Predicting COVID-19 Vaccination Intentions Among UK Parents Using Protection Motivation Theory
DOI:
https://doi.org/10.64074/jorma003Keywords:
COVID-19 vaccination, Protection Motivation Theory, vaccine hesitancy, parental attitudes, childhood immunizationAbstract
Parents’ intentions to vaccinate their children against COVID-19 remain a critical factor in achieving sufficient immunization coverage. Understanding the psychological and social factors that influence vaccination decisions is essential for developing effective public health strategies. This study applied Protection Motivation Theory (PMT) to examine predictors of COVID-19 vaccination intention among parents of young children in the UK. Key constructs of PMT, threat appraisal, and coping appraisal were evaluated alongside sociodemographic variables to identify the strongest determinants of parental vaccine acceptance. A cross-sectional online survey was conducted among 774 parents and guardians of children aged 0–6 years in the UK. Participants responded to a validated PMT questionnaire measuring intention, perceived severity, susceptibility, self-efficacy, response efficacy, response costs, intrapersonal characteristics, and past experience. Sociodemographic data were also collected. Hierarchical logistic regression analyses were performed to assess the relative importance of these factors. The results showed that disease severity, intrapersonal characteristics, past experience, response efficacy, and response costs were the most influential predictors of COVID-19 vaccination intention. While sociodemographic factors such as age and gender had some predictive value, the PMT constructs, particularly severity and efficacy-related measures, provided more robust insights into parental decision-making processes. The final regression model explained 35.5% of the variance in vaccination intention. This study highlights the importance of PMT constructs in understanding parental COVID-19 vaccination intentions. Interventions should focus on increasing awareness of disease severity, enhancing confidence in vaccine efficacy, and addressing perceived response costs. Public health campaigns tailored to these psychological factors, coupled with transparent communication from trusted healthcare providers, are likely to be more effective in reducing vaccine hesitancy among parents in the UK.
References
Abdelamir, A.S. & Hafidh, R.R., (2020). The Possible Immunological Pathways for the Variable Immunopathogenesis of COVID-19 Infections among Healthy Adults, Elderly and Children. Electronic Journal of General Medicine, 17(4), em202.
Abedin, M., Islam, M.A., Rahman, F.N., et al., (2021). COVID-19 vaccine hesitancy and related factors among Bangladeshi adults: a cross-sectional survey. PLOS ONE, 16(8), e0257096.
Abejegah, C., Obohwemu, K.O. and Mdegela, M., (2024). Clinical manifestations and outcome of human mpox infection from 1970 to 2023. A systematic literature review. Clinical Infection in Practice, p.100397.
Al-Regaiey, K., et al., (2022). Social media misinformation and vaccine hesitancy: The spread and influence of misinformation during the COVID-19 pandemic. Journal of Infection and Public Health, 15(5), pp.585–591.
Alwreikat, A., Shehata, A. & Edakar, M., (2021). Parental acceptance of COVID-19 vaccines for children: a Protection Motivation Theory-based study. Journal of Pediatric Health Care, 35(5), pp.452–459.
Anderson, R.M., Heesterbeek, H., Klinkenberg, D. & Hollingsworth, T.D., (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic?. The Lancet, 395(10228), pp.931–934.
Andersson, O., Campos-Mercade, P., Meier, A.N. & Wengström, E., (2022). Anticipation of COVID-19 vaccines reduces willingness to socially distance. Journal of Health Economics, 82, 102581.
Azizi, S.M., et al., (2017). Application of the protection motivation theory to predict COVID-19 preventive behaviours in the Iranian population. BMC Public Health, 21(1), pp.1–9.
Baumgaertner, B., Carlisle, J.E. & Justwan, F. (2018) The influence of political ideology and trust on willingness to vaccinate. PLOS ONE, 13(1), e0191728.
Bell, S., Clarke, R., Mounier-Jack, S., et al. (2020) Parents’ and guardians’ views on the acceptability of a future COVID-19 vaccine: a multi-methods study in England. Vaccine, 38(49), pp.7789–7798.
Betsch, C., Renkewitz, F., Betsch, T. & Ulshöfer, C. (2015) The influence of vaccine-critical websites on perceiving vaccination risks. Journal of Health Psychology, 15(3), pp.446–455.
Bianco, A., Mascaro, V., Zucco, R. & Pavia, M. (2014) Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal? Italian Journal of Pediatrics, 40(1), pp.1–7.
