Predicting intention to receive COVID-19 vaccine among the general population using the health belief model and the theory of planned behavior model

Abstract

BACKGROUND: This study aim to explore the intentions, motivators and barriers of the general public to vaccinate against COVID-19, using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model. METHODS: An online survey was conducted among Israeli adults aged 18 years and older from May 24 to June 24, 2020. The survey included socio-demographic and health-related questions, questions related to HBM and TPB dimensions, and intention to receive a COVID-19 vaccine. Associations between questionnaire variables and COVID-19 vaccination intention were assessed by univariate and multivariate analyses. RESULTS: Eighty percent of 398 eligible respondents stated their willingness to receive COVID-19 vaccine. A unified model including HBM and TPB predictor variables as well as demographic and health-related factors, proved to be a powerful predictor of intention to receive COVID-19 vaccine, explaining 78% of the variance (adjusted R squared = 0.78). Men (OR = 4.35, 95% CI 1.58-11.93), educated respondents (OR = 3.54, 95% CI 1.44-8.67) and respondents who had received the seasonal influenza vaccine in the previous year (OR = 3.31, 95% CI 1.22-9.00) stated higher intention to receive COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived benefits of COVID-19 vaccine (OR = 4.49, 95% CI 2.79-7.22), of perceived severity of COVID-19 infection (OR = 2.36, 95% CI 1.58-3.51) and of cues to action (OR = 1.99, 95% CI 1.38-2.87), according to HBM, and if they reported higher levels of subjective norms (OR = 3.04, 95% CI 2.15-4.30) and self-efficacy (OR = 2.05, 95% CI 1.54-2.72) according to TPB. Although half of the respondents reported they had not received influenza vaccine last year, 40% of them intended to receive influenza vaccine in the coming winter and 66% of them intended to receive COVID-19 vaccine. CONCLUSIONS: Providing data on the public perspective and predicting intention for COVID-19 vaccination using HBM and TPB is important for health policy makers and healthcare providers and can help better guide compliance as the COVID-19 vaccine becomes available to the public.