A little shot of humility: Intellectual humility predicts vaccination attitudes and intention to vaccinate against COVID-19

Individual predictors of vaccine hesitancy in the Italian post COVID-19 pandemic era

A wide range of survey studies have explored vaccination hesitancy/resistance during the COVID-19 pandemic and provided evidence that this can be explained by several individual variables from the ideological, clinical, and socio-affective domain. However, evidence about which individual variables predict vaccine hesitancy in the post-pandemic state of COVID-19 is meager. We administered a battery of questionnaires to a group of 120 Italian participants with high and low scores on the adult vaccine hesitancy scale (aVHS) to investigate the predictive role of ideological (i.e. political orientation), clinical (i.e. anxiety, interoceptive accuracy), and socio-affective (i.e. alexithymia, disgust sensitivity/propensity, empathy) variables on vaccine hesitancy/resistance. This study provides evidence that lower interoceptive awareness and cognitive empathy are predictors of a greater hesitancy to get vaccinated in the post-pandemic COVID-19 state.

Evidence-based scientific thinking and decision-making in everyday life

In today's knowledge economy, it is critical to make decisions based on high-quality evidence. Science-related decision-making is thought to rely on a complex interplay of reasoning skills, cognitive styles, attitudes, and motivations toward information. By investigating the relationship between individual differences and behaviors related to evidence-based decision-making, our aim was to better understand how adults engage with scientific information in everyday life. First, we used a data-driven exploratory approach to identify four latent factors in a large set of measures related to cognitive skills and epistemic attitudes. The resulting structure suggests that key factors include curiosity and positive attitudes toward science, prosociality, cognitive skills, and openmindedness to new information. Second, we investigated whether these factors predicted behavior in a naturalistic decision-making task. In the task, participants were introduced to a real science-related petition and were asked to read six online articles related to the petition, which varied in scientific quality, while deciding how to vote. We demonstrate that curiosity and positive science attitudes, cognitive flexibility, prosociality and emotional states, were related to engaging with information and discernment of evidence reliability. We further found that that social authority is a powerful cue for source credibility, even above the actual quality and relevance of the sources. Our results highlight that individual motivating factors toward information engagement, like curiosity, and social factors such as social authority are important drivers of how adults judge the credibility of everyday sources of scientific information.

Intellectual humility as a tool to combat false beliefs: An individual-based approach to belief revision

False beliefs pose significant societal threats, including health risks, political polarization and even violence. In two studies (N = 884) we explored the efficacy of an individual-based approach to correcting false beliefs. We examined whether the character virtue of intellectual humility (IH)-an appreciation of one's intellectual boundaries-encourages revising one's false beliefs in response to counter-information. Our research produced encouraging but also mixed findings. Among participants who held false beliefs about the risks of vaccines (Study 1) and the 2020 US Election being rigged (Study 2), those with higher IH explored more information opposing these false beliefs. This exploration of opposing information, in turn, predicted updating away from these inaccurate health and political beliefs. IH did not directly predict updating away from false beliefs, however, suggesting that this effect-if it exists-may not be particularly powerful. Taken together, these results provide moderate support for IH as a character trait that can foster belief revision but, simultaneously, suggest that alternate pathways to combat false beliefs and misinformation may be preferred.

Conservatism, anti-vaccination attitudes, and intellectual humility: examining their associations through a social judgment theory framework

Previous research has consistently found that more political conservatism is related to higher anti-vaccination attitudes. However, little work has investigated how intellectual humility could potentially contribute to this relationship. Employing the social judgment theory of attitude change, we examined whether conservatism could mediate the association between intellectual humility and anti-vaccination attitudes. Participants (N = 1,293; 40.1% female; Mage = 38.23 years, SDage = 11.61, range of age was 18-78) completed a multifaceted measure of intellectual humility, an assessment of four types of anti-vaccination attitudes, and a measure of political orientation. Results from structural equation modeling revealed that decreased levels of most aspects of intellectual humility (i.e., independence of intellect and ego, openness to revising one's viewpoint, and lack of intellectual overconfidence) are associated with more conservative political views, which in turn is associated with stronger anti-vaccination attitudes, particularly worries about unforeseen future effects, concerns about commercial profiteering, and preference for natural immunity. These findings suggest that intellectual humility could reflect one's latitude widths, thereby predicting their openness to vaccine massaging, and thus may play an important role in addressing anti-vaccination attitudes, especially when politics is involved.

Comparing the influence of intellectual humility, religiosity, and political conservatism on vaccine attitudes in the United States, Canada, and the United Kingdom

Three studies of US, Canada, and UK respondents examined pro-vaccine attitudes as predicted by intellectual humility, belief in science, religiosity, and political attitudes. Intellectual humility refers to the capacity to understand limits of one's own beliefs and showed strong relationship to pro-vaccine attitudes across samples. Pro-vaccine attitudes were correlated with intellectual humility and negatively correlated with political conservatism and religiosity. Regression models compared overlapping influences of belief predictors on vaccine attitudes. Across countries, intellectual humility was the most consistent predictor of pro-vaccine attitudes when controlling for other beliefs and thinking styles (political conservatism, belief in science, religiosity). In comparison, political conservatism was a significant predictor of vaccine attitudes in regression models on US and Canadian respondents, and religiosity only held as a predictor in regression models in the US sample. We conclude with a discussion of intellectual humility as a predictor of vaccine attitudes and implications for research and persuasion.

