Examining COVID-19 vaccine intention and receipt through the Health Belief Model and the Theory of Planned Behavior Open Access

Abstract

Background. Few studies have used health behavioral theories to understand both COVID-19 vaccine intention and receipt. We used data from a longitudinal population-based survey to understand how the theoretical variables from the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) are associated with vaccine intention and vaccine receipt.

 

Methods. Participants with responses for the 3-month survey in which health beliefs were assessed, and who reported their COVID-19 vaccination status at follow-up (6- and/or 18-months) were included in this study. Multivariable logistic regression models were used to estimate the association between HBM and TPB variables with vaccine intention and vaccine receipt. Phi coefficient, positive predictive value, and negative predictive value were used to compare vaccine intention to vaccine receipt.

 

Results. Among the 661 participants in the sample, 82% (543) intended to receive the COVID-19 vaccine while 90% (592) had received the vaccine at follow-up. The theoretical predictors were observed to be similar for vaccine intention and receipt in the univariable analysis, while they differed in the multivariable analysis. Perceived susceptibility, perceived benefits, and positive attitude were associated with vaccine intention. Perceived benefits, employer mandated vaccination, subjective norm, and positive attitude were associated with vaccine receipt.

 

Conclusions. There is relatively little overlap between theoretical variables predicting vaccine intention and vaccine receipt. Most studies have only investigated vaccine intention, which is unlikely to produce results that will adequately inform public health action. External factors are more likely to impact vaccine receipt, including workplace vaccine mandates and factors influencing subjective norms.

Table of Contents

Introduction, 1-2

Methods, 3-5

Results, 5-10

Discussion, 11-12

Conclusion, 13

References, 14-15

Supplementary Materials, 16-19

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	vaccine intention Health Belief Model vaccine receipt COVID-19 vaccine Theory of Planned Behavior
Committee Chair / Thesis Advisor	Aaron Siegler, Emory University

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