Enablers and barriers to COVID-19 vaccine uptake: An international study of perceptions and intentions

• Published in: Vaccine Vol. 39; no. 36; pp. 5116 - 5128
• Main Authors: Burke, Paul F., Masters, Daniel, Massey, Graham
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 23.08.2021; Elsevier Limited; Published by Elsevier Ltd
• Subjects: Aged; Allergy and Immunology; Altruism; Australia; Behavior; Canada; Conspiracy; Conspiracy beliefs; Coronaviruses; COVID-19; COVID-19 infection; COVID-19 Vaccines; employment; England; Health beliefs model; Herd immunity; Humans; Immunization; income; Influenza; Influenza Vaccines; Intention; International studies; Multivariate statistical analysis; New Zealand; Older people; people; Perception; Perceptions; Public health; questionnaires; religion; SARS-CoV-2; Side effects; Structural equation model; Structural equation modeling; United States; Vaccination; Vaccination hesitancy; Vaccine hesitancy; Vaccines; Variables; United States; New Zealand; England; Canada; Australia; COVID-19; Conspiracy beliefs; Health beliefs model; Immunization; Vaccination hesitancy; Structural equation model
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2021.07.056

The development of COVID-19 vaccines is occurring at unprecedented speeds, but require high coverage rates to be successful. This research examines individuals’ psychological beliefs that may act as enablers and barriers to vaccination intentions. Using the health beliefs model as a guide to our conceptual framework, we explore factors influencing vaccine hesitancy and health beliefs regarding risks and severity of the disease, along with individual variables such as income, age, religion, altruism, and collectivism. A questionnaire using newly created measures for various antecedents provided 4303 usable responses from Australia, Canada, England, New Zealand, and the United States. A factor analytic and structural equation model indicates that trust in vaccine approval, the perceived effectiveness of the vaccine for protecting others, and conspiracy beliefs are the most significant drivers of intentions to vaccinate. Older people, those seeking employment, and those who have received a recent influenza vaccine are more likely to be vaccinated against COVID-19. The findings have implications for improving communication strategies targeting individuals about the merits of vaccination, particularly focusing on younger individuals and expanded message framing to include altruistic considerations, and to improve government transparency regarding the effectiveness and side effects of vaccines.