A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States

OBJECTIVE

To explore the empirical literature on gender/sex differences in vaccine acceptance among U.S.-based adults and adolescents in approximately the first 2 years of the pandemic.

DATA SOURCE

Embase, Medline, PsycINFO, EBSCO, CINAHL, Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

Peer-reviewed studies conducted in the U.S. with those aged 12 and older, published in English before January 12, 2022, examining the relationship between gender/sex on COVID-19 vaccine intentions and/or uptake.

DATA EXTRACTION

Three authors screened studies and extracted data.

DATA SYNTHESIS

Univariate and multivariate results are summarized.

RESULTS

A total of 53 studies met inclusion criteria (48 intentions, 7 uptake), using mostly cross-sectional designs (92.5%) and non-random sampling (83.0%). The majority of studies supported men's greater intentions to vaccinate compared to women, and men's greater vaccine uptake in univariate analyses, but most multivariate analyses supported no gender differences in uptake. Few studies examined gender beyond binary categories (women/men), highlighting a gap in the studies inclusive of transgender or gender-diverse populations in analyses.

CONCLUSION

Women may have been more hesitant to get the vaccine than men early in the pandemic, but these differences may not translate to actual behavior. Future research should include non-binary/transgender populations, explore the gender-specific reasons for hesitancy and differences by sub-populations, utilize more rigorous designs, and test gender-sensitive public health campaigns to mitigate vaccine concerns.

Examining age, period and cohort effects in attitude change to childhood vaccinations in a representative New Zealand survey: a multiyear cohort-sequential growth modelling study

OBJECTIVES

Vaccinations are an important preventative measure in reducing the spread of infectious diseases worldwide. However, concerns of undervaccination during childhood have become increasingly common. The current study aims to investigate changes in attitudes towards childhood vaccinations prior to the COVID-19 pandemic using a national sample from New Zealand.

DESIGN

Age-based, period-based, and cohort-based changes were assessed using cohort-sequential latent growth modelling in 11 overlapping birth cohorts, which spanned the ages of 23-79 years.

SETTING AND PARTICIPANTS

Data were taken from the New Zealand Attitudes and Values Study where 58 654 adults completed at least one wave across a 7-year period (2013 and 2015-2019).

RESULTS

The period-based and cohort-based models fit the data equally well (χ2(282)=8547.93, p<0.001, comparative fit index, CFI=0.894, root mean square error of approximation, (RMSEA)=0.074, standardised root mean square residual, SRMR=0.105; χ2(273)=8514.87, p<0.001, CFI=0.894, RMSEA=0.075, SRMR=0.105, respectively) suggesting societal factors contribute to childhood vaccination attitudes. Additionally, the findings suggest attitudes towards childhood vaccinations were becoming increasingly more positive in all birth cohorts (ps<0.001), with younger and older birth cohorts exhibiting even positive attitudes compared with middle-aged cohorts.

CONCLUSION

Overall, both the cohort-based and period-based models reveal changes in vaccination attitudes suggesting that even prior to the COVID-19 pandemic, societal influences had an impact on attitudes towards childhood vaccination.

Psychological Factors of Vaccination Intent among Healthcare Providers, Parents, and Laypeople

The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from -0.128 to -0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape.

Keep Calm and Be Humble: Can Intellectual Humility Predict Test Anxiety?

Test anxiety is common and may lead to a range of negative outcomes, including poor exam performance. Therefore, it is important to explore psychological predictors of test anxiety. In this paper, we examined whether intellectual humility can predict test anxiety. In Study 1, college students (N = 181) completed an intellectual humility measure with four subscales and two different measures of test anxiety. In Study 2 (N = 196), a community sample recruited from an online workforce completed the same measures. In both studies, we found that intellectual humility was negatively related to test anxiety, such that higher intellectual humility predicted lower test anxiety. Specifically, Study 1 demonstrated a negative correlation between intellectual humility and the Sarason Test Anxiety Scale; Study 2 confirmed this negative relationship with both the Sarason and Westside test anxiety scales. We also found that this relationship was largely driven by the intellectual humility subscale of Independence of Intellect and Ego. Additionally, these results were present even when controlling for key demographic factors. These findings highlight intellectual humility's role in predicting exam anxiety and offer a potential avenue for intellectual humility to be leveraged into interventions to decrease exam anxiety in the future.

Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15-24 years)

BACKGROUND

The Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX's structural, convergent, and discriminant validity is still limited, especially in youth samples.

METHODS

The present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15-24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria.

RESULTS

The results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors' contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry.

CONCLUSIONS

The present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.

