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Abstract

Understanding the determinants of COVID-19 vaccine uptake is important to inform policy decisions and plan vaccination campaigns. The aims of this research were to: (1) explore the individual- and country-level determinants of intentions to be vaccinated against SARS-CoV-2, and (2) examine worldwide variation in vaccination intentions. This cross-sectional online survey was conducted during the first wave of the pandemic, involving 6697 respondents across 20 countries. Results showed that 72.9% of participants reported positive intentions to be vaccinated against COVID-19, whereas 16.8% were undecided, and 10.3% reported they would not be vaccinated. At the individual level, prosociality was a significant positive predictor of vaccination intentions, whereas generic beliefs in conspiracy theories and religiosity were negative predictors. Country-level determinants, including cultural dimensions of individualism/collectivism and power distance, were not significant predictors of vaccination intentions. Altogether, this study identifies individual-level predictors that are common across multiple countries, provides further evidence on the importance of combating conspiracy theories, involving religious institutions in vaccination campaigns, and stimulating prosocial motives to encourage vaccine uptake.

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... The distinctive feature of vaccines as a medical procedure is that they act at both the individual and community level, making the decision to vaccinate inherently social [1][2][3]. Both recent data and recent global and local responses to the COVID-19 epidemic confirm that this kind of unanimous cooperation is not easy to achieve [4,5]. Over time, studies repeatedly demonstrated that peoples' vaccination behavior changes in response to the outbreak of vaccine-preventable diseases [6][7][8][9], creating the following reactive-preventive cycle. ...
... The first ones are relatively stable psychological features, such as thinking styles [25,26], risk-taking tendencies [13], the sources of information people rely on [5,7,27], and both institutional and interpersonal trust [2,[28][29][30][31][32]. Factors specific to vaccine decisions are vaccine hesitancy [8], the feeling of being burdened by the decision [33], freedom of choice [33], perceived social consensus and norms [34,35], and vaccine-conspiracy beliefs [36][37][38], which are especially notable during epidemics [4,39,40]. ...
... Trust in social media emerged as a unique risk factor for this group. The fact that trust in social media, in laypeople, serves as both a risk and a vulnerability factor may reflect their greater reliance on such sources of information, which communicate medical information unclearly and disseminate conspiratorial narratives [4,37,40,66]. However, trust in scientists was a protective factor for this subsample. ...
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The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from −0.128 to −0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape.
... Convenience for its part has been less of an issue (in Western countries at least) as many governments ordered more than enough vaccine doses for their population. Research has also identified specific effects of other factors such as conspiracy beliefs, social media use, and exposure to misinformation (Allington et al., 2021;Chadwick et al., 2021;Enea et al., 2022;Freeman et al., 2020;Loomba et al., 2021). ...
... Health studies also generally find health concern to predict the adoption of health behavior intended to detect or prevent the potential disease (see also Tamers et al., 2014). Similar results arise when considering vaccination intentions specifically (as per the complacency dimension of the 5C model described above; Betsch et al., 2018;Enea et al., 2022;Ryan & Malinga, 2021;Taylor-Clark et al., 2005). Some have distinguished between objective and subjective risk level and concern. ...
... Identity fusion is related to greater empathic concern (Landabur et al., 2022) and, in turn, to greater willingness to self-sacrifice and greater prosocial behavior for the benefit of the community (Segal et al., 2018). In the present context of the COVID-19 pandemic, it could then be expected that self-concern and other-concern align and together drive the adoption of protective behavior for the sake of both the self and the community (see e.g., Kleitman et al., 2021), including taking the vaccine (Enea et al., 2022). ...
Article
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We test the hypothesis that COVID-19 vaccine hesitancy is attributable to distrustful complacency—an interactive combination of low concern and low trust. Across two studies, 9,695 respondents from different parts of Britain reported their level of concern about COVID-19, trust in the UK government, and intention to accept or refuse the vaccine. Multilevel regression analysis, controlling for geographic area and relevant demographics, confirmed the predicted interactive effect of concern and trust. Across studies, respondents with both low trust and low concern were 10%–22% more vaccine hesitant than respondents with either high trust or high concern, and 26%–29% more hesitant than respondents with both high trust and high concern. Results hold equally among White, Black, and Muslim respondents, consistent with the view that regardless of mean-level differences, a common process underlies vaccine hesitancy, underlining the importance of tackling distrustful complacency both generally and specifically among unvaccinated individuals and populations.
... The joy we get from ending the pandemic will spread from person to person, too. Getting a COVID-19 vaccine will bring us one step closer to returning to our way of life." 2 Consistent with this messaging, greater levels of prosociality were associated with higher vaccination intent, both in the case of COVID and earlier vaccination campaigns Enea et al., 2022). Similarly, interventions to prime awareness of the pro-social aspect of vaccination through social nudging have significant effects on vaccine take-up in lab experiments . ...
... Since vaccination has a significant social component Korn et al., 2018Korn et al., , 2020Enea et al., 2022), we expect it to be affected by the same logic: individuals who perceive themselves to live in regions of clashing political ideology would be less willing to get vaccinated as a means of protecting those around them. Just as field experiments show participants to be less likely to work for, or buy goods from ideological foes (McConnell et al., 2018), individuals may be less willing to invest in the public good when they imagine that public to be made up of out-partisans. ...
Article
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What implications might rising animosity towards political out-partisans have for public health? Vaccination has a significant social aspect, protecting not only the vaccinated, but also those around them. While political ideology in the United States was an important driver of individuals’ willingness to get vaccinated against COVID-19, with those on the political right displaying greater hesitancy, we examine the role that political diversity has on vaccine uptake across US states and commuting zones. Using data from the Cooperative Election Study fielded on over 20,000 respondents in November 2021, and controlling for individual partisanship, we find that those who are political outliers in their community are significantly less likely to get vaccinated. By contrast, we find no equivalent negative effect for ethnic diversity. In sum, the impact of affective polarization is not limited to encounters between non-partisans; it can lead to decreased pro-social behavior that harms political friends and foes alike. Yet these behavioral effects depend on how individuals relate to their community’s predominant political ideology.
... Both beliefs in conspiracy theories (e.g., Enea et al., 2022;Hornsey et al., 2018) and trust in authorities (e.g., Miyachi et al., 2020) are wellestablished predictors of vaccination intentions. Previous research also has shown that both are related: lower trust in authorities is associated with a stronger belief in conspiracy theories (Einstein & Glick, 2013;Moore, 2018). ...
... Personality traits, including those related to prosociality, play a role in vaccination decisions (Brewer et al., 2017;Enea et al., 2022;Shim et al., 2012). Getting vaccinated does not only offer direct protection to the vaccinated individual, it also protects vulnerable other people via herd immunity. ...
Article
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Objetivo: Es probable que las personas tengan diferentes actitudes hacia diferentes vacunas (por ejemplo, pueden tener una actitud positiva hacia la vacuna MMR y al mismo tiempo mantener una actitud neutral hacia la vacuna contra la gripe). Para examinar la dimensionalidad de las intenciones de vacunación, medimos las intenciones de vacunación hacia 16 enfermedades diferentes. Hipotetizamos que las personas diferencian entre intenciones de vacunación dirigidas a niños e intenciones de vacunación autodirigidas. Además, planteamos la hipótesis de que algunos factores comúnmente estudiados (p. ej., confianza en las autoridades, miedo a las agujas) podrían tener asociaciones diferentes con los dos subtipos de intenciones de vacunación. Métodos: Utilizamos datos de una muestra representativa a nivel nacional de los Países Bajos recopilados en 2021. Utilizamos análisis exploratorio (N = 865) y confirmatorio (N = 865) para evaluar la hipótesis de dimensionalidad y utilizamos pruebas de hipótesis lineales (N = 1,779) para probar si los factores comúnmente estudiados tuvieron diferentes asociaciones con los diferentes subtipos de intenciones de vacunación. Resultados: El análisis mostró dos factores distintos de la intención de vacunación: intenciones hacia enfermedades infantiles e intenciones hacia enfermedades no infantiles. Además, las creencias espirituales, la confianza en las autoridades y la creencia en teorías de conspiración tenían asociaciones más fuertes con enfermedades no infantiles que con enfermedades infantiles. El miedo a las agujas, la personalidad prosocial y las creencias religiosas ortodoxas no tuvieron asociaciones diferentes con ambos tipos de intenciones de vacunación. Conclusiones: Estos hallazgos sugieren que las intenciones de vacunación son una construcción multidimensional y que las intervenciones pueden beneficiarse si se adaptan a los factores relevantes para cada tipo específico de vacuna.
... Beyond trust towards other people and politicians/government, vaccine uptakes were also positively predicted by trust towards institutions and organizations, such as the World Health Organization, worldwide (Chen et al., 2022;De Freitas et al., 2021), as well as trust towards health professionals (Hara et al., 2021), scientists and the health system generally (Bajos et al., 2022). While the aforementioned types of trust positively predict vaccine uptakes, conspiracy beliefs about COVID-19 and vaccines negatively predicted vaccine behavior and uptakes (Enea et al., 2022;Eshel et al., 2022;Han et al., 2022). Additionally, Enea et al. (2022) also showed that both generic and COVID-19 vaccine-related conspiracy beliefs negatively predicted vaccine uptakes. ...