Bianco, A., Zucco, R., Pileggi, C., et al. (2019) Analyzing public health communication: The vaccine hesitancy phenomenon. Human Vaccines & Immunotherapeutics, 15(7–8), pp.1636–1643.
Bish, A. & Michie, S. (2010) Demographic and attitudinal determinants of protective behaviours during a pandemic: A review. British Journal of Health Psychology, 15(4), pp.797–824.
Bish, A., Yardley, L., Nicoll, A. & Michie, S. (2011) Factors associated with uptake of vaccination against pandemic influenza: A systematic review. Vaccine, 29(38), pp.6472–6484.
Britt, R.K., Hatten, K.N., Chappuis, S.O., et al. (2014) Using protection motivation theory and health literacy to communicate effective COVID-19 preventive measures in social media. Health Communication Research, 29(4), pp.335–348.
Bults, M., Beaujean, D.J.M.A., Richardus, J.H. & Voeten, H.A.C.M. (2011) Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands: results of three consecutive online surveys. BMC Public Health, 11, p.2.
Camerini, A.L., Diviani, N., Fadda, M. & Schulz, P.J. (2019) Using protection motivation theory to predict intention to adhere to official MMR vaccination recommendations in Switzerland. SSM - Population Health, 7, 100321.
Casiday, R.E. (2007) Children’s health and the social theory of risk: exploring the implications of parents’ involvement in health research. Health, Risk & Society, 9(1), pp.47–63.
CDC (2010) Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, United States. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html [Accessed 17 Apr. 2025].
Chen, X., et al. (2021) COVID-19 vaccine hesitancy among parents in Hong Kong. Human Vaccines & Immunotherapeutics, 17(11), pp.3993–3998.
Chinazzi, M., Davis, J.T., Ajelli, M., et al. (2020) The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science, 368(6489), pp.395–400.
Chow, M.Y.K., Danchin, M., Willaby, H.W., et al. (2017) Parental attitudes, beliefs, behaviours and concerns towards childhood vaccinations in Australia: a national online survey. Australian Family Physician, 46(3), pp.145–151.
Collange, F., Verger, P., Launay, O., et al. (2016) Determinants of parental acceptance of H1N1 vaccination: a qualitative approach. Vaccine, 34(5), pp.642–648.
Cordina, M. & Lauri, M.A. (2021) COVID-19 vaccine hesitancy and the role of pharmacotherapy education: A cross-sectional study in Malta. Pharmacy Practice, 19(2), 2252.
D'Alessandro, A., Napolitano, F. and Angelillo, I.F. (2018) Vaccine hesitancy among parents of children with and without chronic conditions. Health Education & Behaviour, 45(5), pp.768–776.
Desmond, H. and Dierickx, K. (2021) Ethical issues in public health research. Bioethics, 35(2), pp.142–149.
Dinga, J.N., Sinda, L.K. and Titanji, V.P.K. (2021) Assessment of vaccine hesitancy in Cameroon: a national survey. The Pan African Medical Journal, 38, p.403.
Dong, E., Du, H. and Gardner, L. (2020) An interactive web-based dashboard to track COVID-19 in real time. The Lancet Infectious Diseases, 20(5), pp.533–534.
Dror, A.A., Eisenbach, N., Taiber, S., Morozov, N.G., Mizrachi, M., Zigron, A., Srouji, S. and Sela, E. (2020) Vaccine hesitancy: the next challenge in the fight against COVID-19. European Journal of Epidemiology, 35(8), pp.775–779.
Dubé, E., Gagnon, D., MacDonald, N.E. and the SAGE Working Group on Vaccine Hesitancy (2018) Strategies intended to address vaccine hesitancy: Review of published reviews. Vaccine, 33(34), pp.4191–4203.
Dubé, E., MacDonald, N.E., Guay, M. and Gagnon, D. (2021) Mapping vaccine hesitancy—Country-specific characteristics of a global phenomenon. Vaccine, 39(42), pp.6392–6399.
Dubé, E., Vivion, M. and MacDonald, N.E. (2016) Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Review of Vaccines, 14(1), pp.99–117.
Eberhardt, J. and Ling, J. (2021a) Predicting COVID-19 vaccination intention using protection motivation theory and conspiracy beliefs. Vaccine, 39(42), pp.6269–6275.
Eberhardt, J. and Ling, J. (2021b) The role of cognitive appraisals and cultural values in predicting COVID-19 vaccine hesitancy. Journal of Health Psychology. Advance online publication.