Intellectual Humility and Responsiveness to Public Health Recommendations

We examined the association between intellectual humility (IH)-a willingness to consider credible new information and alternative views and revise one's own views if warranted-and adherence to experts' health behavior recommendations in the U.S. during the COVID-19 pandemic. Study 1 (N = 541) results showed that people higher in IH are more likely to engage in recommended health behaviors (e.g., mask-wearing, social distancing)-even when controlling for political affiliation. Additional analyses focused specifically on mask-wearing produced initial evidence consistent with mediation of the IH-mask-wearing relationship by the beliefs that mask-wearing 1) is an effective way to slow the spread of COVID-19 and 2) protects others. Based on the pathway from IH to mask-wearing through a concern for others found in Study 1, Study 2 further examined the relationship between IH and prosocial tendencies. The results from Study 2 (Ns for correlation coefficients ranged from 265 to 702) showed an association between IH and several values and traits that reflect a concern for others (e.g., agreeableness, benevolence). These findings suggest that IH may influence behavior through both intra- and interpersonal mechanisms. Implications of these findings for the health-behavior domain are discussed.

Exploring intellectual humility through the lens of artificial intelligence: Top terms, features and a predictive model

Intellectual humility (IH) is often conceived as the recognition of, and appropriate response to, your own intellectual limitations. As far as we are aware, only a handful of studies look at interventions to increase IH - e.g. through journalling - and no study so far explores the extent to which having high or low IH can be predicted. This paper uses machine learning and natural language processing techniques to develop a predictive model for IH and identify top terms and features that indicate degrees of IH. We trained our classifier on the dataset from an existing psychological study on IH, where participants were asked to journal their experiences with handling social conflicts over 30 days. We used Logistic Regression (LR) to train a classifier and the Linguistic Inquiry and Word Count (LIWC) dictionaries for feature selection, picking out a range of word categories relevant to interpersonal relationships. Our results show that people who differ on IH do in fact systematically express themselves in different ways, including through expression of emotions (i.e., positive, negative, and specifically anger, anxiety, sadness, as well as the use of swear words), use of pronouns (i.e., first person, second person, and third person) and time orientation (i.e., past, present, and future tenses). We discuss the importance of these findings for IH and the value of using such techniques for similar psychological studies, as well as some ethical concerns and limitations with the use of such semi-automated classifications.

Psychometric validation of the Korean versions of the Vaccine Hesitancy Scale and Vaccination Attitudes Examination Scale

PURPOSE

Strategies for reducing vaccine hesitancy and negative attitudes toward vaccination and measures to accurately assess them have been developed worldwide. The Vaccine Hesitancy Scale (VHS) and Vaccination Attitudes Examination Scale (VAX) are reliable and valid tools. This study evaluates the validity and reliability of the Korean versions of the Vaccine Hesitancy Scale (K-VHS) and Vaccination Attitudes Examination Scale (K-VAX).

METHODS

We translated the VHS and VAX into Korean using forward and backward translations and tested their psychometric attributes. We collected data from a sample of 2,292 Koreans, recruited in June 2021 from a large online panel using quotas for age and gender. We used content validity, construct validity with confirmatory factor analysis, concurrent validity, and convergent validity to assess the validity of the scales, and tested their reliability with evaluations of internal consistency and stability.

RESULTS

The K-VHS and K-VAX showed good model fits in the validity tests, with seven items for one factor and 12 items for four factors, respectively. The internal consistency (Cronbach's alpha = 0.94 for the K-VHS, and 0.86 for the K-VAX) and stability (ICC = 0.86 for the K-VHS, and 0.88 for the K-VAX) of the measures indicated that they are reliable.

CONCLUSIONS

Both tools are effective psychometric instruments for assessing vaccine hesitancy and vaccination attitudes in Korean adults. K-VHS and K-VAX would be useful for predicting vaccination behaviors in novel infectious disease contexts and communicating the evidence needed to develop related policies or programs.

Psychological mechanisms and interventions directed at vaccination attitudes

Attitudes about vaccination impact not only the individual but also society. Therefore, understanding the underlying psychological processes of those who disagree with vaccination is critical for creating compassion through understanding and change through promoting autonomy. The current review aimed to fill a gap in the literature, outlining the state of the recent research on vaccination attitudes, specifically on the underlying mechanisms driving anti-vaccination movements and individuals' thoughts and behaviors. In addition, we aimed to evaluate current research on the effectiveness of interventions targeting these mechanisms. Overall, results indicated that those declining vaccines had beliefs related to distrust in the scientific community and pharmaceutical companies and moral preferences for purity and liberty. In addition, our review identified the potential for utilizing motivational interviewing techniques as an intervention. This literature review provides a platform for further research and enhances the current understanding of vaccination attitudes.

Not Getting Vaccinated? It Is a Matter of Problem-Solving Abilities and Socio-Cognitive Polarization

The anti-COVID-19 vaccination campaign in the United States provided a significant contribution to the control of the virus spread. Despite the recommendations by public health institutions, vaccine skepticism and hesitancy contributed to low vaccine uptake, thus possibly disrupting the management of preventable diseases associated with the COVID-19 infection. The process that led individuals to accept COVID-19 vaccines required the ability to gather, synthesize, and weigh-up information within a novel, dynamically changing, complex, and ambiguous context. To deal with such complexity, we hypothesized that both the ability of reflection and flexible adaptation played a fundamental role. Based on previous research on cognitive predictors of vaccine refusal, we decided to investigate the combined role of two constructs, namely, problem-solving skills and socio-cognitive polarization (SCP), on vaccine acceptance and uptake. Two-hundred-seventy-seven US participants completed an online survey aimed to measure problem-solving ability, through a rebus puzzles task, and SCP, through a composite measure of absolutist thinking, political conservatism, and xenophobia. Mediation analyses indicated that SCP mediated the association between problem-solving ability and vaccine acceptance, so lower problem-solving abilities associated with higher polarization predicted vaccine rejection. Thus, our findings suggested that low problem-solving skills may represent a risk factor for COVID-19 vaccine refusal, with cognitive and social rigidity playing a crucial role in undermining the anti-COVID-19 vaccine uptake.

