The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia

BACKGROUND: SARS-COV-2 (COVID-19) has severely impacted people's health worldwide. Vaccines are one of the health measures taken to reduce the impact of COVID-19, but recent reports have revealed that some people are reluctant to be vaccinated against COVID-19. Understanding the factors underlying an individual’s decision to take the COVID-19 vaccine is critical to designing an immunisation programme. This study examines factors that influence the intention to take a COVID-19 vaccine using the modified Health Belief Model (HBM) framework and analysing demographic factors. METHOD: A cross-sectional online survey was conducted from 10 January to 20 January 2021. Five hundred thirty-seven respondents above 17 years old and residing in Indonesia voluntarily completed an online survey. Survey questions addressed sociodemographic factors; perception of susceptibility, severity, benefits and barriers; cues to action; and intention to take the COVID-19 vaccine. A Structural Equation Modelling (SEM) approach with SmartPLS software was used to analyse the measurements and model construct. FINDINGS: The results showed that the perception of susceptibility, severity, benefits and barriers, as well as cues to action, predicted people’s intention to take a COVID-19 vaccine. Model structure explained a large proportion of variance in people’s intention to be vaccinated against COVID-19 (R(2) = 66.8 %). Some demographic factors affected the key variables of the HBM. People with low and middle income negatively influence feeling severity, beneficial and barrier in intending to take vaccine. Other demographic factors such as sex, age, marriage and living areas did not affect the components of the HBM, except for females influencing severity and people living in urban areas associated with benefits variable. These findings imply that COVID-19 vaccination programmes should focus on providing accurate information about the severity of COVID-19 and the benefits of taking the vaccine. Building people’s confidence in their ability to eliminate barriers to taking the vaccine and involving family members and community and religious leaders will increase COVID-19 vaccine uptake. CONCLUSION: Despite limitations to the study, such as respondent demographics that are unrepresentative of the wider Indonesian population, inadequate survey timing and an exclusive focus on vaccine intention as the outcome variable, the present study contributes to explaining individuals’ intentions to take a COVID-19 vaccine in a Eastern country context. This study is valuable to providing public health policy recommendations that focus on effectively designing immunisation programme interventions.