Using the health belief model to explain COVID-19 vaccination hesitancy in Dutch urban citizens under thirty

BACKGROUND: Worldwide the Covid-19 pandemic resulted in drastic behavioral measures and lockdowns. Vaccination is widely regarded as the true and only global exit strategy; however, a high vaccination coverage is needed to contain the spread of the virus. Vaccination rates among young people are currently lacking. We therefore studied the experienced motivations and barriers regarding vaccination in young people with the use of the health belief model. METHODS: We conducted a correlational study, based on a convenience sample. At the vaccination location, directly after vaccination, 194participants(16–30 years) who decided to get vaccinated at a pop-up location several weeks after receiving a formal invitation, filled out a questionnaire regarding their attitudes towards vaccination based on concepts defined in the health belief model. We used these concepts to predict vaccination hesitancy. RESULTS: Younger participants and participants with lower educational levels report higher levels of hesitancy regarding vaccination (low education level = 38.9%, high education level = 25.4%). Perceived severity (M(hesitancy) = .23, M(no hesitancy) = .37) and susceptibility (M(hesitancy) = .38, M(no hesitancy) = .69) were not associated with hesitancy. Health related and idealistic benefits of vaccination were negatively associated with experienced hesitancy (M(hesitancy) = .68, M(no hesitancy) = -.37), while individualistic and practical benefits were not associated with hesitancy (M(hesitancy) = -.09, M(no hesitancy) = .05). Practical barriers were not associated with hesitancy (M(hesitancy) = .05, M(no hesitancy) = -.01), while fear related barriers were strongly associated with hesitancy (M(hesitancy) = -.60, M(no hesitancy) = .29). CONCLUSIONS: Health related, and idealistic beliefs are negatively associated with experienced hesitancy about vaccination, while fear related barriers is positively associated with experienced hesitancy. Future interventions should focus on these considerations, since they can facilitate or stand in the way of vaccination in young people who are doubting vaccination, while not principally opposed to it.