The Health Belief Model Perspective of Perceived Facilitators and Barriers of COVID-19 Vaccine Hesitancy
DOI:
https://doi.org/10.63682/jns.v14i31S.9282Keywords:
Covid-19, Vaccine Hesitancy, Vaccination, Perceived Severity, Perceived Susceptibility, Perceived BarriersAbstract
This study examined COVID-19 vaccine hesitancy through the lens of the Health Belief Model, focusing on perceived barriers and facilitators to vaccination. The study included 380 individuals aged 18 to 60 years, selected through convenience sampling. Data were collected using a self-administered questionnaire and analyzed with SPSS. Of the 373 participants included in the final analysis, all were male, with 33.1% identifying as female and 66.9% as male, suggesting a possible reporting or sampling inconsistency. Educational backgrounds varied, with 4.8% being illiterate, 4.3% having completed primary education, 24.4% holding a graduate degree, and 41.0% possessing a postgraduate qualification. Vaccine hesitancy was relatively low, reported by only 10.8% of respondents. In terms of perceived susceptibility, nearly half of the participants felt vulnerable to contracting COVID-19 in the future. Regarding perceived severity, 57.9% believed COVID-19 to be harmful, and 66.2% viewed it as life-threatening. As for perceived benefits, 73.7% believed the vaccine could protect them from infection, and 67% felt it was also safe for their family members. These findings suggest that overall vaccine hesitancy was minimal in the study population, with most individuals recognizing both the severity of COVID-19 and the benefits of vaccination
Downloads
References
World Health Organization. COVID-19 weekly epidemiological update, edition 73, 6 January 2022.
Mahmud S, Mohsin M, Khan IA, Mian AU, Zaman MA. Knowledge, beliefs, attitudes and perceived risk about COVID-19 vaccine and determinants of COVID-19 vaccine acceptance in Bangladesh. PloS one. 2021 Sep 9;16(9):e0257096.
Experts: China's vaccine adverse reaction monitoring system will continue to track the relevant situation after COVID-19 vaccination. Government of the People's Republic of China. 2021. [2021-08-13]. http://www.gov.cn/xinwen/2021-01/03/content_5576402.htm
Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2020;27:1–4.
Neumann-Böhme S, Varghese NE, Sabat I, Barros PP, Brouwer W, van Exel J, Schreyögg J, Stargardt T. Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur J Health Econ. 2020 Sep;21(7):977–982. doi: 10.1007/s10198-020-01208-6. http://europepmc.org/abstract/MED/32591957 .10.1007/s10198-020-01208-6
Guidry JP, Laestadius LI, Vraga EK, Miller CA, Perrin PB, Burton CW, Ryan M, Fuemmeler BF, Carlyle KE. Willingness to get the COVID-19 vaccine with and without emergency use authorization. Am J Infect Control. 2021 Feb;49(2):137–142. doi: 10.1016/j.ajic.2020.11.018. http://europepmc.org/abstract/MED/33227323 .S0196-6553(20)31002-6
Mahmud S, Mohsin M, Khan IA, Mian AU, Zaman MA. Knowledge, beliefs, attitudes and perceived risk about COVID-19 vaccine and determinants of COVID-19 vaccine acceptance in Bangladesh. PloS one. 2021 Sep 9;16(9):e0257096.
Al-Mohaithef M, Padhi BK. Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey. J Multidiscip Healthc. 2020;13: 1657–1663. pmid:33262600
Sherman SM, Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, Rubin GJ, Sevdalis N. COVID-19 vaccination intention in the UK: Results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccin Immunother. 2021 Jun 03;17(6):1612–1621. doi: 10.1080/21645515.2020.1846397. http://europepmc.org/abstract/MED/33242386 .
Mo PK, Luo S, Wang S, Zhao J, Zhang G, Li L, Li L, Xie L, Lau JTF. Intention to receive the COVID-19 vaccination in China: Application of the diffusion of innovations theory and the moderating role of openness to experience. Vaccines (Basel) 2021 Feb 05;9(2):129. doi: 10.3390/vaccines9020129. https://www.mdpi.com/resolver?pii=vaccines9020129 .vaccines9020129
Coe AB, Gatewood SB, Moczygemba LR, Goode J"R, Beckner JO. The use of the health belief model to assess predictors of intent to receive the novel (2009) H1N1 influenza vaccine. Innov Pharm. 2012;3(2):1–11. doi: 10.24926/iip.v3i2.257. http://europepmc.org/abstract/MED/22844651
Wong LP, Alias H, Wong P, Lee HY, AbuBakar S. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum Vaccin Immunother. 2020 Sep 01;16(9):2204–2214. doi: 10.1080/21645515.2020.1790279. http://europepmc.org/abstract/MED/32730103
Mercadante AR, Law AV. Will they, or won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model. Res Social Adm Pharm. 2021 Sep;17(9):1596–1605. doi: 10.1016/j.sapharm.2020.12.012. http://europepmc.org/abstract/MED/33431259 .S1551-7411(20)31240-7
Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q. 1988;15(2):175–183. doi: 10.1177/109019818801500203
Jaafari, S. (2021). The biggest challenge for vaccine workers in Pakistan? Staying alive. The World. www.pri.org/stories/2021-03-02/biggest-challenge-vaccine-workers-pakistan-staying-alive
Hadid, D. (2021). Pakistan's vaccine worries: Rich people and conspiracy theorists. NPR. www.npr.org/sections/goatsandsoda/2021/01/29/961258106/pakistans-vaccine-worries-rich-people-and-conspiracy-theorists
Chen H, Li X, Gao J, Liu X, Mao Y, Wang R, Zheng P, Xiao Q, Jia Y, Fu H, Dai J. Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study. J Med Internet Res. 2021 Sep 6;23(9):e29329. doi: 10.2196/29329. PMID: 34280115; PMCID: PMC8425399.
