Prosociality and Social Responsibility Were Associated With Intention of COVID-19 Vaccination Among University Students in China

Vaccine hesitancy: a structured review from a behavioral perspective (2015-2022)

Vaccine hesitancy, a complex behavioral phenomenon, poses a significant global health threat and has gained renewed attention amidst the COVID-19 pandemic. This paper scrutinized peer-reviewed literature on vaccine hesitancy published from 2015 to 2022, with a specific focus on behavioral perspectives, utilizing a Theories-Constructs-Variables-Contexts-Methods (TCVCM) framework. The study highlighted prominent theoretical approaches, abstract concepts, research variables, global contexts and academic techniques employed across a selected sample of 138 studies. The result is a consolidated overview of research and schematization of the factors influencing vaccine hesitancy and vaccination behaviors. These include individual-level, contextual, vaccine-specific, organizational, and public-policy-related dynamics. The findings corroborated the complexity of vaccine hesitancy and emphasized the difficulties of pursuing vaccine advocacy. The analysis also identified several directions for future research, and the need to conduct more contextual studies in low- and middle-income nations to bring out the cross-cultural nuances of vaccine hesitancy.

From obligation to action: unraveling the roles of social responsibility and prosocial tendency in shaping Chinese doctors' vaccine hesitancy

Background

The hesitation of healthcare professionals towards vaccines is becoming increasingly concerning, potentially undermining public confidence in vaccination programs. This study aimed to investigate the relationship between social responsibility, Prosocial tendency, and vaccine hesitancy among Chinese doctors, and to identify demographic factors associated with vaccine hesitancy.

Method

A cross-sectional survey was conducted among 976 Chinese doctors. Participants completed a questionnaire to assess their sense of social responsibility, Prosocial tendency, and vaccine hesitancy. Demographic information, including age, gender, and marital status, was also collected. Correlation and mediation analyses were conducted to examine the relationships between the main variables.

Results

Social responsibility was negatively correlated with vaccine hesitancy (r=-0.564, P<0.01) and positively correlated with Prosocial tendency (r=0.519, P<0.01). Prosocial tendency was negatively correlated with vaccine hesitancy (r=-0.505, P<0.01) and partially mediated the relationship between social responsibility and vaccine hesitancy. Younger age, female gender, and unmarried status were associated with higher levels of vaccine hesitancy.

Conclusion

This study emphasized the important role of social responsibility and Prosocial tendency in reducing vaccine hesitancy among Chinese doctors. The findings suggest that interventions aimed at fostering a strong sense of social responsibility and promoting Prosocial tendency may effectively address vaccine hesitancy in this population. Additionally, targeted interventions focusing on young, female, and unmarried doctors may be necessary.

The politicized pandemic: Ideological polarization and the behavioral response to COVID-19

In a representative sample of the U.S. population during the first summer of the COVID-19 pandemic, we investigate how prosociality and ideology interact in their relationship with health-protecting behavior and trust in the government to handle the crisis. We find that an experimental measure of prosociality based on standard economic games positively relates to protective behavior. Conservatives are less compliant with COVID-19-related behavioral restrictions than liberals and evaluate the government's handling of the crisis significantly more positively. We show that prosociality does not mediate the impact of political ideology. This finding means that conservatives are less compliant with protective health guidelines - independent of differences in prosociality between both ideological camps. Behavioral differences between liberals and conservatives are roughly only one-fourth of the size of their differences in judging the government's crisis management. This result suggests that Americans were more polarized in their political views than in their acceptance of public health advice.

Psychosocial factors associated with the intention to get a COVID-19 booster vaccine: evidence from a low-income country

Aim

To identify psychosocial predictors of the intention to get a booster COVID-19 vaccine in a low-income country, given that increasing booster vaccination rates against COVID-19 remains a global challenge, especially among low- and middle-income countries (LMIC).

Subject and methods

We used an online survey to collect responses from a non-probabilistic sample of 720 Bolivians regarding vaccine uptake, motives, perceived confidence, information sources, attitudes favouring COVID-19 vaccines, biosafety behaviour, and sociodemographic characteristics. Descriptive, bivariate, and multivariate analyses were performed to identify significant associations and predictors.