... While the aforementioned types of trust positively predict vaccine uptakes, conspiracy beliefs about COVID-19 and vaccines negatively predicted vaccine behavior and uptakes (Enea et al., 2022;Eshel et al., 2022;Han et al., 2022). Additionally, Enea et al. (2022) also showed that both generic and COVID-19 vaccine-related conspiracy beliefs negatively predicted vaccine uptakes. COVID-19 and vaccine conspiracy beliefs was found to remain a robust predictor when accounting also for demographics, such as religiosity or political ideology (Han et al., 2022;Jennings et al., 2021). ...
Article
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A plethora of research has highlighted that trust in science, political trust, and conspiracy theories are all important contributors to vaccine uptake behavior. In the current investigation, relying on data from 17 countries (N = 30,096) from the European Social Survey we examined how those who received (and wanted to receive the COVID-19 vaccine) compared to those who did not differ in their trust in: science, politicians and political parties, international organizations and towards people in general. We also examined whether they differed in how much they believed in conspiracy theories. Those who received (or wanted to receive) the COVID vaccine scored significantly higher in all forms of trust, and lower in conspiracy theory beliefs. A logistic regression suggested that trust in science, politicians, international organizations, as well as belief in conspiracy theories were significant predictors, even after accounting for key demographic characteristics. K E Y W O R D S conspiracy theories, European social survey, multilevel modelling , political ideology, political trust, trust in science, vaccination behavior E M P I R I C A L
... In connection with COVID-19 vaccination, research has shown that hesitation/refusing is associated, for example, with female gender, younger age, lower education (11,(17)(18)(19)(20), living in a partnership (19), rural housing (11,20), lower household income (11,(18)(19)(20), better health condition (17,21), spirituality (22), religiosity (23,24), belief in conspiracy theories (19,25,26) and poorer knowledge about COVID-19 (27). But to the best of our knowledge, this is one of the first studies that assesses the relationship between knowledge about COVID-19 vaccines with a tendency to refuse a COVID-19 vaccine, and in this relationship to compare the declared knowledge against the real knowledge. ...
... Consequently, we also found that people with higher education were less likely to refuse a COVID-19 vaccine which is in line with other studies (11,(17)(18)(19)23). Furthermore, similar to other studies that have found religious people to be less willing to be vaccinated (23,24), our study also shows that religiosity had an influence on vaccine refusal but only in case of believers outside the church. It is possible that believers are more influenced by the official position of the Roman-Catholic Church (the most widespread church in the Czech Republic), which recommended vaccination (43). ...
Article
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Objective: This study examined the willingness to get vaccinated and the factors influencing this attitude in extreme settings—in the Czech Republic (at the time of the survey, the third-worst affected country in the world). Methods: We used national data from the general adult Czech population (N = 1,401) and measured attitudes towards vaccination, sociodemographic characteristics, government trust, knowledge about COVID-19 vaccines, personal characteristics, depression and anxiety. Results: Respondents who were more likely to refuse the vaccine were: female, younger, living without a partner, self-employed or unemployed, living in a town, believers outside the church, and did not trust the government, obtained information about the vaccine from social media, were extroverts and depressed. Conversely, respondents who were less likely to refuse the vaccine were: pensioners, people with higher education, respondents with better real knowledge about the COVID-19 vaccines, those who obtained information about the vaccine from an expert and those who had higher scores in neuroticism. Conclusion: This study thus offers a deeper understanding of the factors that might influence vaccine intention and subsequently the course of the COVID-19 pandemic.
... As revealed in our best-fitting model, state empathy positively predicted, and cognitive load negatively predicted, vaccination likelihood, the former finding similar to Pfattheicher 47 . Past research has also revealed that prosociality increased the intention to vaccinate against COVID-19, whereas religiosity and belief in conspiracy theories reduced vaccination intention 48 . The current results combined with prior literature highlight the www.nature.com/scientificreports/ ...
... Second, we did not measure some potentially relevant individual difference characteristics. For example, the effects of trait empathy may depend on cognitive load too 15,66 , and other individual-and group-level differences including but not limited to political belief, community identification, employment status and conspiracist belief may have accounted for changes in state empathy, support for public health measures or vaccination 39,48,61,76,78 . Indeed, a cross-sectional psychometric analysis of the Pandemic Fatigue Scale found that pandemic fatigue was highest among those who believed they were unlikely to be infected, believed the disease was mild and had low www.nature.com/scientificreports/ ...
Article
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Cognitive load reduces both empathy and prosocial behaviour. However, studies demonstrating these effects have induced cognitive load in a temporally limited, artificial manner that fails to capture real-world cognitive load. Drawing from cognitive load theory, we investigated whether naturally occurring cognitive load from the ongoing COVID-19 pandemic moderated the relationship between empathy and prosocial behaviour (operationalised as support for public health measures). This large study in an Australian sample (N = 600) identified negative relationships between pandemic fatigue, empathy for people vulnerable to COVID-19, and prosocial behaviour, and a positive relationship between empathy and prosocial behaviour. Additionally, we found that the negative effect of the pandemic on prosocial behaviour depended on empathy for vulnerable others, with pandemic fatigue’s effects lowest for those with the highest empathy. These findings highlight the interrelationships of cognitive load and empathy, and the potential value of eliciting empathy to ease the impact of real-world cognitive load on prosocial behaviour.
... Competence was also indirectly related (through greater science mistrust) to lower perceptions of vaccine efficacy and less intention to vaccinate among non-vaccinated participants. These results might be explained by the fact that non-vaccinated individuals are more likely to have a "conspiracy mindset/mentality" [43], and especially to express COVID-19 conspiracy beliefs [44]. Many COVID-19 conspiracies centered on ways to protect oneself did not involve vaccines (e.g., drinking bleach, sunlight) and may have led people who believed in these conspiracies to feel competent in protecting themselves. ...
... Die Zustimmung zu rechtsextremen Positionen und Verschwörungserzählungen geht auch mit der Ablehnung, sich impfen zu lassen, einher (Enea et al. 2022). Die oben beschriebenen Prävalenzen sind aber auch insofern bedeutsam, als die Zustimmung zu Rechtsextremismus, Populismus und Verschwörungsmythen als Wegbereiter für eine demokratiefeindliche Radikalisierung sowie einer Billigung politischer Gewalt führen kann (Küpper et al. 2023). ...
Article
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Zusammenfassung Der Umgang mit der COVID-19-Pandemie hat auch den Justizvollzug vor große Herausforderungen gestellt. Umfangreiche Maßnahmen zur Bekämpfung der Pandemie, die oft erhebliche weitere Einschränkungen für Inhaftierte, aber auch besondere Belastungen für Mitarbeitende im Vollzug mit sich brachten, mussten vorgenommen werden. Der Beitrag prüft, wie diese Maßnahmen im Vollzug erlebt wurden, und inwieweit die Zustimmung zu Verschwörungserzählungen als individuelle Begründung für eine Ablehnung dieser Maßnahmen durch die Art der Vermittlung dieser Maßnahmen seitens der Anstaltsleitung moderiert werden kann. Dazu wurden 501 Bedienstete im AVD und 956 Inhaftierte aus 6 Bundesländern befragt. Die Ergebnisse zeigen bei einer vergleichbaren Belastung beider Gruppen durch die Maßnahmen zur Pandemiebekämpfung eine stärkere Zustimmung zu Verschwörungserzählungen aufseiten der Gefangenen, die auch mit einer deutlich geringer eingeschätzten Angemessenheit der Vermittlung dieser Maßnahmen einhergeht. Eine Moderationsanalyse ergibt, dass der Einfluss der erlebten Restriktionen auf die Zustimmung zu Verschwörungstheorien gemäß dem Konzept der prozeduralen Gerechtigkeit durch eine angemessene Vermittlung der restriktiven Maßnahmen gemildert werden kann. Dieser Moderationseffekt zeigt sich deutlich bei den Bediensteten des AVD, allerdings nur tendenziell bei den Inhaftierten. Gleichwohl lassen die Befunde darauf schließen, dass restriktive Maßnahmen nicht nur bei zukünftigen Krisen transparent und nachvollziehbar vermittelt werden sollten, um eine mit Verschwörungserzählungen begründete Ablehnung der Maßnahmen zu vermeiden.
... Emerging evidence from studies conducted in Germany, Switzerland, and the uk indicates that individuals who are concerned about group-level risks turn out more acceptant toward preventive measures including vaccination to counter the pandemic (Burton, et al. 2022;Jia and Luo 2023;Zimmermann et al. 2021). The underlying mechanism lies in the national solidarity and prosociality sparked by the pandemic, which increases citizens' perceived risks to the state and necessitates their compliance with state-led immunization programs (Enea et al. 2022;Libal and kashwan 2020). In China, Jia and Luo (2023) found out the motivating role of collectivist belief on the acceptance of preventive measures (Jia and Luo 2023). ...
Article
This article presents new arguments on the role of trust in the government and nationalist sentiments in fostering policy-compliant behaviors. In July and September 2020, we launched two waves of a COVID-related survey in China with stratified quota sampling, and formed a longitudinal panel dataset of 822 responses. Based on the data, we examined how risk perceptions and nationalist sentiments jointly elicited trust in government agencies and, consequently, support for the state-sponsored immunization program. We argue that increasing concern about the risk to the state posed by the pandemic motivated Chinese citizens to rally around the government and comply with its vaccination drives. Nationalist sentiments simultaneously elevated risk perceptions, reinforcing their impact on trust in the government. Our findings contribute to the literature on crisis governance, offering new evidence on how trust in the government and nationalist sentiment may influence the dynamic interplay between risk perceptions and policy compliance.
