Integrating health behavior theories to predict COVID-19 vaccines uptake intent among the American public

Abstract

Wide uptake of coronavirus disease 2019 (COVID-19) vaccines is key to containing the ongoing pandemic. Integrating constructs from three prominent health behavior theories (HBT) including the extended parallel process model (EPPM), the health belief model (HBM) and the theory of planned behavior (TPB), the current study seeks to identify sociopsychological factors that influence American public’s COVID-19 vaccines uptake intent. An online survey was delivered to a national sample (N = 934) with demographic composition similar to the U.S. population. This study assessed the influences of risk perception and fear associated with COVID-19, beliefs about and attitudes toward COVID-19 vaccines, self-efficacy, social and psychological contexts, and demographic characteristics on people’s intention to get COVID-19 vaccines. Most respondents intended to get a COVID-19 vaccine once it is available. However, participants tended to underestimate their risks of contracting COVID-19, which may prevent them from getting vaccinated. Exposure to COVID-19 infections and deaths led to higher uptake intent via the mediation of fear. Concerns about the safety of COVID-19 vaccines negatively influenced vaccination intention, while perceived community benefits of the vaccines were positively associated with vaccination intention. Positive attitudes toward vaccines in general and recent vaccine history were also positively linked to COVID-19 vaccines uptake intent. This study attests the effectiveness of HBT constructs in predicting COVID-19 vaccines uptake intent. The results point to the importance of fostering confidence in vaccine safety in interventions seeking to promote COVID-19 vaccines uptake.