Eberhardt, J. and Ling, J. (2022) Health belief model and COVID-19 vaccination: A longitudinal study. Journal of Public Health, 44(1), pp.e45–e53.
Ernsting, C., Gellert, P., Oedekoven, M., O'Sullivan, J.L., Kanzler, M., Kuhlmey, A. and Schnitzer, S. (2011) Using the Protection Motivation Theory to predict intentions to receive the seasonal influenza vaccination. Medical Decision Making, 31(5), pp.650–662.
Etikan, I., Alkassim, R.S. and Abubakar, S. (2016) Comparisons of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), pp.1–4.
Etikan, I., Musa, S.A. and Alkassim, R.S. (2016) Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), pp.1–4.
Faasse, K. and Newby, J.M. (2020) Public perceptions of COVID-19 in Australia: perceived risk, knowledge, health-protective behaviours, and vaccine intentions. Frontiers in Psychology, 11, p.551004.
Floyd, D.L., Prentice-Dunn, S. and Rogers, R.W. (2000) A meta-analysis of research on Protection Motivation Theory. Journal of Applied Social Psychology, 30(2), pp.407–429.
Freimuth, V.S., Jamison, A.M., An, J., Hancock, G.R. and Quinn, S.C. (2017) Determinants of trust in the flu vaccine for African Americans and Whites. Social Science & Medicine, 193, pp.70–79.
Fuchs, C. (2018) Digital Demagogue: Authoritarian Capitalism in the Age of Trump and Twitter. London: Pluto Press.
Gilkey, M.B., Calo, W.A., Marciniak, M.W. and Brewer, N.T. (2013) Parents who refuse or delay HPV vaccine: differences in vaccination behaviour, beliefs, and clinical communication preferences. Human Vaccines & Immunotherapeutics, 9(11), pp.2529–2536.
Goldman, R.D., Yan, T.D., Seiler, M., Cotanda, C.P., Brown, J.C., Klein, E.J., Hoeffe, J., Gelernter, R., Hall, J.E. and Griffiths, M.A. (2020) Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey. Vaccine, 38(48), pp.7668–7673.
Goodwin, R., Haque, S., Neto, F. and Myers, L.B. (2010) Initial psychological responses to Influenza A, H1N1 (‘Swine flu’). BMC Infectious Diseases, 10(1), p.166.
Grano, C., Singh, D. and Di Pucchio, A. (2022) Psychological predictors of COVID-19 vaccination intentions in the UK population. Vaccines, 10(1), p.14.
Han, P.K.J., Moser, R.P. and Klein, W.M. (2016) Perceived ambiguity about cancer prevention recommendations: Associations with cancer-related perceptions and behaviours in a US population survey. Health Expectations, 19(1), pp.3–15.
Heininger, U. (2006) An internet-based survey on parental attitudes towards immunization. Vaccine, 24(37–39), pp.6351–6355.
Heininger, U. (2009) Understanding parents' fears: the key to successful immunization. Pediatric Infectious Disease Journal, 28(8 Suppl), pp.S80–S82.
Henrikson, N.B., Opel, D.J., Grothaus, L., Nelson, J., Scrol, A., Dunn, J. and Grossman, D.C. (2017) Physician communication training and parental vaccine hesitancy: a randomized trial. Pediatrics, 139(1), p.e20162103.
Idowu, T.O., Obohwemu, K.O. and Iyevhobu, K.O., (2024). Knowledge, attitudes and practices of mothers towards childhood vaccination in Lagos State, Nigeria. International Journal of Medical Science and Public Health Research, 5(09), pp.69-100.
Institute of Medicine (IOM). (2004) Immunization safety review: Vaccines and autism. Washington, DC: The National Academies Press.