... These campaigns could also emphasize the individual's role and responsibility in overcoming the crisis to foster autonomous and intrinsic motivation [40]. In addition, effective communication strategies that promote emotions of empathy, prosocial motives, and unity within the population can enhance individuals' commitment to health behaviors [50]. This could be achieved by acknowledging the importance of adhering to social distancing rules, recognizing the challenges people face, and conveying a sense of collective solidarity, such as the message that "we are all in this together" [51,52]. ...
Article
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We investigated the social, emotional, and cognitive predictors of adherence to four health behaviors (handwashing, mask wearing, social contact limitations, and physical distancing) during one critical phase of the COVID-19 pandemic. We collected data (N = 5803, mean age = 53; 57% women) in Belgium at five time points between April and July 2021, a time during which infections evolved from high (third wave of the pandemic) to low numbers of COVID-19 cases. The results show that the social, emotional, and cognitive predictors achieved high levels of explained variance (R² > .60). In particular, the central components of behavioral change (attitudes, intentions, control, habits, norms, and risk) were the strongest and most consistent predictors of health behaviors over time. Likewise, autonomous motivation and empathetic emotions (e.g., attentive, compassionate) had a positive impact on health behavior adherence, whereas it was the opposite for lively emotions (e.g., active, enthusiastic). These results offer policymakers actionable insights into the most potent and stable factors associated with health behaviors, equipping them with effective strategies to curtail the spread of future infectious diseases.
... 46 Among studies that have measured COVID-19 booster dose uptake, "self-needs" and prosocial values were most frequently reported. [47][48][49] In addressing booster dose complacency, public health officials and governmental authorities should honestly communicate both known and uncertain risks of repeated infection that could be provided in parallel to public campaigns encouraging timely receipt of vaccines using extrinsic motivators to schedule and receive booster doses. 50 Trust is a strong driver in reducing vaccine hesitancy 51 that was emphasized among participants regarding COVID-19 bivalent vaccines. ...
Article
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We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32–48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
... Since the pandemic outbreak, many studies have emerged about COVID-19, including many that provide results on the drivers and consequences of the infectious event (for a systematic review, see van Mulukom et al. 1982. While researchers have often focused on the association between the effects of the COVID-19 pandemic on the personalities of individuals (e.g., Bojanowska et al. 2021;Bonetto et al. 2021) and how they deal with it (Enea et al. 2023;Huang et al. 2022), there are now also numerous studies related to conspiracy beliefs and the coronavirus (Georgiou et al. 2020;Hughes and Machan 2021;Kuhn et al. 2021). Values are formed through socialization and education in a social and personal context and are considered relatively stable at the onset of adulthood (Bilsky et al. 2011). ...
Article
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This article simultaneously examines the influence of Schwartz’ higher-order human values (self-transcendence, openness to change, self-enhancement, and conservation) and conspiracy beliefs on four COVID-19-related dependent variables. Using path analysis with large-scale panel data from Germany (N = 4382), we tested if the correlational effects of higher-order values as independent variables on the perceived threat of the infection event, evaluation of government measures, number of self-initiated measures, and trust toward individuals and institutions involved as dependent variables could be mediated by conspiracy beliefs. We found evidence of a significant influence of all four higher-order values on the strength of conspiracy beliefs. In addition, we detected effects of higher-order values and conspiracy beliefs on all four COVID-19-related measures. Self-transcendence with consistently positive and openness to change with consistently negative total, direct, and indirect effects provided the most evident results. The respondents’ country of origin and residence in East or West Germany affected all four COVID-19-related variables. This article has shown that belief in conspiracy narratives reveals associations of higher-order values with all four COVID-19-related measures that would not have been apparent without this mediator. In doing so, it contributes to the understanding of how pandemic mitigation measures are implemented differently. The results of this study can improve the ability to develop and enforce policies to increase the acceptance of scientifically accepted efforts in better governance.
... Taken together, these results suggest that public health recommendations should have particularly focused on young men as well as specific clusters of individuals (e.g. those who had negative attitudes towards vaccination, Enea et al., 2023) and be adapted in light of the subjective representations and meanings that health behaviors generate among those people. ...
... 18,22,23 Vaccine uptake is a type of health behavior that is primarily driven by attitude. [24][25][26] Therefore, understanding attitudes toward vaccination is a critical step to promote vaccination for the benefit of public health through effective communication. [27][28][29][30] Although COVID-19 cases are declining, booster vaccination appears a key strategy to prevent future waves of infection, pending further evidence to support this approach. ...
Article
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Conspiracies regarding vaccines are widely prevalent, with negative consequences on health-seeking behaviors. The current study aimed to investigate the possible association between the embrace of vaccine conspiracies and the attitude to booster COVID-19, seasonal influenza, and monkeypox (mpox) vaccinations as well as the perceived side effects following COVID-19 vaccination. The target population involved academic staff and university students in health colleges in the Kingdom of Saudi Arabia. A self-administered questionnaire was distributed in January 2023 to collect data on participants’ demographics, self-reported side effects following each dose, willingness to get booster COVID-19, seasonal influenza, and mpox vaccinations, as well as an evaluation of vaccine conspiracies and attitude to mandatory vaccination. Among the 273 participants, the willingness to receive yearly booster COVID-19 vaccination was observed among 26.0% of the participants, while it was 46.9% and 34.1% for seasonal influenza and mpox vaccinations, respectively. Multinomial logistic regression analyses demonstrated a significant correlation between endorsing vaccine conspiracies and higher frequency of self-reported side effects following uptake of the second and third doses of COVID-19 vaccines. Vaccine conspiracies were also correlated with attitude toward booster COVID-19, influenza, mpox, and mandatory vaccination. The findings of this pilot study highlighted the potential adverse impact of the preexisting notions and negative attitudes toward vaccines, which could have contributed to heightened perceived side effects following COVID-19 vaccination. The study also highlighted the ongoing divisions concerning mandatory vaccination policies, emphasizing the need for cautious implementation of this strategy as a last resort for public health benefit.
... HPs' and parents' vaccination behavior and attitudes may be primarily shaped by other factors, such as expert knowledge (HPs) or concerns regarding one's key role as a child's decision-makers (parents) that can only be mitigated through institutional sources and authorities such as healthcare system and scientific community, while specific thinking styles become more important with people who do not share HPs' or parents' social roles. Similarly, the unique role of social media as a risk factor that negatively affects vaccination intention in lay people, although small, and a vulnerability factor for all sub-samples, may reflect their greater reliance on such sources of information, which are shown to have unclear communication about medical information as well as a greater dissemination of conspiratorial narratives (Enea et al., 2023;Jolley & Douglas, 2014;Shahsavari et al., 2020). ...
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The interrelatedness of social-structural aspects and psychological features with the vaccination intention provides the context to explore personal psychological fea-tures related to general decision-making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. The aim of our study was to map the function (promotive, protective, risk, vulnerability) of a set of psychological aspects in the intention to vaccinate, in people with different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and lay people, within the context of the after-pandemic. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from -.128 to -.983, all ps < .01). The main results indicate that, regardless of the sam-ple/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate; for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system play such roles, for HPs experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. These results and guidelines for the promotion of positive vaccination behavior are further discussed.
... The scientific literature has consistently shown associations between conspiracy beliefs and negative attitudes toward vaccines. Studies have found that individuals who believe in conspiracy theories, such as the idea that vaccines are designed to harm people rather than protect them [48,49], were less likely to vaccinate and trust the safety and effectiveness of vaccines [72]. It is important to note, however, that these studies were cross-sectional and did not allow for the establishment of causal relationships. ...
Article
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The embrace of coronavirus disease 2019 (COVID-19) vaccine conspiracies has been linked to vaccine hesitancy. This study aimed to investigate the relationship between COVID-19 vaccine conspiracy theories and perceived vaccine effectiveness. The study utilized a longitudinal follow-up study in which adults in Chile completed surveys in December 2020 (T1) and May 2021 (T2). The psychometric properties of the five-item instrument on conspiracy theories for the COVID-19 vaccine were evaluated using data from T1 (n = 578). A confirmatory one-factor structure with suitable indicators of reliability was found. The longitudinal analysis (n = 292) revealed that conspiracy theories about the COVID-19 vaccine in T1 were associated with lower beliefs in its effectiveness in T2. However, no significant association was found between beliefs in effectiveness in T1 and conspiracy theories in T2. The study suggests that beliefs in conspiracy theories may temporally precede beliefs in vaccine effectiveness for COVID-19. The results have implications for strategies to address vaccine conspiracy beliefs and their implementation at the public policy level.
... Most studies emphasize the importance of stakeholders educating and raising the level of awareness among the general public about COVID-19 vaccines with consideration of cultural orientations e.g., collectivism, to foster social responsibility for COVID-19 prevention, including vaccination prosociality, which has been found to be a significant positive predictor of COVID-19 vaccination intention [87]. Therefore, efforts are necessary to combat the effects of misinformation by providing easily accessible information to the general public through multiple platforms, including mainstream and social media. ...
