To Get Vaccinated, or Not to Get Vaccinated, That Is the Question: Illness Representations about COVID-19 and Perceptions about COVID-19 Vaccination as Predictors of COVID-19 Vaccination Willingness among Young Adults in The Netherlands

Abstract

Mass vaccination is considered necessary to reduce the spread of COVID-19; however, vaccination willingness was found to be especially low among young adults. Therefore, based on the extended Common Sense Model, the unique effects and the interplay of illness representations about COVID-19 and perceptions about COVID-19 vaccination in explaining COVID-19 vaccination willingness was investigated using a cross-sectional design. An online survey measuring the relevant variables was filled in by 584 participants (69.9% female) between 18 and 34 years. Correlation analyses showed that all illness representation dimensions except from timeline and both dimensions of vaccination perceptions were related to vaccination willingness. The mediation analysis revealed that less personal control, more prevention control, more concerns about COVID-19 as well as more perceived necessity of and fewer concerns about the vaccination were directly related to higher vaccination willingness. Additionally, prevention control was indirectly related to higher vaccination willingness through stronger perceptions of necessity of the vaccination. The extended Common Sense Model proved to be useful in the context of illness prevention. Campaigns to improve vaccination rates should aim at increasing the perception that COVID-19 is preventable through vaccination and the personal need of the vaccination as well as at decreasing concerns about the vaccination.

Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign

“…We also found higher odds of hesitancy for participants with low confidence in the health services response to COVID-19 and non-COVID-19 and who perceived the measures implemented by the government as inadequate, matching prior publications on this topic [15,46]. Higher odds of hesitancy were also found for participants who perceived their risk of getting COVID-19 as low or non-existent, which was in agreement with the literature [5,8,10,[14][15][16][17][18]22,25,27,30,31,33,37,46]. Risk perception and trust in the authorities and health institutions can vary according to a country's pandemic context during a specific period [51].…”

“…Negative perceptions towards the efficacy [5,8,13,14,17,19,21,25,31,34,37] and safety [5,8,10,13,14,[16][17][18][19]21,25,27,[29][30][31]33,37,40] of COVID-19 vaccines were highly linked to vaccine hesitancy. Given the complexity of this topic, aligned with the growing misinformation present in several media regarding the development process of vaccines, concerns about the safety and efficacy of the vaccines are understandable [2,15].…”

“…Hence, the reported vaccine acceptance or hesitancy was mostly assessed using hypothetical questions as there were still no vaccines available outside of the clinical trial setting [3][4][5][6][8][9][10]. Several cross-sectional studies have since explored COVID-19 vaccine acceptance and hesitancy and their determinants after the respective countries' vaccination program implementation, namely in European countries [2], such as the United Kingdom [15,16,20,21], Germany [15,22], Denmark [15,23], France [15], Hungary [15], Sweden [15], Italy [15], Norway [21], Poland [24], the Netherlands [25], Spain [26] and Greece [27]. Additional studies were also conducted in Saudi Arabia [28], the United States of America [13,17,21,29], South Africa [21,30], Jordan [31], Israel [32], Chile [33], China [18,21,34,35], Japan [21,36] and Australia [21], among others [21].…”

“…Negative perceptions on the safety [5,8,10,13,14,[16][17][18][19]21,25,27,[29][30][31]33,37] or efficacy/effectiveness [5,8,13,14,16,17,19,21,25,31,34,37] of these vaccines and misinformation on this topic [2,15] were described in individuals hesitant about COVID-19 vaccination. Additionally, a perception of COVID-19 as not a risk to self [5,8,10,[14][15][16][17][18]22,25,27,[30][31][32][33]37,38], as well as general distrust of COVID-19 vaccines [14,17], the go...…”

Public perceptions of myocardial infarction: Do illness perceptions predict preferences for health check results

“…However, in recent years there have been examples in the context of healthy members of the public ( Figueiras and Alves, 2007 ). For instance, illness perceptions were associated breast cancer screening attendance in Malta ( Marmarà et al, 2017 ), and COVID-19 vaccination willingness among young Dutch citizens ( Vollmann and Salewski, 2021 ). To our awareness CSM have not been used to explain willingness to participate in health checks, which are a strategy to prevent CVDs within the public.…”