The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review

Abstract

This study systematically analyzes the research that used the Health Belief Model (HBM) as a theoretical basis to examine the influence of HBM constructs on COVID-19 vaccine hesitancy. Following PRISMA guidelines, PubMed, Web of Science, Google Scholar, and Scopus were searched for quantitative studies. Sixteen studies with 30,242 participants met inclusion criteria. The prevalence of COVID-19 vaccine hesitancy was 33.23% (95% CI 24.71–41.39%). Perceived barriers and perceived benefits were the most common HBM constructs that were significantly associated with vaccine hesitancy. While perceived benefits was inversely associated, a positive association was found between perceived barriers and vaccine hesitancy. Other HBM constructs that were frequently examined and inversely associated were perceived susceptibility, cues to action, perceived severity, and self-efficacy. The most common HBM modifying factor that was directly associated with COVID-19 vaccine hesitancy was gender, followed by education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity; however, a few studies report inconsistent results. Other modifying variables that influenced vaccine hesitancy were knowledge of COVID-19, prior diagnosis of COVID-19, history of flu vaccination, religion, nationality, and political affiliation. The results show that HBM is useful in predicting COVID-19 vaccine hesitancy.

Count on trust: the indirect effect of trust in government on policy compliance with health behavior instructions

“…As our findings show, contrary to one of the core hypotheses of the HBM, risk perceptions were not associated with compliance intentions in all of our studies (see Table 7 ). Although these results contradict some recent evidence that support the risk perception-compliance relationship (e.g., Limbu et al, 2022 ; Shmueli, 2021 ), other studies demonstrate similar results to ours, such that this relationship is insignificant, partial or applies only to specific health behaviors but not to others (e.g., Al-Sabbagh et al, 2021 ; Coe et al, 2012 ; Tong et al, 2020 ; Wong et al, 2020 ). This may be explained by the fact that the HBM was originally developed for explaining voluntary health behaviors, such as screening tests, recommended by healthcare professionals, and not governmentally issued instructions (Davis et al, 2013 ; Janz & Becker, 1984 ).…”

Vaccine Hesitancy: Obstacles and Challenges

“…People should believe that vaccines are effective, safe, and part of a trustworthy medical system. According to the health belief model (HBM), vaccine confidence is influenced by perceived susceptibility and severity of a disease, perceived benefits and barriers to vaccination, cues (like social media messages and recommendations by family members and healthcare workers), and self-efficacy [ 31 ]. For COVID-19 vaccines, health messaging that decrease perceived risks and highlight benefits were effective in overcoming vaccine hesitancy [ 31 ]; HBM modifiers including education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity have inconsistent effects on VH.…”

Vaccine Hesitancy Hotspots in Africa: An Insight from Geotagged Twitter Posts

“…T HE emergence of the novel COVID-9 pandemics changed the way the world does things, especially in the restrictions of movement and lockdowns of businesses in the last two years [1]- [3]. The impact of the lockdown of businesses on the world's economy is clearly significant in the rate of inflation in recent times [4].…”