Kata, A. (2012) 'Anti-vaccine activists, Web 2.0, and the postmodern paradigm—An overview of tactics and tropes used online by the anti-vaccination movement', Vaccine, 30(25), pp. 3778–3789. https://doi.org/10.1016/j.vaccine.2011.11.112
Kayode, M., Ajisegiri, S. W., Ogbonna, C. U., and Adepoju, K. A. (2022) 'Information sources and COVID-19 vaccine hesitancy in sub-Saharan Africa: The Nigerian perspective', BMC Public Health, 22, 843. https://doi.org/10.1186/s12889-022-13310-z
Khatatbeh, M., Khasawneh, A. I., Alhalaiqa, F., et al. (2022) 'Factors associated with COVID-19 vaccine acceptance among healthcare providers in Jordan', PLOS ONE, 17(5), e0269254. https://doi.org/10.1371/journal.pone.0269254
Khosravi, M. (2020) 'Perceived risk of COVID-19 pandemic: The role of public worry and trust', Electronic Journal of General Medicine, 17(4), em203. https://doi.org/10.29333/ejgm/7856
Ko, N. Y., Lu, W. H., Chen, Y. L., et al. (2020) 'COVID-19-related information sources and the relationship with confidence in people coping with COVID-19: Facebook survey study in Taiwan', Journal of Medical Internet Research, 22(6), e20021. https://doi.org/10.2196/20021
Kreps, S. and Kriner, D. L. (2021) 'Model uncertainty, political contestation, and public trust in science: Evidence from the COVID-19 pandemic', Science Advances, 7(1), eabd4563. https://doi.org/10.1126/sciadv.abd4563
Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J. and Hsueh, P. R. (2020) 'Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges', International Journal of Antimicrobial Agents, 55(3), 105924. https://doi.org/10.1016/j.ijantimicag.2020.105924
Le, T. T., Andreadakis, Z., Kumar, A., et al. (2020) 'The COVID-19 vaccine development landscape', Nature Reviews Drug Discovery, 19(5), pp. 305–306. https://doi.org/10.1038/d41573-020-00073-5
Lee, B. Y., Bartsch, S. M., Wong, K. F., et al. (2020) 'Simulation shows that early vaccination of children against COVID-19 can decrease cases, hospitalizations, and deaths across all age groups', Health Affairs, 40(2), pp. 302–310. https://doi.org/10.1377/hlthaff.2020.01530
Leventhal, H. (1970) 'Findings and theory in the study of fear communications', Advances in Experimental Social Psychology, 5, pp. 119–186. https://doi.org/10.1016/S0065-2601(08)60091-X
Li, H. O., Bailey, A., Huynh, D. and Chan, J. (2020) 'YouTube as a source of information on COVID-19: A pandemic of misinformation?', BMJ Global Health, 5(5), e002604. https://doi.org/10.1136/bmjgh-2020-002604
Limaye, R. J., Sauer, M., Ali, J., et al. (2021) 'Building trust while influencing online COVID-19 content in the social media world', The Lancet Digital Health, 3(6), pp. e359–e360. https://doi.org/10.1016/S2589-7500(21)00082-7
Ling, J., Eberhardt, J. and Sanderson, M. (2019) 'Predicting intention to receive influenza vaccination using Protection Motivation Theory', Health Promotion Perspectives, 9(1), pp. 1–8. https://doi.org/10.15171/hpp.2019.01
Lippke, S. and Ziegelmann, J. P. (2008) 'Theory-based health behaviour change: Developing, testing, and applying theories for evidence-based interventions', Applied Psychology: An International Review, 57(4), pp. 698–716. https://doi.org/10.1111/j.1464-0597.2008.00339.x
Liu, P. L., Liang, J. and Hsieh, C. H. (2016) 'Applying protection motivation theory to understand hepatitis B vaccination intentions among migrant workers', BMC Public Health, 16, 1243. https://doi.org/10.1186/s12889-016-3880-6
Lourenco, J., Paton, R., Ghafari, M., et al. (2020) 'Fundamental principles of epidemic spread highlight the immediate need for large-scale serological surveys to assess the stage of the SARS-CoV-2 epidemic', medRxiv. https://doi.org/10.1101/2020.03.24.20042291
Napolitano, F., D’Alessandro, A., Angelillo, I. F. (2016) 'Knowledge, attitudes, and practices of parents towards varicella and its vaccination', BMC Infectious Diseases, 16, 356. https://doi.org/10.1186/s12879-016-1703-y
Napolitano, F., D'Alessandro, A., Angelillo, I. F. (2018) 'Investigating Italian parents’ vaccine hesitancy: A cross-sectional survey on childhood immunizations', Human Vaccines & Immunotherapeutics, 14(7), pp. 1558–1565. https://doi.org/10.1080/21645515.2018.1458505
Obohwemu, K., Christie-de Jong, F. and Ling, J., (2022). Parental childhood vaccine hesitancy and predicting uptake of vaccinations: a systematic review. Primary Health Care Research & Development, 23, p.e68.
Obohwemu, K.O., (2024a). Improving maternal awareness and childhood vaccination uptake in Delta State, Nigeria. International Journal of Medical Science and Public Health Research, 5(12), pp.37-57.