Hochbaum GM. Public participation in medical screening programs: A socio-psychological study. US Department of Health, Education, and Welfare, Public Health Service, Bureau of State Services, Division of Special Health Services, Tuberculosis Program; 1958.
Rosenstock. (1960). What research in motivation suggests for public health. American Journal of Public Health and the Nations Health, 50(3_Pt_1), 295-302.
Rosenstock. (1966). Why people use health services. The Milbank Memorial Fund Quarterly, 44(3), 94-127.
Rosenstock. (1974a). The Health Belief Model and Preventive Health Behavior. Health Education & Behavior, 2(4), 354.
Lewin, K. (1935). A dynamic theory of personality-selected papers. New York, NY: McGraw Hill.
Maiman, & Becker. (1974). The Health Belief Model: Origins and Correlates in Psychological Theory*. Health Education & Behavior, 2(4), 336. doi:10.1177/109019817400200404
Waxman JG, Makov-Assif M, Reis BY, Netzer D, Balicer RD, Dagan N, Barda N. Comparing COVID-19-related hospitalization rates among individuals with infection-induced and vaccine-induced immunity in Israel. Nature communications. 2022 Apr 22;13(1):1-6.
Marfe G, Perna S, Shukla AK. Effectiveness of COVID 19 vaccines and their challenges. Experimental and Therapeutic Medicine. 2021 Dec 1;22(6):1-9.
Mercadante AR, Law AV. Will they, or Won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model. Research in Social and Administrative Pharmacy. 2021 Sep 1;17(9):1596-605.
Al‐Metwali BZ, Al‐Jumaili AA, Al‐Alag ZA, Sorofman B. Exploring the acceptance of COVID‐19 vaccine among healthcare workers and general population using health belief model. Journal of evaluation in clinical practice. 2021 Oct;27(5):1112-22.
Tao L, Wang R, Han N, Liu J, Yuan C, Deng L, Han C, Sun F, Liu M, Liu J. Acceptance of a COVID-19 vaccine and associated factors among pregnant women in China: a multi-center cross-sectional study based on health belief model. Human Vaccines & Immunotherapeutics. 2021 Aug 3;17(8):2378-88.
Mahmud I, Kabir R, Rahman MA, Alradie-Mohamed A, Vinnakota D, Al-Mohaimeed A. The health belief model predicts intention to receive the covid-19 vaccine in saudi arabia: Results from a cross-sectional survey. Vaccines. 2021 Aug 5;9(8):864.
Fall E, Izaute M, Chakroun-Baggioni N. How can the health belief model and self-determination theory predict both influenza vaccination and vaccination intention? A longitudinal study among university students. Psychology & health. 2018 Jun 3;33(6):746-64.
Shmueli, L. Predicting intention to receive COVID-19 vaccine among the general population using the health belief model and the theory of planned behavior model. BMC Public Health 21, 804 (2021). https://doi.org/10.1186/s12889-021-10816-7
Lin Y, Hu Z, Zhao Q, Alias H, Danaee M, Wong LP. Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China. PLoS neglected tropical diseases. 2020 Dec 17;14(12):e0008961.
Wang J, Zhang Y, Long S, Fu X, Zhang X, Zhao S, Xiu S, Wang X, Lu B, Jin H. Non-EPI vaccine hesitancy among Chinese adults: a cross-sectional study. Vaccines. 2021 Jul 10;9(7):772.
Greyling T, Rossouw S. Positive attitudes towards COVID-19 vaccines: A cross-country analysis. PLoS One. 2022 Mar 10;17(3):e0264994. doi: 10.1371/journal.pone.0264994. PMID: 35271637; PMCID: PMC8912241.
Kumari A, Ranjan P, Chopra S, Kaur D, Kaur T, Upadhyay AD, Isaac JA, Kasiraj R, Prakash B, Kumar P, Dwivedi SN, Vikram NK. Knowledge, barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: A cross-sectional survey from one thousand two hundred and forty-nine participants. Diabetes Metab Syndr. 2021 May-Jun;15(3):987-992. doi: 10.1016/j.dsx.2021.04.015. Epub 2021 May 1. PMID: 33984818; PMCID: PMC8087578.