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The COVID-19 pandemic is a severe concern worldwide, particularly in Africa. Vaccines are crucial in the fight against the COVID-19 pandemic. This scoping review examined existing literature from 2020 to 2022 on individual, interpersonal, and structural barriers and facilitators to COVID-19 vaccination within Africa to facilitate more informed health promotion interventions to improve vaccine uptake. This review was conducted using Arksey and O’Malley’s five-stage methodological framework. A comprehensive search was undertaken from 2021 to 2022 using six electronic databases: EBSCOhost, PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar. Data was collected, charted into themes, and summarized using a standard data extraction sheet in Microsoft Excel. A total of forty (n = 40) published academic articles were reviewed, with many conducted in Nigeria (n = 10), followed by Ethiopia (n = 5) and Ghana (n = 4) and the rest elsewhere in Africa. Thematic narratives were used to report data into six themes: attitudes and perceptions about COVID-19 vaccines, intention to uptake COVID-19 vaccines; factors and barriers associated with COVID-19 vaccine uptake; socio-demographic determinants affecting the intention and uptake; and information sources for COVID-19 vaccines. The intention for uptake ranged from 25% to 80.9%, resulting in a suboptimal uptake intention rate (54.2%) on the African continent. Factors that promoted vaccine acceptance included confidence in the COVID-19 vaccines and the desire to protect people. Age, education, and gender were the most common factors significantly associated with vaccine acceptance. Most studies revealed that considerable barriers to vaccine uptake exist in Africa. Concerns about potential side effects, vaccine ineffectiveness, a perceived lack of information, and inaccessibility were among the individual, interpersonal, and structural barriers to COVID-19 vaccine uptake. The unwillingness to receive the COVID-19 vaccine was strongly correlated with being female. Mass and social media were the main sources of information regarding COVID-19 vaccines. To encourage vaccine uptake, governments should pay attention to refuting misinformation through integrated community-based approaches, such as creating messages that convey more than just information.
... Există foarte multe studii care măsoară factorii contextuali care influențează intenția de vaccinare pentru alte vaccinuri, însă pentru vaccinarea împotriva Covid-19 astfel de studii sunt deocamdată puține. Un astfel de studiu arată că factori contextuali măsurați la nivel de țară, precum dimensiunile culturale de individualism și colectivism sau distanța față de putere, nu sunt predictori semnificativi pentru intenția de vaccinare (Enea et al. 2022). ...
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Acest studiu analizează factorii asociați vaccinării propriu-zise și intenției de vaccinare împotriva Covid-19 în România.
... Studies showed that individuals who supported COVID-19-related conspiracy theories were less likely to trust experts' recommendations intended to reduce infection rates and were, therefore, less prone to adhere to prescribed public health measures and to undergo the medical procedures intended to control the contagion (Biddlestone et al., 2020;Juanchich et al., 2021;Enea et al., 2022). ...
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Introduction In times of great uncertainty and hardship, calls for a strong leader tend to arise. The present study delved into this issue by examining possible sociopsychological antecedents of the wish for a strong leader during the COVID-19 crisis. Methods We examined the role of social identification, belief in conspiracy theories related to COVID-19, and trust in various relevant social actors in a sample of 350 Italian citizens. Results Structural equation modeling analyses showed that identification with Italians was related to a lower wish for a strong leader through the mediation of trust. Identification with Europeans had a direct and negative association with the wish for a strong leader. Finally, greater endorsement of conspiracy beliefs was related to a greater wish for a strong leader, directly and through diminished trust. Discussion These findings suggest that belief in conspiracy theories might drive individuals to depart from democratic principles, whereas relying on meaningful social identities can effectively contrast possible authoritarian turns brought about by a global societal crisis, such as the coronavirus outbreak.
... Anti-vaccination advocates spread conspiracy theories about the development, safety, and effectiveness of vaccines (e.g., vaccines can alter your genes), which are inconsistent with scientific evidence (Enea et al., 2022;Jolley & Douglas, 2014). There is a great deal of evidence that people's beliefs in conspiracy theories are associated with vaccine hesitancy. ...
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It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p < .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p < .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p < .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.
... Following this line of reasoning, a focus on the risks of others could lead to more accurate appraisal of the pandemic risks, and therefore in turn to more caution in handling one's own role during the pandemic. These considerations and further consistent evidence obtained recently in a COVID-19 context (e.g., Christner et al., 2020;Enea et al., 2022;van Hulsen et al., 2021;Jung & Albarracín, 2021) emphasize the potential of prosocial messages, that is, focusing on the pandemic risks of others, to motivate protective behaviors. ...
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Although most protective behaviors related to the COVID-19 pandemic come with personal costs, they will produce the largest benefit if everybody cooperates. This study explores two interacting factors that drive cooperation in this tension between private and collective interests. A preregistered experiment (N = 299) examined (a) how the quality of the relation among interacting partners (social proximity), and (b) how focusing on the risk of self-infection versus onward transmission affected intentions to engage in protective behaviors. The results suggested that risk focus was an important moderator of the relation between social proximity and protection intentions. Specifically, participants were more willing to accept the risk of self-infection from close others than from strangers, resulting in less caution toward a friend than toward a distant other. However, when onward transmission was the primary concern, participants were more reluctant to effect transmission to close others, resulting in more caution toward friends than strangers. These findings inform the debate about effective nonclinical measures against the pandemic. Practical implications for risk communication are discussed.
... Previous studies suggested a number of factors that influence the degree to which people in different societies supported or rejected COVID-19 pandemic-related health behaviors, including selfinterest, pro-sociality, religiosity, conspiracy beliefs, trust, national identification, perceived effectiveness, and quality of institutions (7)(8)(9)(10)(11)(12)(13)(14). In this paper, we argue that in order to understand why people support or oppose certain measures, it is crucial to understand (I) which individuals, groups, social movements, or organizations (referred to as 'protagonists' in the following) people identify as relevant and (II) how they are evaluated. ...
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It is crucial to understand why people comply with measures to contain viruses and their effects during pandemics. We provide evidence from 35 countries (Ntotal = 12,553) from six continents during the COVID-19 pandemic that the social perception of key protagonists on two basic dimensions of social perception – warmth and competence – played a crucial role in shaping pandemic-related behaviors. Firstly, heads of state, physicians, and protest movements were universally identified as key protagonists across countries. Secondly, the social perception of these and other protagonists differed significantly within and between countries across warmth and competence. Thirdly, warmth and competence perceptions of heads of state, physicians, and protest movements translated into support and opposition intentions, containment and prevention behaviors, as well as vaccination uptake. Our results have important implications for designing effective interventions to motivate desirable health outcomes and coping with future health crises and other global challenges.
... The diversity of predictive psychosocial factors of the acceptance of vaccination against COVID-19 has been pointed out, such as political opinions, attitudes towards science, antisocial tendencies [7], or prosociality [8]. An international study that included 24 countries and more than 5000 participants found that anti-vaccine attitudes were more frequent in people who had a high level of conspiratorial thinking. ...
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Citation: Espejo, B.; Martín-Carbonell, M.; Romero-Acosta, K.C.; Fernández-Daza, M.; Paternina, Y. (2022). Journal of Clinical Medicine, 11(16), 4682; https://doi.org/10.3390/jcm11164682 Having a valid tool to assess attitudes toward vaccination and identify the concerns that drive vaccine refusal can facilitate population studies and help guide public health interventions. The objective of this study has been to adapt the Vaccination Attitudes Examination (VAX) scale in Colombian university students and to study its psychometric properties in a non-probabilistic sample of 1074 Colombian university students. Methods: A confirmatory factor analysis was used to study the factorial structure. A structural equation model was tested to study concurrent validity and to check whether the factors predicted having received the coronavirus vaccine. Gender-based measurement invariance was also studied for the best model. Results: The results support the structure of four related factors. The composite reliability index was good for all the factors, but the average variance extracted was not as good for the second factor. There was strong measurement invariance by gender, and two factors are good predictors of being vaccinated or not. Conclusions: The VAX has shown construct and concurrent validity and is a reliable tool for evaluating attitudes towards vaccines in university students in Colombia. It may help guide the implementation of actions for the National Vaccination Plan and institutional policies.
... The diversity of predictive psychosocial factors of the acceptance of vaccination against COVID-19 has been pointed out, such as political opinions, attitudes towards science, antisocial tendencies [7], or prosociality [8]. An international study that included 24 countries and more than 5000 participants found that anti-vaccine attitudes were more frequent in people who had a high level of conspiratorial thinking. ...
Article
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Background: Having a valid tool to assess attitudes toward vaccination and identify the concerns that drive vaccine refusal can facilitate population studies and help guide public health interventions. The objective of this study has been to adapt the Vaccination Attitudes Examination (VAX) scale in Colombian university students and to study its psychometric properties in a non-probabilistic sample of 1074 Colombian university students. Methods: A confirmatory factor analysis was used to study the factorial structure. A structural equation model was tested to study concurrent validity and to check whether the factors predicted having received the coronavirus vaccine. Gender-based measurement invariance was also studied for the best model. Results: The results support the structure of four related factors. The composite reliability index was good for all the factors, but the average variance extracted was not as good for the second factor. There was strong measurement invariance by gender, and two factors are good predictors of being vaccinated or not. Conclusions: The VAX has shown construct and concurrent validity and is a reliable tool for evaluating attitudes towards vaccines in university students in Colombia. It may help guide the implementation of actions for the National Vaccination Plan and institutional policies.
... Conspiratorial theories seem to play an important role in shaping the pandemic-related behaviors, especially less adherence to the restrictions (e.g. Freeman et al., 2020;Jolley & Douglas, 2014;Kowalski et al., 2020;Swami & Barron, 2021;Venea et al., 2022). ...
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Because conspiracy theories have many negative consequences, understanding the psychological factors underlying their endorsement is an important task for researchers. We examined whether people's time perspective (TP) – the tendency to focus on the certain aspects of the past, present, or future – is associated with conspiracy beliefs. In two studies we investigated general (Study 1; N = 263) and COVID-19 related (Study 2; N = 570) conspiracy theories. The most consistent finding was the positive correlation between two present TPs: hedonism and fatalism and the endorsement of conspiracy ideations. Moreover, we found that hostility and a tendency toward irrational thinking mediated these associations. Additionally, but only in Study 2, conspiracy beliefs were associated with higher levels of the Past Negative TP and less balanced TP. We conclude that conspiracy theories provide simple and immediate answers of important events and that is why they are attractive to present oriented people who look for immediate explanations of complex and difficult situations.