Everything has a limit: How intellectual humility lowers the preference for naturalness as reflected in drug choice

OBJECTIVE

Across a broad range of cultures, people demonstrate a strong preference for items that are labeled as natural. Yet, less is known about methods that can reduce the natural-is-better bias. The objective of the present research is to see whether intellectual humility, a moral virtue that can be understood as a more open and curious mindset, reduces naturalness bias in terms of drug-related decisions.

METHODS

We tested our hypotheses across four studies using different populations (university students and community adults) and methods (correlational and experimental). Study 1 involved a survey exploring whether university students choosing a synthetic drug tended to display a higher level of intellectual humility than those choosing a natural drug. Study 2 assessed the link using observation of real-world behavior in non-student adults. Study 3 adopted an experimental approach to test the idea that reflecting on one's intellectual fallibility can at least temporarily reduce naturalness bias on drug choice. Study 4 examined the potential mediating mechanism underlying the observed effect.

RESULTS

We found correlational and experimental evidence that participants higher in intellectual humility were more likely to choose the synthetic drug than those lower in intellectual humility in both self-report and behavioral measures. The results also demonstrate that openness to experience mediated the effect of intellectual humility on naturalness bias.

CONCLUSIONS

These results highlight intellectual humility as a malleable, psychological variable that can combat biased thinking associated with health-related decision-making.

People's perspectives about COVID-19 vaccination certificate: Findings from a representative Italian sample

In Italy, like in other countries, issues still exist regarding how to reach high vaccine coverage and several countries have considered policies to increase vaccine uptake. In the present study, we focused on people who have a favorable attitude towards vaccination. In March-April 2021, we asked a representative sample of Italian participants (N = 1,530) to assess to what extent they would support the adoption of a COVID-19 vaccination certificate, excluding unvaccinated people from participating in public and cultural events. Furthermore, as the vaccination coverage increases, severe forms of COVID-19 requiring hospitalization more likely involve unvaccinated individuals, who might be perceived as those who don't contribute to ending the pandemic and who constitute a significant health cost for society. We then asked participants to assess to what extent they would favor the idea of requiring people who refuse the vaccine to pay for their own medical expenses in case of hospitalization. We hypothesized that support for the adoption of the vaccination certificate would be predicted by the COVID-19 vaccination status (received, booked, high-, medium-, low-willingness to be vaccinated, or refused) and by the same factors that are known to affect the willingness to get vaccinated. These factors were also tested in a model aimed at investigating if a vaccinated person would favor a measure requiring the unvaccinated individuals to pay for medical expenses. Results confirmed that the support towards the vaccination certificate policy was strongly predicted by the vaccination status and by factors known to affect the willingness to get vaccinated. Interestingly (and surprisingly), a similar pattern was observed for the support of the policy about medical expenses. In conclusion, support for a COVID-19 vaccination certificate was high among the Italian population in the early phases of the vaccination rollout. The findings are discussed considering potential policies to tackle the pandemic.

Anticipating hopes, fears and expectations towards COVID-19 vaccines: A qualitative interview study in seven European countries

Vaccine uptake is essential to managing the ongoing COVID-19 pandemic, and vaccine hesitancy is a persistent concern. At the same time, both decision-makers and the general population have high hopes for COVID-19 vaccination. Drawing from qualitative interview data collected in October 2020 as part of the pan-European SolPan study, this study explores early and anticipatory expectations, hopes and fears regarding COVID-19 vaccination across seven European countries. We find that stances towards COVID-19 vaccines were shaped by personal lived experiences, but participants also aligned personal and communal interests in their considerations. Trust, particularly in expert institutions, was an important prerequisite for vaccine acceptance, but participants also expressed doubts about the rapid vaccine development process. Our findings emphasise the need to move beyond the study of factors driving vaccine hesitancy, and instead to focus on how people personally perceive vaccination in their particular social and political context.

Examining four types of anti-vaccination attitudes prior to and during the COVID-19 pandemic

People hold different anti-vaccination attitudes. Having an understanding of how these attitudes have changed prior to and during the COVID-19 pandemic is critical for combatting anti-vaccination attitudes and increasing vaccine intention and uptake. Data were collected from different samples in the United States at three time points prior to (n = 840) and four time points during (n = 1543) the pandemic. All participants completed a multi-dimensional measure of anti-vaccination attitudes (VAX Scale) through an online platform. Results showed that, when it comes to vaccines, worries about unforeseen side effects, concerns about commercial profiteering, and preference for natural immunity were higher during the COVID-19 pandemic than they were prior to it. However, mistrust of vaccine benefit was lower during the COVID-19 pandemic than prior to it. These differences were found even after controlling for the potential effects of participant sex, education, socioeconomic status, age, and race/ethnicity. Additionally, worries about unforeseen side effects, concerns about commercial profiteering, and preference for natural immunity increased linearly alongside the persistence of COVID-19; whereas, mistrust of vaccine benefit showed no change. Although it might be intuitive to emphasize vaccines' effectiveness to increase uptake, the public's trust in vaccine effectiveness did not appear to be the major concern. Thus, public health efforts to increase uptake of vaccines should also focus on reducing concerns about potential side effects from the vaccine, tempering the attention on financial benefits to pharmaceutical companies, and rebuffing the overreliance on natural immunity.

Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).

Methods

Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles.

Results

A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection.

Conclusion

This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.

A Systematic Investigation of American Vaccination Preference via Historical Data

While COVID-19 vaccines are generally available, not all people receive vaccines. To reach herd immunity, most of a population must be vaccinated. It is, thus, important to identify factors influencing people’s vaccination preferences, as knowledge of these preferences allows for governments and health programs to increase their vaccine coverage more effectively. Fortunately, vaccination data were collected by U.S. Census Bureau in partnership with the CDC via the Household Pulse Survey (HPS) for Americans. This study presents the first analysis of the 24 vaccination datasets collected by the HPS from January 2021 to May 2022 for 250 million respondents of different ages, genders, sexual orientations, races, education statuses, marital statuses, household sizes, household income levels, and resources used for spending needs, and with different reasons for not receiving or planning to receive a vaccine. Statistical analysis techniques, including an analysis of variance (ANOVA), Tukey multiple comparisons test, and hierarchical clustering (HC), were implemented to analyze the HPS vaccination data in the R language. It was found that sexual orientation, gender, age, and education had statistically significant influences on the vaccination rates. In particular, the gay/lesbian group showed a higher vaccination rate than the straight group; the transgender group had a lower vaccination rate than either the female or the male groups; older respondents showed greater preference for vaccination; respondents with higher education levels also preferred vaccination. As for the other factors that were not significant enough to influence vaccinations in the ANOVA, notable trends were found. Asian Americans had higher vaccination rates than other races; respondents from larger household sizes had a lower chance of getting vaccinated; the unmarried group showed the lowed vaccination rate in the marital category; the respondents depending on borrowed money from the Supplemental Nutrition Assistance Program (SNAP) showed a lower vaccination rate than people with regular incomes. Concerns regarding the side-effects and the safety of the vaccines were the two major reasons for vaccination hesitance at the beginning of the pandemic, while having no trust in the vaccines and no trust in the government became more common in the later stage of the pandemic. The findings in this study can be used by governments or organizations to improve their vaccination campaigns or methods of combating future pandemics.

Do Side Effects to the Primary COVID-19 Vaccine Reduce Intentions for a COVID-19 Vaccine Booster?

BACKGROUND

Vaccines are being administered worldwide to combat the COVID-19 pandemic. Vaccine boosters are essential for maintaining immunity and protecting against virus variants. The side effects of the primary COVID-19 vaccine (e.g., headache, nausea), however, could reduce intentions to repeat the vaccination experience, thereby hindering global inoculation efforts.

PURPOSE

The aim of this research was to test whether side effects of a primary COVID-19 vaccine relate to reduced intentions to receive a COVID-19 booster. The secondary aim was to test whether psychological and demographic factors predict booster intentions.

METHODS

Secondary data analyses were conducted on a U.S. national sample of 551 individuals recruited through the online platform Prolific. Key measures in the dataset were side effects reported from a primary COVID-19 vaccination and subsequent intentions to receive a booster vaccine. Psychological and demographic variables that predicted primary vaccination intentions in prior studies were also measured.

RESULTS

Booster intentions were high. COVID-19 booster vaccine intentions were uncorrelated with the number of side effects, intensity of side effects, or occurrence of an intense side effect from the primary COVID-19 vaccine. Correlational and regression analyses indicated intentions for a booster vaccination increased with positive vaccination attitudes, trust in vaccine development, worry about the COVID-19 pandemic, low concern over vaccine side effects, and democratic political party affiliation.

CONCLUSIONS

Side effects of a primary COVID-19 vaccine were not directly associated with lower intentions to receive a booster of the COVID-19 vaccine early in the pandemic. However, many variables that predict primary vaccination intentions also predict booster intentions.

To vaccinate or not: The relationship between conscientiousness and individual attitudes toward vaccination in real-life contexts

Despite the availability of a safe and effective vaccine being well-recognized as a critical tool to end the COVID-19 pandemic, many individuals remain vaccine hesitant for various reasons. In the literature, one well-established finding is that skeptical attitudes towards vaccination are higher amongst individuals low in conscientiousness. However, no research is available to corroborate whether the relationship between conscientiousness and intention to vaccinate has force in real life. The present research investigated whether, in addition to self-reported conscientiousness, objectively observable index of conscientiousness behaviors is related to individual perception of vaccination. Based on self-reported data, Study 1 fully replicated prior findings that higher levels of conscientiousness are associated with more positive attitudes towards vaccination in a Chinese student sample. Using the time of arrival for an appointment as a proxy measure for conscientiousness behaviors, Study 2 revealed that non-student adults who arrived early to appointments showed stronger COVID-vaccine uptake intentions than those who arrived late to appointments. Moving beyond vaccination intention to actual behavior, Study 3 found that the arrival punctuality rates of vaccinated participants were higher than those of unvaccinated participants. Overall, our research highlights the important role of conscientiousness-related traits in individuals' COVID-19 vaccination attitudes and behavior.