Emily Hallgren, Ramey Moore, Rachel S. Purvis, Spencer Hall, Don E. Willis, Sharon Reece, Sheena CarlLee, Morgan Gurel-Headley & Pearl A. McElfish (2021) Facilitators to vaccination among hesitant adopters, Human Vaccines & Immunotherapeutics, 17:12, 5168-5175, DOI: 10.1080/21645515.2021.2010427
Mental health Covid-19 (2020). Survey Results: Understanding People’s Concerns About the Mental Health Impacts of the COVID-19 Pandemic. Available online at: https://acmedsci.ac.uk/file-download/99436893 (accessed May 26, 2020).
Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., et al. (2020). Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J. Am. Acad. Child Adolesc. Psychiatry doi: 10.1016/j.jaac.2020.05.009
Khan KS, Mamun MA, Griffiths MD, Ullah I. The mental health impact of the COVID-19 pandemic across different cohorts. International journal of mental health and addiction. 2020 Jul 9:1-7.
Mertens G, Lodder P, Smeets T, Duijndam S. Fear of COVID-19 predicts vaccination willingness 14 months later. Journal of Anxiety Disorders. 2022 May 1;88:102574.
Elhadi, M., Alsoufi, A., Alhadi, A. et al. Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine: a cross-sectional study. BMC Public Health 21, 955 (2021). https://doi.org/10.1186/s12889-021-10987-3
Ababu Y, Braka F, Teka A, Getachew K, Tadesse T, Michael Y, Birhanu Z, Nsubuga P, Assefa T, Gallagher K. Behavioral determinants of immunization service utilization in Ethiopia: a cross-sectional community-based survey. The Pan African Medical Journal. 2017;27(Suppl 2).
Purvis RS, Hallgren E, Moore RA, Willis DE, Hall S, Gurel-Headley M, McElfish PA. Trusted Sources of COVID-19 Vaccine Information among Hesitant Adopters in the United States. Vaccines (Basel). 2021 Dec 1;9(12):1418. doi: 10.3390/vaccines9121418. PMID: 34960164; PMCID: PMC8706404.
Syed Alwi, S.A.R., Rafidah, E., Zurraini, A. et al. A survey on COVID-19 vaccine acceptance and concern among Malaysians. BMC Public Health 21, 1129 (2021). https://doi.org/10.1186/s12889-021-11071-6
Chen H, Li X, Gao J, Liu X, Mao Y, Wang R, Zheng P, Xiao Q, Jia Y, Fu H, Dai J, Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study, J Med Internet Res 2021;23(9):e29329
Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2021 Feb;27(2):225-228
Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM. Parental vaccine safety concerns in 2009. Pediatrics 2010 Apr;125(4):654-659
Moran KR, Del Valle SY. A meta-analysis of the association between gender and protective behaviors in response to respiratory epidemics and pandemics. PLoS One 2016;11(10):e0164541
Karafillakis, E. , & Larson, H. J. (2017). The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine, 35(37), 4840–4850.
Karlsson, L. C. , Soveri, A. , Lewandowsky, S. , Karlsson, L. , Karlsson, H. , Nolvi, S. , Karukivi, M. , Lindfelt, M. , & Antfolk, J. (2020). Fearing the disease or the vaccine: The case of COVID‐19. PsyArXiv. 10.31234/osf.io/7n3gt
Sherman, S. M. , Smith, L. E. , Sim, J. , Amlôt, R. , Cutts, M. , Dasch, H. , Rubin, G.G. , & Sevdalis, N. (2020). COVID‐19 vaccination intention in the UK: Results from the COVID‐19 Vaccination Acceptability Study (CoVAccS), a nationally representative cross‐sectional survey. medRxiv, 10.1101/2020.08.13.20174045
Zampetakis LA, Melas C. The health belief model predicts vaccination intentions against COVID-19: A survey experiment approach. Appl Psychol Health Well Being. 2021 May;13(2):469-484. doi: 10.1111/aphw.12262. Epub 2021 Feb 26. PMID: 33634930; PMCID: PMC8014148.
Dror AA, Eisenbach N, Taiber S, Morozov NG, Mizrachi M, Zigron A, et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. Eur J Epidemiol. 2020;35(8):775–9. https://doi.org/10.1007/s10654-020-00671-y.
Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: how many people would get vaccinated? Vaccine. 2020;38(42):6500–7. https://doi.org/10.1016/j.vaccine.2020.08.043.
Khalid S, Usmani BA and Siddiqi S (2022) COVID-19 Vaccine Hesitancy in Pakistan: A Mini Review of the Published Discourse. Front. Public Health 10:841842. doi: 10.3389/fpubh.2022.841842
Tahir, M.J., Saqlain, M., Tariq, W. et al. Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan. BMC Public Health 21, 1759 (2021). https://doi.org/10.1186/s12889-021-11814-5
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.