... Appeals to individuals' prosocial sentiments and inclinations toward generosity, in fact, can be effective in the vaccination context, 4,5 with emerging evidence also supporting their effectiveness with COVID-19 vaccines. 6,7 To further facilitate a transition from self-interest to solidarity in COVID-19 vaccine messaging, 3 potential strategies stand out. First, it needs to be clearer that COVID-19 vaccines resulted from collective investment. ...
... This means that people's general tendency to adhere to a variety of conspiracy beliefs regarding COVID-19 may shape their motivations to get vaccinated. Unsurprisingly, endorsement of COVID-19 conspiracy beliefs emerged as a strong negative predictor of vaccination intentions (Bertin et al., 2020;Enea et al., 2022) and actual behavior (van Prooijen et al., 2021). ...
Article
Rationale Vaccination willingness is a critical step in the effort to reach herd immunity and control the COVID-19 pandemic. Nevertheless, many people remain reluctant to be vaccinated. Objective Integrating the literature on Self-Determination Theory, trust in authorities, and conspiracy theories, this research examines (a) the direct and indirect effect of government trust and conspiracism via underlying forms of motivations for (not) getting vaccinated against COVID-19 and (b) whether these associations differ across the two largely politically independent Belgian linguistic groups. Methods Using Structural Equation Modeling, we tested our models in two independent samples, in February 2021 (T1) and April 2021 (T2) (Total N = 8264). Results At T1 and T2, Government trust and conspiracism both predict COVID-19 vaccination intention, respectively positively and negatively. These relations are fully mediated by motivational factors, with identified motivations having a larger positive contribution. Looking at linguistic context, differences emerge at T2, with French-speaking Belgians showing lower levels of government trust and higher levels of conspiracism than Dutch speakers. Conclusions Results highlight the importance of integrating distal (trust in government, conspiracism) and proximal (motivational) variables to understand vaccination intentions.
... Therefore, it is necessary to help the patients strengthen or extend their social support networks, by increasing support from family, providing peer support, creating special help lines for people with diabetes, and patients' communities. Emphasizing the importance of preventive measures (Enea et al., 2022) and the vaccine's efficacy in protecting people with diabetes against COVID-19 could prove beneficial for mitigating their death concern and fear of COVID-19. ...
Article
Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.
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Objective Social media’s arrival eased the sharing of mis- and disinformation. False information proved challenging throughout the coronavirus disease 2019 (COVID-19) pandemic with many clinicians and researchers analyzing the “infodemic.” We systemically reviewed and synthesized COVID-19 mis- and disinformation literature, identifying the prevalence and content of false information and exploring mitigation and prevention strategies. Design We identified and analyzed publications on COVID-19-related mis- and disinformation published from March 1, 2020, to December 31, 2022, in PubMed. We performed a manual topic review of the abstracts along with automated topic modeling to organize and compare the different themes. We also conducted sentiment (ranked −3 to +3) and emotion analysis (rated as predominately happy, sad, angry, surprised, or fearful) of the abstracts. Results We reviewed 868 peer-reviewed scientific publications of which 639 (74%) had abstracts available for automatic topic modeling and sentiment analysis. More than a third of publications described mitigation and prevention-related issues. The mean sentiment score for the publications was 0.685, and 56% of studies had a negative sentiment (fear and sadness as the most common emotions). Conclusions Our comprehensive analysis reveals a significant proliferation of dis- and misinformation research during the COVID-19 pandemic. Our study illustrates the pivotal role of social media in amplifying false information. Research into the infodemic was characterized by negative sentiments. Combining manual and automated topic modeling provided a nuanced understanding of the complexities of COVID-19-related misinformation, highlighting themes such as the source and effect of misinformation, and strategies for mitigation and prevention.
Article
Health research demonstrates that prosocial health behaviors, while typically voluntarily, can be influenced by dispositional empathy. However, the motivating circumstances regarding this link between empathy and prosocial health behavior have not been well understood. Self‐determination theory provides a framework for motivating voluntary behavior. Three preregistered studies ( n total = 630) sought to integrate self‐determination's autonomous and controlled motivation to protect vulnerable populations from illness as potential mediators associated with dispositional empathy and face mask wearing behavior (Studies 1 and 2), and flu vaccination (Study 3). Results demonstrate that autonomous motivation positively mediates the empathy‐prosocial health behavior pathway whereas controlled motivation does not. Findings postulate the importance of identifying motivation in predicting face mask behavior and flu vaccination.
Article
Behavioral nudges in Facebook ads reached nearly 15 million people across six diverse countries and, consequently, many thousands took the step of navigating to governments’ vaccine signup sites. However, none of the treatment ads caused significantly more vaccine signup intent than placebo uniformly across all countries. Critically, reporting the descriptive norm that 87% of people worldwide had either been vaccinated or planned vaccination—social proof—did not meaningfully increase vaccine signup intent in any country and significantly backfired in Taiwan. This result contradicts prominent prior findings. A charge to “protect lives in your family” significantly outperformed placebo in Taiwan and Turkey but saw null effects elsewhere. A message noting that vaccination significantly reduces hospitalization risk decreased signup intent in Brazil and had no significant effects in any other country. Such heterogeneity was the hallmark of the study: some messages saw significant treatment effects in some countries but failed in others. No nudge outperformed the placebo in Russia, a location of high vaccine skepticism. In all, widely touted behavioral nudges often failed to promote vaccine signup intent and appear to be moderated by cultural context.
Article
Introduction: COVID-19 vaccine hesitancy studies, most of which were completed prior to the release of the vaccine, speculated on factors that might influence inoculation intention when a vaccine was introduced. This paper examines actual vaccination decisions among US residents after COVID-19 vaccines were approved, with a focus on trust in vaccine effectiveness, increased trust in government pandemic response, and individual-versus-collective value orientation. Method: The data set was from the Kaiser Family Foundation COVID-19 Vaccine Monitor, a nationally representative sample reflecting the opinions of 1519 American adults aged 18 and above. Data were collected in September 2021-approximately nine months after the first COVID-19 vaccines were approved for distribution. Indicators of trust in vaccine effectiveness included individual opinions regarding breakthrough infections and vaccine boosters. Increased trust in government indicated approval of official COVID-19 responses, and value orientation denoted respondent emphasis on personal choice versus protecting the health of others. We established three categories of a vaccine hesitancy dependent variable: none, some, and full rejection. A multinomial regression analysis was employed to compare vaccine hesitancy in three pairs of contrasting groups. Results: While we noted distinct patterns in decision-making factors for each of the contrasting pairs, we also observed strong effects for trust in vaccine effectiveness and value orientation on vaccine decisions across all three. Both effects were more substantial than those associated with three control variables-social-demographic characteristics, political party affiliation, and health risk. Conclusion: Our findings suggest that in order to increase vaccination rates, policymakers and influencers should focus on reducing individual scepticism over breakthrough infections and vaccine boosters, and on influencing a value orientation shift from personal choice to social responsibility.
Article
Despite evidence of the safety and effectiveness of COVID‐19 vaccines and their wide availability, many in the U.S. are not vaccinated. Research demonstrates that prosocial orientations predict COVID‐19 health behaviors (e.g., social distancing) and vaccination intentions, however, little work has examined COVID‐19 vaccination willingness in the U.S. since vaccines were approved. Findings from two U.S. samples show that, in contrast to other COVID‐19 health behaviors, vaccine willingness in unvaccinated people is unrelated to prosocial orientation. Study 2 demonstrates that the lack of association between vaccine willingness and prosocial orientation in unvaccinated participants was specific to those with stronger beliefs that COVID‐19 vaccines are ineffective. Thus, in prosocial people, perceptions of vaccines' ineffectiveness may undermine COVID‐19 vaccine willingness.
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Background Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. Method In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). Results In total, 2189 adult participants (82% female, 57.2% aged 31–59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). Conclusions This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.
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This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.
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ภาวะการระบาดระดับโลกของโรคโควิด-19 เป็นปรากฏการณ์ที่ส่งผลกระทบต่อผู้คนทั่วโลกหลาย ๆ ด้าน ในขณะเดียวกันมนุษย์พยายามเสาะแสวงหาข้อมูลต่างๆที่เกี่ยวกับการระบาด แต่กลับพบ “ความเชื่อหรือทฤษฎีสมคบคิด” ที่เกี่ยวกับโรคโควิด-19 ที่ดูไม่น่าเชื่อถือและสมเหตุสมผล ซึ่งมีบางคนกลับปักใจเชื่อและส่งผลกระทบต่อความคิดและพฤติกรรมมนุษย์ บทความนี้นำเสนอมุมมองทางจิตวิทยาของความเชื่อสมคบคิดเพื่ออธิบายที่มาผลกระทบของความเชื่อสมคบคิดที่มีต่อผลลัพธ์ทางสังคมทั้งพฤติกรรมป้องกันการติดเชื้อ การแพร่ระบาด และการช่วยเหลือกันลดลง อคติ การซื้อด้วยความตื่นตระหนก การกักตุน และความรุนแรง และเสนอแนวทางการรับมือความเชื่อสมคบคิด The COVID-19 pandemic is a phenomenon which has affected people all over the world. At the same time, when people have tried to seek for pandemic-related information, they found COVID-19-related“conspiracy beliefs or theories” which some people believed and this affected their thoughts and behaviors. This article proposes a psychological perspective of conspiracy beliefs to explain the origin and the effects of conspiracy beliefs and their social consequences including less preventive and helping behaviors, prejudice, panic buying, hoarding and violence, and suggests the guidelines on dealing with conspiracy beliefs.