Results

We found that having already received the third dose, obtaining recommendations from family or friends, recommendation from the government, perceived confidence in the previously received dose, and higher attitudes in favour of COVID-19 vaccines significantly predicted the intention to get a booster dose. The associations were significant even when adjusting the model for sociodemographic variables.

Conclusion

Including certain psychosocial factors could enhance the promotion of voluntary booster doses among residents of low- and middle-income countries such as Bolivia, where cultural, social, political, and contextual variables may influence health behaviour and increase health-associated risk factors.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01937-x.

Promoting HPV Vaccination in People with HIV: Factors to Consider

People with HIV (PWH) and their sexual partners have increased risk of human papillomavirus (HPV) infection. Despite recommended HPV vaccination for PWH aged 18-26 years, vaccination rates among PWH remain low. This qualitative study used the Information-Motivation-Behavioral Skills (IMBS) model to identify factors influencing the decisions of PWH around promoting HPV vaccination to their sexual partners. Fourteen PWH with diverse sociodemographic characteristics participated in four focus-group discussions. Data were analyzed using thematic content analysis; codes and themes included IMBS constructs. For the information construct, the need for improved HPV education emerged as the driving factor for HPV vaccine uptake and discussing HPV vaccines with partners. Focal reasons for being unvaccinated included low knowledge of HPV risk, asymptomatic cancer-causing HPV, HPV vaccines, and vaccine eligibility. Salient factors in the motivation construct included the preventive benefits of HPV vaccination to both self and sexual partners. Salient factors in the behavioral skills construct included: accessing vaccine, low self-confidence and skills for promoting vaccination, relationships with sexual partners, partners' vaccine hesitancy, and stigma. Race/ethnicity impacted HPV vaccination promotion; important determinants included perceptions of HPV-related diseases as "White people's diseases" among Black people, and discrimination against those with HPV-related diseases among the Hispanic population.

Uptake of COVID-19 Vaccination and Its Associated Factors among College Students in China: A Nationwide Cross-Sectional Study

Our study aims to assess the uptake of COVID-19 vaccination and its associated factors among Chinese college students. A web-based cross-sectional study was conducted from 18 May to 17 June 2022. A total of 3916 participants were included. The coverage of the first dose, complete vaccination and booster vaccination among college students was 99.49%, 81.96% and 79.25%, respectively. College students with an older age (AOR: 0.72, 95% CI: 0.57-0.90), non-medical major (0.47, 0.37-0.61) and studying in north-east China (0.35, 0.22-0.58) were less likely to complete vaccination. Individuals who were female (1.62, 1.35-1.94) and received a recombinant subunit vaccine (8.05, 5.21-12.45) were more likely to complete vaccination. Non-medical students (0.56, 0.43-0.73) and students studying in north-east China (0.28, 0.16-0.49) were less likely to receive a booster dose, while female students (1.51, 1.23-1.85) had a higher likelihood. The main reason for being unvaccinated was "contraindication" (75.00%), and the main reason for not receiving a booster dose was "being too busy to attend to it" (61.37%). This study demonstrated a high adherence to the COVID-19 vaccination policy among Chinese college students. Targeted strategies should be applied to remove barriers to COVID-19 vaccination among college students.

Stability of pro-sociality and trust amid the Covid-19: panel data from the Netherlands

The Covid-19 has impacted most spheres of life and continues to influence the future course of socio-economic decisions. The effects of pandemic and virus contraction on the stability of social preferences are however relatively less know. This study examines the effects of the Covid-19 on pro-sociality and general trust by using the LISS panel data (time frame: 2019-2020) from the Netherlands. The fixed effects panel regressions show that pro-social behavior and general trust do not differ pre-and-after the Covid-19. The article further analyzes the stability of pro-sociality and general trust among people who unfortunately contracted the Covid-19 virus and the uninfected ones (time frame: 2019-2020) using difference-in-differences (DD) method to infer a causal effect of infections on preferences. The DD analysis also leads to insignificant causal effect of virus contractions on pro-sociality and trust. However, the sub-group analysis shows a positive causal impact of infections on trust for respondents above 60 years. Overall, both fixed effects regressions and DD analysis suggest that pro-sociality and to a large extent general trust in the Netherlands are stable despite the negative Covid-19 shock.

Does pro-sociality or trust better predict staying home behavior during the Covid-19?

