicting intention to receive a COVID-19 vaccine. Hence, public awareness and educational programs aimed at promoting COVID-19 vaccination intention should consider using TPB as a framework to achieve the goal.

Associations between the Self-Reported Likelihood of Receiving the COVID-19 Vaccine, Likelihood of Contracting COVID-19, Discrimination, and Anxiety/Depression by Sexual Orientation

“…In line with TPB postulations, our moderation analysis showed individuals who reported a higher perceived likelihood of contracting COVID-19 were more likely to express vaccine intent, which is consistent with other studies [ 20 , 23 , 42 , 43 ]. Interestingly, we also found sexual minority individuals with mild anxiety/depression symptoms had the highest likelihood of receiving the COVID-19 vaccine, but individuals with moderate and severe anxiety/depression had a lower likelihood of vaccination.…”

“…Presently, knowledge on COVID-19 vaccination uptake and attitudes among sexual minority populations is still developing. According to the Theory of Planned Behavior (TPB), an individual’s vaccine intention is likely to be influenced by their attitudes, subjective norms and beliefs, or perceived behavioral control over COVID-19 vaccination [ 23 ]. Furthermore, vaccination intentions can be modified by sociodemographic and mental health factors [ 23 ].…”

“…According to the Theory of Planned Behavior (TPB), an individual’s vaccine intention is likely to be influenced by their attitudes, subjective norms and beliefs, or perceived behavioral control over COVID-19 vaccination [ 23 ]. Furthermore, vaccination intentions can be modified by sociodemographic and mental health factors [ 23 ]. Likewise, McNaghten et al [ 13 ] reported higher levels of vaccine confidence and vaccination among LGB adults compared to non-LGB persons (as of 30 October 2021), and barriers to vaccine uptake unique to sexual minority communities continue to persist [ 20 ].…”

A Time to Get Vaccinated? The Role of Time Perspective, Consideration of Future Consequences, Conspiracy Beliefs, Religious Faith, Gender, and Race on Intention to Vaccinate for COVID-19 in the United States

“…Regarding H1N1, the Theory of Planned Behavior has appeared to contribute to intended vaccination uptake in one study [ 60 ], predicted 60% of adults’ intention to receive an H1N1 vaccination in another study [ 61 ], and explained 70% of the variance in vaccination intention in another study [ 62 ]. Regarding COVID-19, a recent systematic review and meta-analysis investigated the role of Theory of Planned Behavior constructs in determining intention to get vaccinated against COVID-19 [ 63 ]. The findings of this meta-analysis revealed that the COVID-19 vaccination intention rate was relatively high at 73%.…”

COVID-19-related burnout reduces COVID-19 vaccination intention in cardiac patients: a cross-sectional study in Greece

“…Socio-demographic variables, psychological factors, vaccine hesitancy, COVID-19 related variables, personal beliefs, knowledge, fear, conspiracy theories, fake news, and trust are the most important factors that influence individuals' decision to accept the COVID-19 vaccines. [17][18][19][20][21][22] New SARS-CoV-2 variants are emerged and COVID-19 is still a public health issue especially for vulnerable groups such as people with chronic medical conditions. Thus, vaccination uptake against COVID-19 among high-risk groups should be maintained in high levels in order to avoid the negative consequences of the disease.…”