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It is crucial to understand why people comply with measures to contain viruses and their effects during pandemics. We provide evidence from 35 countries ( N total = 12,553) from 6 continents during the COVID-19 pandemic (between 2021 and 2022) obtained via cross-sectional surveys that the social perception of key protagonists on two basic dimensions—warmth and competence—plays a crucial role in shaping pandemic-related behaviors. Firstly, when asked in an open question format, heads of state, physicians, and protest movements were universally identified as key protagonists across countries. Secondly, multiple-group confirmatory factor analyses revealed that warmth and competence perceptions of these and other protagonists differed significantly within and between countries. Thirdly, internal meta-analyses showed that warmth and competence perceptions of heads of state, physicians, and protest movements were associated with support and opposition intentions, containment and prevention behaviors, as well as vaccination uptake. Our results have important implications for designing effective interventions to motivate desirable health outcomes and coping with future health crises and other global challenges.
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Although many virtuous leaders are guided by the ideal of prioritizing the needs and welfare of their subordinates, others advance their self-interest at the expense of the people they purport to serve. In this article, we discuss conspiracy theories as a tool that leaders use to advance their personal interests. We propose that leaders spread conspiracy theories in service of four primary goals: 1) to attack opponents; 2) to increase support from their ingroup members; 3) to shift blame and responsibility; and 4) to undermine institution that threaten their power. We argue that authoritarian, populist, and conservative leaders are most likely to spread conspiracy theories during periods of instability.
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Some people feel they are invincible to the novel coronavirus SARS-CoV-2 (COVID-19). They believe that being infected with COVID-19 would not be a serious threat to their health. While these people may or may not be correct in their personal risk assessment, we find that such perceived invincibility may undermine community efforts to achieve herd immunity. Multi-level analysis of survey respondents across 51 countries finds that perceived invincibility from COVID-19 is negatively associated with believing there is a need to prevent the spread of COVID-19 in one’s community (n = 218,956) and one’s willingness to inoculate against the disease (n = 71,148). These effects are most pronounced among individuals from countries lower in cultural collectivism (e.g., USA, UK, Canada) and highlight the need to consider the interplay of individual and cultural factors in our efforts to understand, predict, and promote preventative health behavior during a pandemic.
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The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis. Consequently, many countries have adopted restrictive measures that caused a substantial change in society. Within this framework, it is reasonable to suppose that a sentiment of societal discontent, defined as generalized concern about the precarious state of society, has arisen. Literature shows that collectively experienced situations can motivate people to help each other. Since societal discontent is conceptualized as a collective phenomenon, we argue that it could influence intention to help others, particularly those who suffer from coronavirus. Thus, in the present study, we aimed (a) to explore the relationship between societal discontent and intention to help at the individual level and (b) to investigate a possible moderating effect of societal discontent at the country level on this relationship. To fulfil our purposes, we used data collected in 42 countries(N = 61,734) from the PsyCorona Survey, a cross-national longitudinal study. Results of multilevel analysis showed that, when societal discontent is experienced by the entire com-munity, individuals dissatisfied with society are more prone to help others. Testing the model with longitudinal data (N = 3,817) confirmed our results. Implications for those findings are discussed in relation to crisis management.
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The current research examined the role of values in guiding people’s responses to COVID-19. Results from an international study involving 115 countries (N = 61,490) suggest that health and economic threats of COVID-19 evoke different values, with implications for controlling and coping with the pandemic. Specifically, health threats evoked prioritization of communal values related to caring for others and belonging, whereas economic threats predicted prioritization of agentic values focused on competition and achievement. Concurrently and over time, prioritizing communal values over agentic values was associated with enactment of prevention behaviors that reduce virus transmission, motivations to help others suffering from the pandemic, and positive attitudes toward outgroup members. These results, which were generally consistent across individual and national levels of analysis, suggest that COVID-19 threats may indirectly shape important responses to the pandemic through their influence on people’s prioritization of communion and agency. Theoretical and practical implications are discussed.
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While there is an increasing body of research on the individual predispositions affecting conspiracy beliefs, little research has to date analysed potential effects on the context level. In this research note, we develop the argument that socialization and communication factors on the context level may directly affect aggregate levels of generic conspiracy beliefs. Second, we analyse whether these context level factors also interact with specific characteristics of the conspiracy theory – in our case, the actors involved in the CT. Running survey experiments in Germany, Poland, and Jordan (total N = 4,113), we find evidence for aggregate level differences between countries and for interactions between country-specific heuristics and characteristics of the CT. These findings are in line with expectations based on context level socialization and communication mechanisms. In closing, we discuss remaining limitations and outline promising avenues for future research.
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Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs. Survey data collected across ten low-income and middle-income countries (LMICs) in Asia, Africa and South America compared with surveys from Russia and the United States reveal heterogeneity in vaccine confidence in LMICs, with healthcare providers being trusted sources of information, as well as greater levels of vaccine acceptance in these countries than in Russia and the United States.
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The 2019 COVID-19 pandemic has amplified inequalities and human rights challenges; in some states, COVID-19 policies have been introduced that further curtail human rights. Although some limits may be justified in the time of a public health emergency, other rights are vital to secure precisely because of pandemic conditions. Following a discussion of the concept of political solidarity, we examine how COVID-19 has underscored democratic “deficits” and human rights failures within the United States and India. Emergency “stay-at-home” orders and social distancing measures make political dissent challenging, yet this extreme moment has created opportunities for solidarity, initially in restrained ways via the internet or local forms of collective support and protest, and later through mass mobilizations to end racial injustice (in the United States). Our assessment of the challenges and promises of solidarist action in two of the largest democracies offers reasons for guarded optimism.
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Rumors and conspiracy theories thrive in environments of low confidence and low trust. Consequently, it is not surprising that ones related to the COVID-19 pandemic are proliferating given the lack of scientific consensus on the virus’s spread and containment, or on the long-term social and economic ramifications of the pandemic. Among the stories currently circulating in US-focused social media forums are ones suggesting that the 5G telecommunication network activates the virus, that the pandemic is a hoax perpetrated by a global cabal, that the virus is a bio-weapon released deliberately by the Chinese, or that Bill Gates is using it as cover to launch a broad vaccination program to facilitate a global surveillance regime. While some may be quick to dismiss these stories as having little impact on real-world behavior, recent events including the destruction of cell phone towers, racially fueled attacks against Asian Americans, demonstrations espousing resistance to public health orders, and wide-scale defiance of scientifically sound public mandates such as those to wear masks and practice social distancing, countermand such conclusions. Inspired by narrative theory, we crawl social media sites and news reports and, through the application of automated machine-learning methods, discover the underlying narrative frameworks supporting the generation of rumors and conspiracy theories. We show how the various narrative frameworks fueling these stories rely on the alignment of otherwise disparate domains of knowledge, and consider how they attach to the broader reporting on the pandemic. These alignments and attachments, which can be monitored in near real time, may be useful for identifying areas in the news that are particularly vulnerable to reinterpretation by conspiracy theorists. Understanding the dynamics of storytelling on social media and the narrative frameworks that provide the generative basis for these stories may also be helpful for devising methods to disrupt their spread.
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Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.
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Most vaccines protect both the vaccinated individual and the society by reducing the transmission of infectious diseases. In order to eliminate infectious diseases, individuals need to consider social welfare beyond mere self-interest—regardless of ethnic, religious, or national group borders. It has therefore been proposed that vaccination poses a social contract in which individuals are morally obliged to get vaccinated. However, little is known about whether individuals indeed act upon this social contract. If so, vaccinated individuals should reciprocate by being more generous to a vaccinated other. On the contrary, if the other doesn’t vaccinate and violates the social contract, generosity should decline. Three preregistered experiments investigated how a person’s own vaccination behavior, others’ vaccination behavior, and others’ group membership influenced a person’s generosity toward respective others. The experiments consistently showed that especially compliant (i.e., vaccinated) individuals showed less generosity toward nonvaccinated individuals. This effect was independent of the others’ group membership, suggesting an unconditional moral principle. An internal metaanalysis (n = 1,032) confirmed the overall social contract effect. In a fourth experiment (n = 1,212), this pattern was especially pronounced among vaccinated individuals who perceived vaccination as a moral obligation. It is concluded that vaccination is a social contract in which cooperation is the morally right choice. Individuals act upon the social contract, and more so the stronger they perceive it as a moral obligation. Emphasizing the social contract could be a promising intervention to increase vaccine uptake, prevent free riding, and, eventually, support the elimination of infectious diseases.
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SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to be transmitted mainly by person-to-person contact (1). Implementation of nationwide public health orders to limit person-to-person interaction and of guidance on personal protective practices can slow transmission (2,3). Such strategies can include stay-at-home orders, business closures, prohibitions against mass gatherings, use of cloth face coverings, and maintenance of a physical distance between persons (2,3). To assess and understand public attitudes, behaviors, and beliefs related to this guidance and COVID-19, representative panel surveys were conducted among adults aged ≥18 years in New York City (NYC) and Los Angeles, and broadly across the United States during May 5-12, 2020. Most respondents in the three cohorts supported stay-at-home orders and nonessential business closures* (United States, 79.5%; New York City, 86.7%; and Los Angeles, 81.5%), reported always or often wearing cloth face coverings in public areas (United States, 74.1%, New York City, 89.6%; and Los Angeles 89.8%), and believed that their state's restrictions were the right balance or not restrictive enough (United States, 84.3%; New York City, 89.7%; and Los Angeles, 79.7%). Periodic assessments of public attitudes, behaviors, and beliefs can guide evidence-based public health decision-making and related prevention messaging about mitigation strategies needed as the COVID-19 pandemic evolves.