Voluntary compliance of preventive and mitigation measures due to social concerns can play a crucial role in slowing down the spread of the Covid-19. The existing economic models for disease spread however do not direct a lot of focus on the possible role of pro-social behavior and general trust in predicting preventive behaviors amid the Covid-19. Therefore, this study analyzes whether pro-sociality and general trust measured in the short run (2020 and 2019) and in the long run (2015 and 2010) predict attitudes towards the stay home behavior and the intended stay home behavior in case the government mandates it due to the Covid-19 in the Netherlands. The results suggest that these preferences positively influence attitudes towards staying home behavior. However, trust in comparison to pro-sociality is a stable and robust predictor of stay home attitudes both in the short as well as long run. On the other hand, neither trust nor pro-sociality influences the intended stay home behavior in case the government mandates the lockdown, and it is most likely due to the timing of the survey coinciding with a significant drop in the Covid-19 infections and easing out of the lockdown restrictions by the Dutch government.

Perceived Benefits and Barriers to Chinese COVID-19 Vaccine Uptake Among Young Adults in China

Survey-based research has provided us with breadth regarding perceived benefits and barriers to COVID-19 vaccination among Chinese people. Most such research has been conducted within hypothetical COVID-19 vaccine contexts, and few studies are specific to young adults aged 18–40, a pivotal target population for COVID-19 vaccination. Now that the Sinopharm and Sinovac COVID-19 vaccines have been conditionally approved in China, qualitative investigation of young adults' perceptions of benefits and barriers to taking them is warranted. Such research may suggest potential candidate themes in the COVID-19 vaccination promotional messages targeting this population. Through in-depth interviews with 55 Chinese young adults and thematic analysis guided by the health belief model, social benefits and worry reduction emerged as significant positive factors in young adults' intention to vaccinate. Several novel barriers emerged as well, including perceptions that the vaccines' advantages are weak relative to non-medical preventions and beliefs regarding Ti Zhi (the individual human constitution), which confused some participants about their suitability for vaccination. The study also identified two modifying factors, trust in the government and perceived vaccine information insufficiency, both of which appeared to be indirectly associated with vaccination intention by augmenting the perceived barriers. The results suggest that more attention could be paid to young adults' cultural background when developing relevant health communications.

Persistence of Vaccine Hesitancy and Acceptance of the EU Covid Certificate Among French Students

Covid-19 vaccine hesitancy among young adults is a current public health issue that needs to be addressed considering the seasonally driven waves of disease and the administration of vaccine boosters. As a prevention measure, the EU Covid certificate had been implemented to increase vaccine uptake, but its application was controversial. Our study investigated students’ opinions and attitudes towards Covid-19 vaccination and the EU Covid certificate through a mixed-methods design. An 18-item questionnaire was administered to 200 students during a vaccination campaign in September 2021 at the University of Bordeaux, France. Simultaneously, 30 students attended a semi-structured interview. Collected data were analyzed separately then discussed together through a parallel and convergent approach. Results showed that vaccine hesitancy was high among students, mostly from fear of short-term side effects. However, respondents decided to get vaccinated to obtain the EU Covid certificate, even if they considered it as a violation of their freedom. Straightforward communication about Covid-19 vaccination did not reach students, although this was a strong expectation from governmental and health institutions. Findings suggest that key health personnel should provide evidence-based information about vaccines in efforts of building trust with young people.

Barriers and facilitators of willingness to vaccinate against COVID-19: Role of prosociality, authoritarianism and conspiracy mentality. A four-wave longitudinal study

AIM

We investigated longitudinal relations between individual willingness to undergo vaccination against COVID-19 and three social factors: conspiracy mentality, prosociality, and authoritarianism.

METHOD

This longitudinal study comprised four measurement points. The first wave sample included 1130 responses and was representative of the Polish population in terms of gender, age, and place of residence. Analyses were performed using random intercept cross-lagged panel models.

RESULTS

We observed bidirectional positive cross-lagged relationships between prosociality and willingness to undergo vaccination in the first three waves of measurement. Authoritarianism and conspiracy mentality translated into a lower willingness to vaccinate between the third and fourth points of measurement when the vaccination became a near-term possibility.

CONCLUSIONS

Eliciting prosocial motivation to vaccinate can be paramount in overcoming vaccine hesitancy. Because conspiracy thinking may be a crucial barrier to willingness to be vaccinated, it is critical to focus on planning interventions and campaigns undermining conspiracy theories about COVID-19.

