Predicting COVID-19 vaccination uptake in Armenia using the Health Belief Model: Results from a nationwide survey

Health behavior theories have been effectively used for studying populations' awareness, attitudes, and beliefs related to COVID-19 preventative behaviors. The aim of this study was to explore the factors associated with the intention to get vaccinated against COVID-19 in the Armenian population using the Health Belief Model (HBM) as a framework. We applied stratified two-stage random sampling to conduct a telephone survey of 3,483 adults in 2021. The multi-domain survey instrument included questions on socio-demographic characteristics, COVID-19-related knowledge, COVID-19 susceptibility, severity and self-efficacy beliefs, sources of information on COVID-19, COVID-19 vaccination practice, and its benefits and barriers. We performed bivariate and hierarchical multivariate regression analysis with the entry of variables in blocks. In total, about 12% of the sample (n = 393) was vaccinated against COVID-19. Of 2,838 unvaccinated participants, about 53% (n = 1516) had an intention to get vaccinated. The final hierarchical logistic regression model containing socio-demographic characteristics, knowledge about COVID-19, and HBM constructs explained 43% of the variance in the intention to get vaccinated against COVID-19. Participants' age, employment status, average monthly expenditures, perceived threat, benefits, perceived barriers, self-efficacy, and cues to action were significant and independent predictors of the intention to get COVID-19 vaccination. This study confirmed the utility of the HBM in highlighting drivers of an important health-protective behavior in the context of pandemics. Health policy makers, communication specialists, and healthcare providers should particularly stress the effectiveness and safety of the vaccines in their efforts to increase vaccination rates and focus on unemployed and low-income population groups.

Attitudes toward COVID-19 vaccines and vaccine uptake intent in China: The role of collectivism, interpersonal communication, and the use of news and information websites

Vaccines can be an effective way to help prevent COVID-19 infections. However, in the age of "infodemic" and people holding different values, promoting COVID-related prevention can be difficult. Based on a survey of 460 Chinese residents in March 2021, the present analysis aims to provide a detailed understanding of the role of values and information sources on the Chinese's attitudes toward COVID-19 vaccines and their vaccination intent. Results revealed that collectivism and the use of mainstream websites were positively associated with value-expressive attitudes, trust toward vaccines, and norms, which in turn predicted vaccination intent. Furthermore, collectivism was negatively associated with attitudes toward inconvenience or minor side effects, whereas interpersonal communication was positively associated with such attitudes. Overall, collectivism appeared to be a much stronger predictor of the Chinese's vaccination intent than the media and interpersonal communication. Although this research was conducted in China, where the pace of mass vaccination was fast, the results can provide insights on what might contribute to the success or failure of a vaccination campaign and be used to compare COVID-19 vaccination campaigns in other countries.

Forming and updating vaccination beliefs: does the continued effect of misinformation depend on what we think we know?

People may cling to false facts even in the face of updated and correct information. The present study confronted misconceptions about the measles, mumps and rubella vaccine and a novel, fictitious Zika vaccine. Two experiments are reported, examining misconceptions as motivated by a poor risk understanding (Experiment 1, N = 130) or the exposure to conspiracy theories (Experiment 2, N = 130). Each experiment featured a Misinformation condition, wherein participants were presented with fictitious stories containing some misinformation (Experiment 1) and rumours focused on conspiracy theories (Experiment 2) that were later retracted by public health experts and a No misinformation condition, containing no reference to misinformation and rumours. Across experiments, participants were more hesitant towards vaccines when exposed to stories including vaccine misinformation. Notwithstanding, our results suggest a positive impact of a trusted source communicating the scientific consensus about vaccines. Zika virus represents a particular case showing how missing information can easily evolve into misinformation. Implications for effective dissemination of information are discussed.

Improving vaccination intent among skeptics through confidence in governments' handling of the COVID-19 pandemic

Scientific evidence suggests that individuals vaccinated with COVID-19 vaccines are less likely to require hospitalization, possibly lowering the burden on the healthcare system. Despite such benefits, substantial segments of the world's population remain skeptical of COVID-19 vaccines and are hesitant to take them. Even if such individuals have been inoculated with COVID-19 vaccines out of economic, social, or legal necessity, they may be less inclined to receive booster shots or vaccinate their offspring when such options become available. What might help reduce this hesitancy? We examined this question using nationally representative survey data across 15 developed countries (max N = 122,516). Our findings suggest that inspiring confidence in the government's handling of the pandemic is pivotal in enhancing vaccination intent among vaccine skeptics. Specifically, results from a hierarchical linear analysis showed that among vaccine skeptics, confidence in the government's management of the pandemic was associated with greater intent to (a) take COVID-19 vaccines (b) take booster shots and (c) vaccinate one's children.

Racial/ethnic disparities in intent to obtain a COVID-19 vaccine: A nationally representative United States survey

Black, Latino, Pacific Islander, and American Indian/Alaska Native adults are more likely than White adults to experience SARS-CoV-2-related infections, hospitalizations, and mortality. We assessed intent to be vaccinated and concerns among 7 U.S. racial/ethnic groups (1,000 Black/African American, 500 American Indian/Alaska Native, 1,000 Asian, 1,000 Latino (500 English- and 500 Spanish-speaking), 500 Pacific Islander, 500 multiracial, and 1,000 White adults) in a cross-sectional online survey conducted December 2020-February 2021, weighted to be nationally representative within groups. Intent to be vaccinated was ascertained with: "If a COVID-19 vaccine becomes available, how likely are you to get vaccinated?" (not at all/slightly/moderately/very/extremely likely). Respondents identified which concerns would keep them from being vaccinated: cost, not knowing where, safety, effectiveness, side-effects, and other. Multinomial logistic regression models assessed associations of race/ethnicity with odds of being extremely/very/moderately, slightly likely to be vaccinated (ref = not at all), controlling for demographics and health. Overall, 30% were extremely likely, 22% not at all likely, and 48% unsure. Compared to White respondents, American Indian/Alaska Native (Adjusted Odds Ratio (AOR) = 0.66, 95% CI, 0.47-0.92) and Black/African American (AOR = 0.54, 95% CI, 0.41-0.72) respondents were less likely, and Asian (AOR = 2.21, 95% CI, 1.61-3.02) and Spanish-speaking Latino respondents (AOR = 3.74, 95% CI, 2.51-5.55) were more likely to report being extremely likely to be vaccinated. Side-effects (52%) and safety (45%) were overriding concerns. Intent and vaccination rates are changing rapidly; these results constitute a comprehensive baseline for ongoing vaccination efforts among U.S. racial and ethnic groups.

The effects of source expertise and trustworthiness on recollection: the case of vaccine misinformation

Designing effective communication strategies for correcting vaccines misinformation requires an understanding of how the target group might react to information from different sources. The present study examined whether erroneous inferences about vaccination could be effectively corrected by a perceived credible (i.e. expert or trustworthy) source. Two experiments are reported using a standard continued influence paradigm, each featuring two correction conditions on vaccine misinformation. Participants were presented with a story containing a piece of information that was later retracted by a perceived credible or not so credible source. Experiment 1 showed that providing a correction reduced participants' use of the original erroneous information, yet the overall reliance on misinformation did not significantly differ between the low- and high-expertise correction groups. Experiment 2 revealed that a correction from a high-trustworthy source decreased participants' reliance on misinformation when making inferences; nonetheless, it did not positively affect the reported intent to vaccinate one's child. Overall, source trustworthiness was more relevant than source expertise.