Bayesian subjectivism and psychosocial attitude toward COVID-19 vaccines

Background: People resistant to vaccination against the coronavirus disease 2019 (COVID-19) pandemic have been counted in almost all countries worldwide. This anti-scientific subjectivity attitude could be explained by assuming as background the individual probability theory originally elaborated by the statistical school of de Finetti. Methods: This research method is based on a sample of 613 subjects from European countries who completed a questionnaire on attitudes towards COVID-19 vaccinations. On a six-value scale, a questionnaire investigated knowledge, assessments, degree of confidence, level of fear, anguish, and anger. Some items proposed an imaginary bet on the probability of not getting sick to deepen the possible presence of subjectivist assumptions about pandemics. Results: 50.4% were against vaccines and 52.5% against the so-called "Green Pass". Results of t-tests and correlations and stepwise regressions indicate that the sample's reasons for opposing vaccination are related to an ego centred vision of the values that assign minor, if any, confidence to authority. Conclusions: This result supports the conclusion that No Vax decisions are more based on subjectivist probabilistic assumptions, thus in line with the significant social trend called "individualism".

Validation and psychometric properties of the Italian Vaccination Attitudes Examination (VAX-I) scale

Despite the massive volume of scientific evidence on the benefits of immunisation, vaccine hesitancy is still a global health threat and represents an obstacle to controlling the spread of viruses such as SARS-CoV-2 and its associated COVID-19. Thus, the present study aimed to adapt and validate an Italian version of the Vaccination Attitudes Examination (VAX) scale. The Italian version of the scale (VAX-I), along with validation measures (general health perceptions, perceived sensitivity to medicines, intention to get the flu vaccine, and trust in health authorities) were administered to a sample of 534 Italian participants aged 18 to 87 (M = 32.41, SD = 15.35). The original version of the VAX scale was translated into Italian using a back-translation method. The parallel and confirmatory factor analyses showed that the scale's four-factor structure fits the data well, as in the original version. Reliability coefficients indicated that the VAX-I scale showed good internal consistency and measurement invariance results demonstrated that the VAX-I scale is stable across gender. Construct validity was supported by the significant negative correlation with general health perceptions, intentions to get the flu vaccine, and trust in health authorities, and the weak but significant and positive correlation with perceived sensitivity to medicines. Overall, the VAX-I scale appears to be a valid instrument to assess vaccine hesitancy in the Italian context.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03209-5.

What Lies Behind Substantial Differences in COVID-19 Vaccination Rates Between EU Member States?

Background

Despite the billions of doses at disposal, less than three-quarters of EU citizens received a COVID-19 vaccine by the end of 2021. The situation is particularly worrying in transition societies, which experience much stronger opposition to vaccination compared to their Western counterparts. To understand whether and to what extent this has to do with the socialist legacy, in this paper we explore wider economic, political, and cultural determinants of the COVID-19 vaccine uptake in the EU.

Methods

Data from Flash Eurobarometer 494 conducted in May 2021 were used to model the attitudes of EU citizens toward COVID-19 vaccination. Based on their views and intentions, each of 26,106 survey participants was allocated into one of the following categories: (1) already vaccinated/plan to get vaccinated; (2) indecisive; (3) refuse vaccination. Multilevel multinomial logit was employed to understand what underlies the reasoning of each group.

Results

The survey revealed that 13.4% of Europeans planned to delay vaccination against COVID-19, while 11.2% did not intend to get vaccinated. Although numerous demographic and socio-economic factors jointly shape their viewpoints, it is trust (in the authorities, science, peers, and online social networks above all) that strongly dominates citizens' reasoning. Given that most transition societies are witnessing the pandemic of distrust at various levels, this seemingly unrelated feature appears to be vital in explaining why newer member states record lower vaccination rates. Education was also found to play a pivotal role, which is reflected in an individual's ability to critically assess information from various sources.

Conclusion

The study results clearly illustrate how long-lasting structural problems (specific for, but not confined to, transition countries) can manifest themselves in unforeseen circumstances if left unaddressed. It is hence of vital importance to learn the lesson and prevent similar issues in the future. Above all, this would require wide-ranging reforms aiming to repair the imperceptible psychological contract between citizens and the state authorities.

The Psychology of Coronavirus Behavioral Health Mindset, Vaccination Receptivity, Customer Orientation and Community Public Service

Three studies were conducted to explore the psychological determinants of COVID-deterrent behaviors. In Study 1, using data collected and analyzed both before and after the release of COVID-19 vaccines, mask-wearing, other preventative behaviors like social distancing, and vaccination intentions were positively related to assessments of the Coronavirus Behavioral Health Mindset (CVBHM); belief in the credibility of science; progressive political orientation; less use of repressive and more use of sensitization coping; and the attribution of COVID-19 safety to effort rather than ability, powerful forces, fate, or luck. In Study 2, favorable COVID-19 vaccination intentions were related to greater willingness to work, lower emotional distress, and greater customer experience mindset. Study 3 examined the personality and motives of individuals who volunteered to help deliver COVID-19 inoculations to the local community. The vaccine-giving volunteers, especially those with prosocial motives, had high CVBHM scores, belief in the credibility of science, low use of repressive coping, greater attribution of COVID-19 protection to effort, low likelihood of voting conservative, were older, and had more education than others. The majority of public health volunteers expressed prosocial motives to help people or join a cause (60.7%), but many (39.3%) expressed the personal motives of getting the COVID-19 vaccination for themselves, conveying a public image of compassion, or structuring time. Based on the three research studies, a COVID-19 Mindset Hierarchy model is proposed to integrate the results.