Investigating the intention to receive the COVID-19 vaccination in Macao: implications for vaccination strategies

BACKGROUND

Understanding the intention of receiving COVID-19 vaccines is important to inform effective vaccination strategies. This study aimed to investigate such intention, identify the key influencing factors, and determine the most important intention predictors using a theoretically principled model.

METHODS

An online, cross-sectional survey method was implemented in Macao in May 2021. People aged 18 years or above and residing in Macao for 12 months prior to the study were recruited through social media. Intention to receive COVID-19 vaccines and the main constructs of the protection motivation theory and the health belief model were the main measures encompassing threat appraisal, intrapersonal characteristics, cues to action, coping appraisal, past experiences and information seeking behavior. Descriptive statistics, Pearson correlation and multiple linear regression were used for data analysis.

RESULTS

A total of 552 valid responses were received. Among the respondents, 79.5% aged between 25 and 54 years old, 59.4% were female, and 88% had a bachelor degree or above; 62.3% of the respondents indicated their intention to receive COVID-19 vaccination while 19.2% were hesitant and 18.5% did not have any intention. While 67.0% believed COVID-19 infection was life-threatening, only 19.0% thought they were at risk of getting infected. Control variables such as age, gender, education level, and having travel plans were significantly correlated with intention. Significant associations between intention with perceived severity, perceived susceptibility, maladaptive response reward, self-efficacy, response-efficacy, response cost, social attitude, social norm, past experience and information seeking behavior were identified (P < 0.05). The most important positive predictors of intention were "being able to make arrangement to receive the vaccine" (β = 0.333, P < 0.001), "a sense of social responsibility" (β = 0.326, P < 0.001), and "time off from work after vaccination" (β = 0.169, P < 0.001), whereas "concerns over vaccine safety" (β = - 0.124, P < 0.001) and "relying on online resources for vaccine information" (β = - 0.065, P < 0.05) were negative predictors. Perceived severity in terms of COVID-19 being a life threatening illness was not a predictor of intention.

CONCLUSION

This study reaffirmed that intention to receive COVID-19 vaccination is an ongoing concern in the combat of the pandemic. Multi-component strategies to enhance health literacy that supports well-informed decision-making, increase vaccination convenience, promote social responsibility, and provide time-off incentives are among the key considerations in designing and improve vaccination campaigns in Macao.

Predictors of the Intention to Be Vaccinated against COVID-19 in a Sample of Italian Respondents at the Start of the Immunization Campaign

COVID-19 vaccines are the most promising means of limiting the pandemic. The present study aims at determining the roles of several psychological variables in predicting vaccination intention in Italy. An online questionnaire was disseminated between 9 March and 9 May 2021. The sample included 971 participants. Results showed that most of the participants were willing to vaccinate. Acceptance rates were correlated with age, marital status, and area of residence. Intention to be vaccinated was positively correlated with perceived risk, pro-sociality, fear of COVID-19, use of preventive behaviors, and trust in government, in science, and in medical professionals. Intention to be vaccinated was negatively associated with belief in misinformation. The degree of acceptance is likely to be a result of the campaign tailored to address people’s negative attitudes towards vaccines. Trust in government and trust in science were among the strongest psychological predictors of vaccination intention. Fear of COVID-19, but not perceived risk, was associated with increased vaccine uptake, suggesting that the affective component of risk perception was more important than the cognitive component in predicting participants’ behaviors. Belief in misinformation was associated with reduced vaccination intention. Future studies will take into consideration these variables, to better understand the multifaceted process underlying vaccination intention.

Parents' intention for their children to receive COVID-19 vaccine: Implications for vaccination program in Macao

INTRODUCTION

The decision about vaccinating children is subject to their parents' decision. To inform strategies that support full vaccination coverage, it is important to understand the parents' vaccination attitude and tendency to act. This study aims to investigate the intention and the factors affecting parents' decision-making about vaccinating their children.

METHODS

A cross-sectional, self-administered online questionnaire was completed by parents of children aged 3-12 yeas in Macao between 7 March and 17 April 2022. The survey tool was informed by the Theory of Planned Behavior (TPB) which composes of the variable "intention" and three TPB constructs (Attitude, Subjective Norm, and Perceived Behavioral Control). Respondents rated their level of agreement on the construct statements using a 5-point Likert scale. Multiple linear regression analysis was used to determine if the TPB constructs were predictors of parents' intention.

