The Role of Emotional Competences in Parents' Vaccine Hesitancy

Political ideology shapes risk and benefit judgments of COVID-19 vaccines

In April 2021, the use of the Johnson & Johnson COVID-19 vaccine was paused to investigate whether it had caused serious blood clots to a small number of women (six out of 6.8 million Americans who had been administered that vaccine). As these events were unfolding, we surveyed a sample of Americans (N = 625) to assess their reactions to this news, whether they supported the pausing of the vaccine, and potential psychological factors underlying their decision. In addition, we employed automated text analyses as a supporting method to more classical quantitative measures. Results showed that political ideology influenced the support for the pausing of the vaccine; liberals were more likely to oppose it than conservatives. In addition, the effect of political ideology was mediated by the difference between perceived benefit and risk and the language style used to produce reasons in support (or against) the decision to pause the vaccine. Liberals perceived the benefit of vaccines higher than the risk, used a more analytic language style when stating their reasons, and had a more positive attitude toward the vaccine. We discuss the implications of our findings considering vaccine hesitancy and risk perception during the COVID-19 pandemic.

To vaccinate or not to vaccinate? The interplay between pro- and against- vaccination reasons

BACKGROUND

By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March-April 2021) balanced in terms of age, gender, educational level and area of residence.

METHODS

Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine.

RESULTS

High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p < 0.001). One strong reason in favor of vaccines is enough to unbalance the decision toward acceptance of vaccination, even when reasons against it are also present (p < 0.001). Protection and absence of distrust are the reasons that mostly drive willingness to be vaccinated and acceptance of an offered vaccine.

CONCLUSIONS

Knowing the reasons that drive people's decision about such an important choice can suggest new communication insights to reduce possible negative reactions toward vaccination and people's hesitancy. Results are discussed considering results of other national and international studies.

Predicting COVID-19 and Influenza Vaccination Confidence and Uptake in the United States

This study investigates and compares the predictors of COVID-19 and influenza vaccination confidence and uptake in the U.S. Vaccine hesitancy is defined as the reluctance or refusal (i.e., less than 100% behavioral intention) to vaccinate despite the availability of effective and safe vaccines. Vaccine hesitancy is a major obstacle in the fight against infectious diseases such as COVID-19 and influenza. Predictors of vaccination intention are identified using the reasoned action approach and the integrated behavioral model. Data from two national samples (N = 1131 for COVID-19 and N = 1126 for influenza) were collected from U.S. Qualtrics panels. Tobit regression models were estimated to predict percentage increases in vaccination intention (i.e., confidence) and the probability of vaccination uptake (i.e., intention reaching 100%). The results provided evidence for the reasoned approach and the IBM model and showed that the predictors followed different patterns for COVID-19 and influenza. The implications for intervention strategies and message designs were discussed.

Effect of psychological factors on COVID-19 vaccine hesitancy

BACKGROUND

Vaccine hesitancy can prevent full immunization against coronavirus infectious disease-19 (COVID-19). We hypothesized that multiple factors, including an individual's personality and psychological factors, are associated with vaccine hesitancy.

METHODS

A total of 275 non-vaccinated individuals were recruited for this study. Participants completed a self-report questionnaire including sociodemographic factors, health status, COVID-19 literacy and psychological factors (depressive symptoms, generalized anxiety, somatization, illness anxiety, temperament and character). In a hierarchical logistic regression analysis, a discrete set of hierarchical variables with vaccine acceptance or hesitancy as the dependent variable was added to the demographic factors for Model 1; Model 1 + health status for Model 2; Model 2 + COVID-19 literacy for Model 3 and Model 3 + psychological factors for Model 4.

RESULTS

Models 3 and 4 could predict vaccine hesitancy. High scores on the Generalized Anxiety Disorder-7 and the Illness Attitude Scale, low confidence, low collective responsibility and low reward dependence were risk factors for vaccine hesitancy.