Predicting willingness to be vaccinated for Covid-19: Evidence from New Zealand

Governments around the world are seeking to slow the spread of Covid-19 and reduce hospitalisations by encouraging mass vaccinations for Covid-19. The success of this policy depends on most of the population accepting the vaccine and then being vaccinated. Understanding and predicting the motivation of individuals to be vaccinated is, therefore, critical in assessing the likely effectiveness of a mass vaccination programme in slowing the spread of the virus. In this paper we draw on the I3 Response Framework to understand and predict the willingness of New Zealanders to be vaccinated for Covid-19. The Framework differs from most studies predicting willingness to be vaccinated because it is based on the idea that the willingness to adopt a behaviour depends on both involvement (a measure of motivational strength) with the behaviour and attitudes towards the behaviour. We show that predictions of individuals' willingness to be vaccinated are improved using involvement and attitudes together, compared to attitudes alone. This result has important implications for the implementation of mass vaccination programmes for Covid-19.

Your pain, my gain: The relationship between self-report and behavioral measures of everyday sadism and COVID-19 vaccination intention

Vaccination plays a crucial role in containing the spread of the COVID-19 pandemic. However, a significant fraction of the global population is reluctant to take a coronavirus vaccine. A burgeoning literature has considered mainly adaptive personality traits as antecedents of vaccine hesitancy (i.e., Big Five and HEXACO), while maladaptive personality traits (i.e., "Dark Tetrad" of personality) are often a comparatively neglected area. In this research, we examined the relationship between everyday sadism and intention to get vaccinated against COVID-19. We theorized that driven by antisocial tendencies and social indifference, individuals with higher sadism may be less willing to obtain a vaccine. Employing a bug-killing paradigm to capture everyday sadism, we tested this prediction in a Chinese sample of non-student adults (N = 188). Support for this proposition was found in the lab task, which demonstrates that sadism was associated with more vaccine refusal spanning the self-report and behavioral domains. In addition, we showed that the sadistic behavioral choices can be predicted with self-report measure of sadistic personality. These findings highlight the important role of maladaptive personality traits in predicting vaccination attitudes and intentions.

Anguish and fears about attitude towards Covid-19 vaccines: contrasts between yes and no vax

The present research investigates the possible causes of resistance to vaccination against the COVID-19 virus. A significant percentage of different countries' populations is refractory to being vaccinated (i.e., in October 2021, in Italy, 20% aged 40–50 years old). A 92-item questionnaire was filled in by a sample of 613 subjects, of which 50.4% said they were against COVID-19 vaccines (63.1% female). Guided by the hypothesis that emotionality constitutes a basis of pre-reflective judgment, items relating to fear, anger and anguish were introduced in the survey. The subjects compiled the Difficulties in Emotional Regulation Scale. The differences between the means of the two samples evaluated with the Student test show that it is, above all, the underlying anguish that constitutes the primary discriminant between the two samples. No Vax mainly considers external the sources of anguish, while Yes Vax sources of anguish appear more internal. From this result an interpretation is advanced: it seems more difficult for No Vax to trust authority recommendations/obligations to get vaccinated because anguish is located just outside the one's body, where Authority dominates.

COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

OBJECTIVE

This state of the art review focuses on bioethical questions and considerations from research findings and methodological issues, including design and recruitment of participants, in studies related to COVID-19 vaccine hesitation in Black individuals. Ethical concerns identified were applied to otolaryngology with recommendations for improving health inequities within subspecialties.

DATA SOURCES

An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021.

REVIEW METHODS

A systematic review approach was taken to search and analyze the research on this topic, which was coupled with expert analysis in identifying and classifying vital ethical considerations.

CONCLUSIONS

The most common COVID-19 vaccine hesitation factors were related to the development of the vaccine, mistrust toward government agencies, and misconceptions about safety and side effects. These findings raised bioethical concerns around mistrust of information, low health literacy, insufficient numbers of Black participants in medical research, and the unique positions of health professionals as trusted sources. These bioethical considerations can be applied in otolaryngology and other health-related areas to aid the public in making informed medical decisions regarding treatments, which may reduce health inequalities among Black Americans and other racial and ethnic minority groups.

IMPLICATIONS FOR PRACTICE

Addressing ethical questions by decreasing mistrust, tailoring information for specific populations, increasing minority representation in research, and using health professionals as primary sources for communicating health information and recommendations may improve relationships with Black communities and increase acceptance of new knowledge and therapies such as COVID-19 vaccination.