RESULTS

A total of 1,217 parents completed the questionnaire. The majority of participants were mothers (83.2%), aged 31-40 years (62.7%), having two or more children (74.1%), had at least one dose of COVID-19 vaccine (84.4%) and considered themselves knowledgeable about the vaccine (62.1%), all of which were significantly associated with the intention to vaccinate their children (all p < 0.05). Their intention varied from negative (19.1%), neutral (38.4%) to positive (42.5%). Respondents were mostly concerned about the serious side effects that the COVID-19 vaccine (mean = 3.96 ± 1.23), highly acknowledged the expectation by the school (mean = 3.94 ± 1.15) and the community (mean = 3.90 ± 1.19) of children vaccination, and rated highly the ease of making necessary arrangement (mean = 3.93 ± 1.25). In the multiple linear regression model which explained 63.5% of the variance in the intention-to-vaccinate their children, only Attitude (B = 0.52, p < 0.001) and Subjective Norm (B = 0.39, p < 0.001) were identified as strong predictors. The major reasons for not having intention were safety concerns (n = 646/699, 92.4%). Participants' most trusted local information sources were doctors (n = 682), government (n = 426) and healthcare professional organizations (n = 416).

CONCLUSIONS

Vaccinating children with COVID-19 vaccine is a complex decision-making for parents. A key to a successful COVID-19 vaccination program is effective communication about the safety profile and the usage experiences warranting the integration of reliable information sources across different healthcare sectors.

Dualistic Determinants of COVID-19 Vaccination Intention among University Students in China: From Perceived Personal Benefits to External Reasons of Perceived Social Benefits, Collectivism, and National Pride

Vaccination is one of the most effective ways of controlling the COVID-19 pandemic. However, vaccine hesitancy is prevalent, and relatively few studies have explored how variables related to personal and external motives have affected the intention to vaccinate. The present study investigated the association between perceived personal benefits, variables reflecting external motives (i.e., perceived social benefits, collectivism, and national pride) and intention to receive COVID-19 vaccination among university students in China. The interaction between perceived personal benefits and the three factors reflecting external motives on intention to receive COVID-19 vaccination was also examined. A total of 6922 university students from five provinces of China completed a cross-sectional survey. Results showed that adjusting for significant background variables, perceived personal benefits, perceived social benefits, collectivism, and national pride were all significant factors of intention to receive COVID-19 vaccination. Results from interaction analyses also showed that the association between perceived personal benefits and COVID-19 vaccination intention was stronger among those with lower levels of national pride. Findings highlighted the important role of self-directed interest and external motives in promoting uptake of COVID-19 vaccination.

Positive Association between Individualism and Vaccination Resistance against COVID-19 Vaccination among Chinese Adults: Mediations via Perceived Personal and Societal Benefits

Background: Vaccination resistance is the key hurdle against herd immunity as it limits the final vaccination coverage. This study investigated the prevalence and factors of COVID-19 vaccination resistance (i.e., those indicating definitely not taking up COVID-19 vaccination), including individualism, perceived personal benefits (PPB) and perceived societal benefits (PSB) of COVID-19 vaccination, and related mechanisms of the association. Methods: A random telephone survey interviewed 395 unvaccinated adults aged 18–75 not having scheduled for COVID-19 vaccination in May 2021 in Hong Kong, China (response rate = 56.8%). Results: The prevalence of vaccination resistance was 56.5%. Adjusted for background factors, individualism, PPB, and PSB were significantly associated with vaccination resistance. Path analysis showed that individualism exhibited a direct effect on vaccination resistance and a 3-step indirect effect (individualism → PSB → PPB→ vaccination resistance) that explained 46.8% of the total effect. The two 2-step indirect paths via PPB only and via PSB only were non-significant. Conclusion: High prevalence of vaccination resistance was observed. Individualism increased vaccination resistance via its direct and indirect effects. Health promotion may emphasize collective good to reduce the impact of individualism and promote PPB/PSB, which may reduce vaccination resistance directly and alleviate the impact of individualism on vaccination resistance indirectly.