CONCLUSIONS

The present study demonstrates that psychological factors play critical roles in vaccine hesitancy. In addition to conventional policies that emphasize COVID-19 vaccines' safety and efficacy and the collective benefits of vaccination, a more individualized approach that considers an individual's emotions and personality is necessary.

Parents' COVID-19, HPV, and Monkeypox vaccination intention: A multilevel structural equation model of risk, benefit, barrier, and efficacy perceptions and individual characteristics

OBJECTIVE

This study seeks to comparatively examine parents' intention to vaccinate their children for three infectious diseases, including COVID-19, HPV, and monkeypox.

METHODS

Utilizing a mixed-design survey and multilevel structural equation models, we investigated if perception of the diseases and vaccines explained the variance in parents' vaccine-specific decision-making and population difference in vaccination intention.

RESULTS

Compared with the COVID-19 vaccine, parents were more willing to get an HPV vaccine for their children due to greater perceived benefit and lower perceived barrier. Concerns about vaccine safety and lower disease risk perception were associated with lower intention to get a monkeypox vaccine. Parents of color, less educated, and lower-income parents were less willing to get vaccines for their children due to low benefit perception and high perceived barriers.

CONCLUSION

Parents were motivated by different social and psychological factors when deciding whether to get a COVID-19, HPV, and monkeypox vaccine for their children.

PRACTICE IMPLICATIONS

Vaccine promotion should be tailored to the characteristics of the target population and the vaccines. Underprivileged communities may be better approached with information about vaccine benefit and barriers, and vaccines for unfamiliar diseases may be better communicated with disease risk information.

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.

Motivational Factors to Receive the COVID-19 Vaccine in the United Arab Emirates: A Cross-Sectional Study

The United Arab Emirates has been very successful in its vaccination campaign for the COVID-19 injection, and vaccine hesitancy is not currently a major concern. Nevertheless, the motivations of residents in the UAE to receive the COVID-19 vaccine are varied. In this study with 426 vaccinated participants, 55% expressed health motivations to receive the vaccine, whereas 45% expressed non-health motivations. Nationality was a predictive factor in motivation, as expatriates from South Asian countries expressed the lowest motivation to get the vaccine on the basis of intrinsic health reasons, followed by expatriates from Arab countries, Emiratis, and expatriates from the rest of the world. The same nationality pattern was observed in vaccine readiness and vaccine knowledge. Both of these variables had a correlation with intrinsic health motivation in receiving the vaccine. No significant difference across nationalities was observed regarding vaccine conspiracy beliefs, and this variable only had a weak negative correlation with motivations to receive the vaccine.

Who is likely to vacillate in their COVID-19 vaccination decision? Free-riding intention and post-positive reluctance

Despite the actual availability of COVID-19 vaccines to combat the pandemic, many people are still vacillating in their decision to vaccinate. In this study, we considered the effect of two relevant contextual issues on vaccination intention: the number of people infected with COVID-19 is increasing, and the pace of vaccination is gaining speed. Specifically, we hypothesized that having already contracted SARS-CoV-2 (post-positive reluctance) could lead people to underestimate the importance of vaccination. Moreover, as the number of vaccinated people increases, more hesitant people could fall into the free-riding intention category, benefitting from the immunity provided by others' vaccinations. Vaccine hesitancy becomes more critical as the vaccination campaign proceeds: at one point, it will be inevitable to deal with hesitant people. This study is part of a WHO Regional Office for Europe project and involved a representative sample of 5006 Italians interviewed in January-February 2021. In case of post-positive reluctance, both young age and female gender increase vaccine hesitancy, while a high level of education reduces free-riding intention. Considering post-positive reluctance and free riding, a protective effect on hesitancy is associated with negative affective states, adherence to protective behaviors, trust in health information sources, and resilience. In contrast, increased vaccine hesitancy is associated with a high level of conspiracy-mindedness and trust in media information sources. Recognizing and studying the post-positive reluctance and the phenomenon of free-riding people can help us to become more efficient in combatting the virus.