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The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
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Scholarly efforts to understand conspiracy theories have grown significantly in recent years, and there is now a broad and interdisciplinary literature. In reviewing this body of work, we ask three specific questions. First, what factors are associated with conspiracy beliefs? Our review of the literature shows that conspiracy beliefs result from a range of psychological, political, and social factors. Next, how are conspiracy theories communicated? Here, we explain how conspiracy theories are shared among individuals and spread through traditional and social media platforms. Next, what are the societal risks and rewards associated with conspiracy theories? By focusing on politics and science, we argue that conspiracy theories do more harm than good. We conclude by suggesting several promising avenues for future research.
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Vaccination provides direct protection for the vaccinating individual and indirect protection for other, unvaccinated individuals via herd immunity. Still, some people do not get vaccinated – either because they cannot (e.g., due to health conditions) or they don’t want to (e.g., due to vaccine hesitancy). We investigate whether non-vaccinators’ level of responsibility for not being vaccinated affects individuals’ motivation to vaccinate and, thus, to indirectly protect non-vaccinators. In Study 1 (N = 101), the intention to vaccinate increased (Cohen’s d = 0.99) when non-vaccinators were described as willing but unable to get vaccinated (low responsibility) compared to when they were able but unwilling to get vaccinated (high responsibility). Study 2 (N = 297) replicated this finding with regard to vaccination behavior in an interactive vaccination (I-Vax) game (OR = 2.38). Additionally, knowing about non-vaccinators’ low responsibility also increased the willingness to vaccinate compared to when there was no information on non-vaccinators’ level of responsibility. Amplified levels of social welfare concerns in the case of non-vaccinators’ low responsibility mediated the latter effect. This finding informs effective communication strategies for improving the vaccination rates.
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Background: Vaccination protects individuals directly and communities indirectly by reducing transmission. We aimed to determine whether information about herd immunity and local vaccination coverage could change an individual's vaccination plans and concern about influenza. Methods: We surveyed Minnesota residents ≥18 years during the 2016 Minnesota State Fair. Participants were asked to identify the definition of herd immunity, to report their history of and plans to receive influenza vaccine, to report their concern about influenza, and to estimate the reported influenza vaccination coverage in their county. After providing educational information about herd immunity and local vaccination rates, we reassessed vaccination plans and concerns. We used logistic regression to estimate predicted percentages for those willing to be vaccinated, for concern about influenza, and for changes in these outcomes after the intervention. We then compared those individuals with and without prior knowledge of herd immunity, accounting for other characteristics. Results: Among 554 participants, the median age was 57 years; most were female (65.9%), white (91.0%), and non-Hispanic/Latino (93.9%). Overall, 37.2% of participants did not know about herd immunity and 75.6% thought that the influenza vaccination coverage in their county was higher than it was reported. Those not knowledgeable about herd immunity were significantly less likely than those knowledgeable about the concept to report plans to be vaccinated at baseline (67.8% versus 78.9%; p = 0.004). After learning about herd immunity and influenza vaccination coverage, the proportion of those not knowledgeable about herd immunity who were willing to be vaccinated increased significantly by 7.3 percentage points (p = 0.001). Educating participants eliminated the significant difference in the proportion planning to be vaccinated between these two groups (80.1% of those knowledgeable and 75.1% of those who were not initially knowledgeable became willing; p = 0.148). Conclusions: Education about herd immunity and local vaccination coverage could be a useful tool for increasing willingness to vaccinate, generating benefits both to individuals and communities.
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In order to gather a global picture of vaccine hesitancy and whether/how it is changing, an analysis was undertaken to review three years of data available as of June 2017 from the WHO/UNICEF Joint Report Form (JRF) to determine the reported rate of vaccine hesitancy across the globe, the cited reasons for hesitancy, if these varied by country income level and/or by WHO region and whether these reasons were based upon an assessment. The reported reasons were classified using the Strategic Advisory Group of Experts (SAGE) on Immunization matrix of hesitancy determinants (www.who.int/immunization/sage/meetings/2014/october/SAGE_working_group_revised_report_vaccine_hesitancy.pdf). Hesitancy was common, reported by >90% of countries. The list of cited reasons was long and covered 22 of 23 WHO determinants matrix categories. Even the most frequently cited category, risk- benefit (scientific evidence e.g. vaccine safety concerns), accounted for less than one quarter of all reasons cited. The reasons varied by country income level, by WHO region and over time and within a country. Thus based upon this JRF data, across the globe countries appear to understand the SAGE vaccine hesitancy definition and use it to report reasons for hesitancy. However, the rigour of the cited reasons could be improved as only just over 1/3 of countries reported that their reasons were assessment based, the rest were opinion based. With respect to any assessment in the previous five years, upper middle income countries were the least likely to have done an assessment. These analyses provided some of the evidence for the 2017 Assessment Report of the Global Vaccine Action Plan recommendation that each country develop a strategy to increase acceptance and demand for vaccination, which should include ongoing community engagement and trust-building, active hesitancy prevention, regular national assessment of vaccine concerns, and crisis response planning (www.who.int/immunization/sage/meetings/2017/october/1_GVAP_Assessment_report_web_version.pdf).
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Background: The national guideline for use of the vaccine targeting oncogenic strains of the human papillomavirus (HPV) is an evidence-based practice that is poorly implemented in primary care. Recommendations include completion of the vaccine series before the 13th birthday for girls and boys, giving the first dose at the 11- to 12-year-old check-up visit, concurrent with other recommended vaccines. Interventions to increase implementation of this guideline have had little impact, and opportunities to prevent cancer continue to be missed. Methods: We used a theory-informed approach to develop a pragmatic intervention for use in primary care settings to increase implementation of the HPV vaccine guideline recommendation. Using a concurrent mixed methods design in 10 primary care practices, we applied the Consolidated Framework for Implementation Research (CFIR) to systematically investigate and characterize factors strongly influencing vaccine use. We then used the Behavior Change Wheel (BCW) and the Theoretical Domains Framework (TDF) to analyze provider behavior and identify behaviors to target for change and behavioral change strategies to include in the intervention. Results: We identified facilitators and barriers to guideline use across the five CFIR domains: most distinguishing factors related to provider characteristics, their perception of the intervention, and their process to deliver the vaccine. Targeted behaviors were for the provider to recommend the HPV vaccine the same way and at the same time as the other adolescent vaccines, to answer parents' questions with confidence, and to implement a vaccine delivery system. To this end, the intervention targeted improving provider's capability (knowledge, communication skills) and motivation (action planning, belief about consequences, social influences) regarding implementing guideline recommendations, and increasing their opportunity to do so (vaccine delivery system). Behavior change strategies included providing information and communication skill training with graded tasks and modeling, feedback of coverage rates, goal setting, and social support. These strategies were combined in an implementation intervention to be delivered using practice facilitation, educational outreach visits, and cyclical small tests of change. Conclusions: Using CFIR, the BCW and the TDF facilitated the development of a pragmatic, multi-component implementation intervention to increase use of the HPV vaccine in the primary care setting.
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Objective: Strengthening of antivaccination movements in recent decades has coincided with unprecedented increases in the incidence of some communicable diseases. Many intervention programs work from a deficit model of science communication, presuming that vaccination skeptics lack the ability to access or understand evidence. However, interventions focusing on evidence and the debunking of vaccine-related myths have proven to be either nonproductive or counterproductive. Working from a motivated reasoning perspective, we examine the psychological factors that might motivate people to reject scientific consensus around vaccination. To assist with international generalizability, we examine this question in 24 countries. Methods: We sampled 5,323 participants in 24 countries, and measured their antivaccination attitudes. We also measured their belief in conspiracy theories, reactance (the tendency for people to have a low tolerance for impingements on their freedoms), disgust sensitivity toward blood and needles, and individualistic/hierarchical worldviews (i.e., people's beliefs about how much control society should have over individuals, and whether hierarchies are desirable). Results: In order of magnitude, antivaccination attitudes were highest among those who (a) were high in conspiratorial thinking, (b) were high in reactance, (c) reported high levels of disgust toward blood and needles, and (d) had strong individualistic/hierarchical worldviews. In contrast, demographic variables (including education) accounted for nonsignificant or trivial levels of variance. Conclusions: These data help identify the "attitude roots" that may motivate and sustain vaccine skepticism. In so doing, they help shed light on why repetition of evidence can be nonproductive, and suggest communication solutions to that problem. (PsycINFO Database Record
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In the present contribution, we examine the link between societal crisis situations and belief in conspiracy theories. Contrary to common assumptions, belief in conspiracy theories has been prevalent throughout human history. We first illustrate historical incidents suggesting that societal crisis situations—defined as impactful and rapid societal change that calls established power structures, norms of conduct, or even the existence of specific people or groups into question—have stimulated belief in conspiracy theories. We then review the psychological literature to explain why this is the case. Evidence suggests that the aversive feelings that people experience when in crisis—fear, uncertainty, and the feeling of being out of control—stimulate a motivation to make sense of the situation, increasing the likelihood of perceiving conspiracies in social situations. We then explain that after being formed, conspiracy theories can become historical narratives that may spread through cultural transmission. We conclude that conspiracy theories originate particularly in crisis situations and may form the basis for how people subsequently remember and mentally represent a historical event.
