A Psychosocial Model of COVID-19 Vaccination: Antecedent and Concurrent Effects of Demographics, Traits, Political Beliefs, Vaccine Intention, Information Sources, Mandates, and Flu Vaccine History

Background To date, research investigating psychosocial correlates of COVID-19 vaccination has been cross-sectional, parochial, and/or reliant upon non-stratified international samples, resulting in difficulty in clarifying the contributions of various vaccination-related influences. Purpose The present study tested a novel integration of prospective and concurrent associations of demographic and dispositional tendencies, intervening illness and preventive beliefs, vaccine intention, illness experiences, and concurrent contextual vaccine-related influences with subsequent COVID-19 vaccination. Methods The preregistered study used a stratified online U.S. sample (N = 500), with assessments aligned to (a) 15 days to slow the spread in March 2020, (b) vaccine authorization and major case/mortality surge during December 2020 and January 2021, and (c) the period following full vaccine approval in August 2021 during the third major/case mortality surge during September and October 2021. Results Path modeling showed the absence of children in the household and greater education were prospective predictors of vaccination. Trait openness and less conservative political beliefs showed indirect prospective associations with vaccination via stronger intermediating vaccine intention. Contextual vaccine-related influences of vaccine-related information sources, employer mandates, and flu vaccine history also showed direct associations with vaccination. In contrast to expectations, lower conscientiousness showed a direct prospective association with vaccination. Conclusions Controlling for interrelations among study variables, the results of the integrative psychosocial model clarified the unique contributions and pathways from antecedent characteristics to vaccination while accounting for vaccine-related contextual influences, providing further direction for refining the timing and content of public health messaging for vaccination. Lay Summary The present study used 3 assessments across 18 months to investigate psychosocial and behavioral predictors of COVID-19 vaccination in a stratified U.S. sample. Consistent with preregistered hypotheses, the absence of children in the household and greater education assessed in March 2020, predicted vaccination by the fall of 2021. Greater vaccination intention during the Delta surge from December 2020 to January 2021 (prior to widespread vaccine availability), predicted vaccination by the fall of 2021. In addition, greater trait openness (curious, reflective) and less conservative political beliefs assessed during March 2020, predicted vaccination through stronger vaccination intention. Employer vaccine mandates, a stronger history of flu vaccination, and the use of more reliable health information sources for COVID-19 vaccines also predicted greater vaccination. Contrary to expectations, greater conscientiousness (careful, thorough) assessed during March 2020, predicted less vaccination by the fall of 2021. Notably, the results suggest that for some parents, general vaccine concerns, however, misinformed, may have extended to the consideration of COVID-19 vaccines for themselves. Moreover, for more careful and thorough individuals, novel vaccine hesitancy may be an expression of perceived harm avoidance that is specific to the vaccine, rather than to perceived risks of infection or illness.

Automated summary

This study examined psychosocial and behavioral predictors of COVID-19 vaccination in a stratified U.S. sample over a span of 18 months. The results indicated that the absence of children in the household and higher education level were prospective factors predicting vaccination. Greater vaccination intention during the assessment period from December 2020 to January 2021 predicted vaccination in the fall of 2021. Additionally, greater openness and less conservative political beliefs were found to predict vaccination through stronger intention. Employer mandates, flu vaccine history, and reliable health information sources were also predictors of higher vaccination rates. Contrary to expectations, greater conscientiousness predicted lower vaccination rates.