Toward controlling of a pandemic: How self-control ability influences willingness to take the COVID-19 vaccine

What influences people's vaccine attitudes and intentions in the combat against the COVID-19 pandemic? Extending beyond health factors, the present research examines whether non-health-specific factors—such as one's self-control ability—influence individual attitudes toward vaccination. Drawing on the social psychology literature, we propose that self-control, which is often associated with adherence to social norms and with engagement in socially desirable behaviors, can lead to more favorable attitudes toward vaccines. Study 1 provided correlational evidence for our theoretical perspective that students scoring high on trait self-control expressed less vaccine hesitancy than students scoring low on self-control. Employing a more representative population, Study 2 examined the relationship with behaviors. It was found that non-student adults with higher self-control strength levels were more likely to accept vaccine appointments opportunities than those with lower self-control strength levels. Using an experimental design, Study 3 found that participants exerting a high level of effort for attentional self-control in the incongruent Stroop task condition showed lower COVID-19 vaccine acceptance than participants in the congruent condition. In sum, our research provides the first experimental evidence that high self-control can have a reliable impact on individual perceptions of vaccination.

Psychosocial Predictors of Intention to Vaccinate Against the Coronavirus (COVID-19)

The COVID-19 pandemic has wreaked havoc across the world. Public health efforts to combat the disease and return life to normalcy largely rests upon COVID-19 vaccination distribution and uptake. Thus, it is critical to examine factors that predict people's intentions to vaccinate. This study explored predictors of intention to vaccinate against COVID-19 among demographic and personal factors, health behaviors and beliefs, COVID-19-specific beliefs, and trust in physicians, using a sample of U.S. adults. We employed bivariate correlations and hierarchical regression to analyze the data. We found that the strongest predictors are political orientation, trust in physicians, subjective norms, and prior flu shot uptake. These associations suggest that individuals who held more liberal political views, expressed higher levels of trust in their primary care provider, perceived stronger social pressure to vaccinate against COVID-19, and received a flu shot during the previous flu season, had a stronger intention to vaccinate against COVID-19. Based on our results, we suggest that public health efforts to increase vaccination uptake for COVID-19 vaccines focus on addressing political orientation (conservatism), involve primary care providers, emphasize vaccination as the norm (and not the exception), and use information about previous flu vaccinations to target vaccination campaigns.

Politicization of COVID-19 health-protective behaviors in the United States: Longitudinal and cross-national evidence

During the initial phase of the COVID-19 pandemic, U.S. conservative politicians and the media downplayed the risk of both contracting COVID-19 and the effectiveness of recommended health behaviors. Health behavior theories suggest perceived vulnerability to a health threat and perceived effectiveness of recommended health-protective behaviors determine motivation to follow recommendations. Accordingly, we predicted that-as a result of politicization of the pandemic-politically conservative Americans would be less likely to enact recommended health-protective behaviors. In two longitudinal studies of U.S. residents, political conservatism was inversely associated with perceived health risk and adoption of health-protective behaviors over time. The effects of political orientation on health-protective behaviors were mediated by perceived risk of infection, perceived severity of infection, and perceived effectiveness of the health-protective behaviors. In a global cross-national analysis, effects were stronger in the U.S. (N = 10,923) than in an international sample (total N = 51,986), highlighting the increased and overt politicization of health behaviors in the U.S.

Sociodemographic and Psychological Predictors of Intention to Receive a COVID-19 Vaccine in Elderly Peruvians

The implementation of a vaccine against COVID-19 is one of the most important health strategies to mitigate the spread of the disease. The objective of this study was to estimate the prevalence of the intention to be vaccinated against COVID-19 and its predictors in older Peruvian adults. This is a cross-sectional study, where information was collected through an online survey regarding vaccination intention of the participants, as well as sociodemographic and psychological variables. A multiple regression analysis was applied to identify predictors of intention to be vaccinated against COVID-19. We evaluated 245 participants, who had a mean age of 72.74 years old (SD = 6.66). 65.5% of these older adults expressed a high likelihood of accepting vaccination, while 20.9% expressed a low likelihood of accepting vaccination, and 13.6% were hesitant. Eleven predictors were identified that explained 66.69% of the intention to vaccinate against COVID-19. This identified place of residence, perceived likelihood of contracting COVID-19, severity of previous infection with COVID-19, fear of the disease, previous refusal of a vaccine, concerns about vaccine sales and speculation, and trust toward vaccines against COVID-19, as the main predictors. Our results show that confidence in vaccines and previous vaccine refusal are relevant predictors of intention to vaccinate against COVID-19 in older adults; these findings may be useful to guide the development of campaigns for the immunization of this vulnerable group in the current pandemic.

Intellectual humility: an old problem in a new psychological perspective

Though having been emphasised by philosophers and theologians for centuries, it is only in the last few years that the concept of intellectual humility has been explicitly defined and studied by empirical psychology. However, it has been long enough to recognise the prominent role that being intellectually humble plays for humane functioning, both at an intra- and inter-individual level. Having started with a broader philosophical and historical context, the present paper discusses the psychological conceptualisations of intellectual humility. Then the recent empirical studies are reviewed, including four strands of research referring to personality traits, cognitive functioning, social relations and religiosity. After presenting selected results, the prospects of psychological research on intellectual humility are discussed, including the limitations and challenges of measurement techniques as well as possible directions for future studies.