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What psychological factors drive the popularity of conspiracy theories that explain important events as secret plots by powerful and malevolent groups? What are the psychological consequences of adopting these theories? We review the current research, and find that it answers the first of these questions more thoroughly than the second. Belief in conspiracy theories appears to be driven by motives that can be characterized as epistemic (understanding one’s environment), existential (being safe and in control of one’s environment) and social (maintaining a positive image of the self and the social group). However, little research has investigated the consequences of conspiracy belief, and to date, this research does not indicate that conspiracy belief fulfills people’s motivations. Instead, for many people conspiracy belief may be more appealing than satisfying. Further research is needed to determine for whom, and under what conditions, conspiracy theories may satisfy key psychological motives.
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Vaccine hesitancy has become the focus of growing attention and concern globally despite overwhelming evidence of the value of vaccines in preventing disease and saving the lives of millions of individuals every year. Measuring vaccine hesitancy and its determinants worldwide is important in order to understand the scope of the problem and for the development of evidence-based targeted strategies to reduce hesitancy. Two indicators to assess vaccine hesitancy were developed to capture its nature and scope at the national and subnational level to collect data in 2014: 1) The top 3 reasons for not accepting vaccines according to the national schedule in the past year and whether the response was opinion- or assessment-based and 2) Whether an assessment (or measurement) of the level of confidence in vaccination had taken place at national or subnational level in the previous 5 years. The most frequently cited reasons for vaccine hesitancy globally related to (1) the risk-benefit of vaccines, (2) knowledge and awareness issues, (3) religious, cultural, gender or socio-economic factors. Major issues were fear of side effects, distrust in vaccination and lack of information on immunization or immunization services. The analysis revealed that 29% of all countries had done an assessment of the level of confidence in their country, suggesting that vaccine confidence was an issue of importance. Monitoring vaccine hesitancy is critical because of its influence on the success of immunization programs. To our knowledge, the proposed indicators provide the first global snapshot of reasons driving vaccine hesitancy and depicting its widespread nature, as well as the extent of assessments conducted by countries.
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Background: Human papillomavirus (HPV) vaccination targets high-risk HPV16/18 that cause 70% of all cancers of the cervix. In Australia there is a fully-funded, school-based National HPV Vaccination Program which has achieved vaccine initiation rate of 82% among age-eligible females. Improving HPV vaccination rates is important in the prevention of morbidity and mortality associated with HPV-related disease. This study aimed to identify factors and barriers associated with uptake of the HPV vaccine in the Australian Program. Methods: Between 2011 and 2014, females aged 18-25 years, living in Victoria, Australia who were offered HPV vaccination between 2007 and 2009 as part of the National HPV Vaccination Program, living in Victoria, Australia were recruited into a a young women's study examining effectiveness of the Australian National HPV Vaccination Program. Overall, 668 participants completed the recruitment survey, which collected data of participants' demographics and HPV knowledge. In 2015 these participants were invited to complete an additional supplementary survey on parental demographics and attitudes towards vaccinations. Results: In 2015, 417 participants completed the supplementary survey (62% response rate). Overall, 19% of participants were unvaccinated. In multivariate analyses, HPV vaccination was significantly associated with their being born in Australia (p<0.001), having completed childhood vaccinations (p<0.001) and their parents being main decision-makers for participants' HPV vaccination (p<0.001). The main reason reported for HPV non-vaccination was parental concern about vaccine safety (43%). Compared with HPV-vaccinated participants, those unvaccinated were significantly more likely to be opposed to all vaccines, including HPV vaccines (p<0.001) and were less likely to consider vaccinating their own children with all vaccines (p = 0.033), including HPV vaccines (p<0.001). Overall, 61% of unvaccinated participants reported that a recommendation from GPs would increase HPV vaccine acceptance. Conclusions: Attitudes towards general health, vaccinations in general, as well as HPV vaccines are important in HPV vaccine uptake. Long-term monitoring of the knowledge, attitude and beliefs towards HPV vaccination in the community is critical to ensure a continued high uptake of the vaccine and success of the program.
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Influenza vaccination for health care personnel (HCP) is recommended particularly because it indirectly protects patients to contract the disease. Vaccinating can therefore be interpreted as a pro-social act. However, HCP vaccination rates are often far too low to prevent nosocomial infections. Effective interventions are needed to increase HCP’s influenza vaccine uptake. Here we devise a novel tool to experimentally test interventions that aim at increasing pro-socially motivated vaccine uptake under controlled conditions. We conducted a large-scale and cross-cultural experiment with participants from countries with either a collectivistic (South Korea) or individualistic (USA) cultural background. Results showed that pro-socially motivated vaccination was more likely in South Korea compared to the US, mediated by a greater perception of vaccination as a social act. However, changing the default of vaccination, such that participants had to opt-out rather than to opt-in, increased vaccine uptake in the US and therefore compensated for the lower level of pro-social vaccination. In sum, the present study provides both a novel method to investigate HCP influenza vaccination behavior as well as interventions to increase their vaccine uptake.
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Objective: Americans do not vaccinate nearly enough against Influenza (flu) infection, despite severe health and economic burden of influenza. Younger people are disproportionately responsible for transmission, but do not suffer severely from the flu. Thus, to achieve herd immunity, prosocial motivation needs to be a partial driver of vaccination decisions. Past research has not established the causal role of prosociality in flu vaccination, and the current research evaluates such causal relationship by experimentally eliciting prosociality through messages about flu victims. Methods: In an experimental study, we described potential flu victims who would suffer from the decision of others to not vaccinate to 3952 Internet participants across eight countries. We measured sympathy, general prosociality, and vaccination intentions. The study included two identifiable victim conditions (one with an elderly victim and another with a young victim), an unidentified victim condition, and a no message condition. Results: We found that any of the three messages increased flu vaccination intentions. Moreover, this effect was mediated by enhanced prosocial motives, and was stronger among people who were historical non-vaccinators. In addition, younger victim elicited greater sympathy, and describing identifiable victims increased general sympathy and prosocial motives. Conclusions: These findings provide direct experimental evidence on the causal role of prosocial motives in flu vaccination, by showing that people can be prompted to vaccinate for the sake of benefiting others.
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This research examines the role of different forms of positive regard for the in-group in predicting beliefs in intergroup conspiracies. Collective narcissism reflects a belief in in-group greatness contingent on others’ recognition. We hypothesized that collective narcissism should be especially likely to foster out-group conspiracy beliefs. Positive yet non-narcissistic in-group positivity should predict a weaker tendency to believe in conspiracy theories. In Study 1 the endorsement of conspiratorial explanations of out-group actions was positively predicted by collective narcissism but negatively by non-narcissistic in-group positivity. Study 2 showed that the opposite effects of collective narcissism and non-narcissistic in-group positivity on conspiracy beliefs were mediated via differential perceptions of threat. Study 3 manipulated whether conspiracy theories implicated in-group or out-group members. Collective narcissism predicted belief in out-group conspiracies but not in-group conspiracies, while non-narcissistic in-group positivity predicted lower conspiracy beliefs, regardless of them being ascribed to the in-group or the out-group.
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Although public endorsement of conspiracy theories is growing, the potentially negative societal consequences of widespread conspiracy ideation remain unclear. While past studies have mainly examined the personality correlates of conspiracy ideation, this study examines the conspiracy-effect; the extent to which exposure to an actual conspiracy theory influences pro-social and environmental decision-making. Participants (N = 316) were randomly assigned to one of three conditions; (a) a brief conspiracy video about global warming, (b) an inspirational pro-climate video or (c) a control group. Results indicate that those participants who were exposed to the conspiracy video were significantly less likely to think that there is widespread scientific agreement on human-caused climate change, less likely to sign a petition to help reduce global warming and less likely to donate or volunteer for a charity in the next six months. These results strongly point to the socio-cognitive potency of conspiracies and highlight that exposure to popular conspiracy theories can have negative and undesirable societal consequences.
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This chapter addresses two questions; how big is the "gap" between intentions and behavior, and what psychological variables might be able to "bridge" the intention-behavior gap? A meta-analysis of meta-analyses is used to quantify the gap and a conceptual analysis of intention-behavior discrepancies is presented. Research is described on the extent to which four groups of variables-behavior type, intention type, properties of intention, and cognitive and personality variables-moderate intention-behavior relations. Finally, the scope of the intention construct is discussed in the light of recent evidence concerning the role of habits and automaticity in human behavior.
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The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences. Copyright © 2015. Published by Elsevier Ltd.
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Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985, 1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is found to be well supported by empirical evidence. Intentions to perform behaviors of different kinds can be predicted with high accuracy from attitudes toward the behavior, subjective norms, and perceived behavioral control; and these intentions, together with perceptions of behavioral control, account for considerable variance in actual behavior. Attitudes, subjective norms, and perceived behavioral control are shown to be related to appropriate sets of salient behavioral, normative, and control beliefs about the behavior, but the exact nature of these relations is still uncertain. Expectancy— value formulations are found to be only partly successful in dealing with these relations. Optimal rescaling of expectancy and value measures is offered as a means of dealing with measurement limitations. Finally, inclusion of past behavior in the prediction equation is shown to provide a means of testing the theory*s sufficiency, another issue that remains unresolved. The limited available evidence concerning this question shows that the theory is predicting behavior quite well in comparison to the ceiling imposed by behavioral reliability.
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