Obohwemu, K.O., (2024b). Maternal attitudes towards childhood vaccination in Delta State, Nigeria. Frontline Medical Sciences and Pharmaceutical Journal, 4(12), pp.43-66.
Obohwemu, K.O., Idomeh, J.E. and Chauhan, R., (2025b). Sociodemographic Factors and Maternal Knowledge of Childhood Vaccination in Nigeria. International Journal of Medical Science and Public Health Research, 6(01), pp.7-21.
Obohwemu, K.O., Owusuaa-Asante, A.M., Ibiangake, N.F., Abayomi, G.O., Idomeh, J.E., Chauhan, R. and Sharma, S., (2025a). The Interplay of Ethnicity, Education, and Employment on Maternal Attitudes Toward Childhood Vaccination in Nigeria. The American Journal of Medical Sciences and Pharmaceutical Research, 7(01), pp.65-77.
Opel, D. J., Diekema, D. S., Lee, N. R. and Marcuse, E. K. (2009) 'Social marketing as a strategy to increase immunization rates', Archives of Pediatrics & Adolescent Medicine, 163(5), pp. 432–437. https://doi.org/10.1001/archpediatrics.2009.61
Opel, D. J., Mangione-Smith, R., Taylor, J. A., et al. (2011b) 'Development of a survey to identify vaccine-hesitant parents: The parent attitudes about childhood vaccines survey', Human Vaccines, 7(4), pp. 419–425. https://doi.org/10.4161/hv.7.4.14120
Opel, D. J., Robinson, J. D., Heritage, J., et al. (2011a) 'Characterizing providers’ immunization communication practices during health supervision visits with vaccine-hesitant parents: A pilot study', Vaccine, 30(7), pp. 1269–1275. https://doi.org/10.1016/j.vaccine.2011.12.043
Opel, D. J., Taylor, J. A., Zhou, C., et al. (2013) 'The relationship between parent attitudes about childhood vaccines survey scores and future child immunization status: A validation study', JAMA Pediatrics, 167(11), pp. 1065–1071. https://doi.org/10.1001/jamapediatrics.2013.2483
Özceylan, G., Toprak, D. and Esen, E. (2021) 'Vaccine rejection and hesitation in Turkey', Human Vaccines & Immunotherapeutics, 17(5), pp. 1125–1132. https://doi.org/10.1080/21645515.2020.1821183
Paek, H. J., Hove, T., Jeong, H. J. and Kim, M. (2008) 'Determinants of preventive behaviours in response to the 2009 H1N1 influenza pandemic', Journal of Health Communication, 13(8), pp. 761–776. https://doi.org/10.1080/10810730802487445
Parker, C., Scott, S. and Geddes, M. (2019) 'Snowball sampling', in Atkinson, P., Delamont, S., Cernat, A., Sakshaug, J. W. and Williams, R. A. (eds.) SAGE research methods foundations. London: SAGE. https://doi.org/10.4135/9781526421036851710
Paterson, P., Chantler, T. and Larson, H. J. (2018) 'Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England', Vaccine, 36(36), pp. 5397–5401. https://doi.org/10.1016/j.vaccine.2017.08.016
Paterson, P., Meurice, F., Stanberry, L. R., Glismann, S., Rosenthal, S. L. and Larson, H. J. (2016) 'Vaccine hesitancy and healthcare providers', Vaccine, 34(52), pp. 6700–6706. https://doi.org/10.1016/j.vaccine.2016.10.042
Petrie, A. and Sabin, C. (2019) Medical statistics at a glance, 4th edn. Oxford: Wiley-Blackwell.
Posey, C., Roberts, T. L. and Lowry, P. B. (2015) 'The impact of organizational commitment on insiders’ motivation to protect organizational information assets', Journal of Management Information Systems, 32(4), pp. 179–214. https://doi.org/10.1080/07421222.2015.1138374
Quinn, S. C., Jamison, A. M., Freimuth, V. S., An, J. and Hancock, G. R. (2017) 'Determinants of influenza vaccination among high-risk Black and White adults', Vaccine, 35(51), pp. 7154–7159. https://doi.org/10.1016/j.vaccine.2017.11.019
Quinn, S. C., Kumar, S., Freimuth, V. S., Kidwell, K. and Musa, D. (2009) 'Public willingness to take a vaccine or drug under emergency use authorization during the 2009 H1N1 pandemic', Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 7(3), pp. 275–290. https://doi.org/10.1089/bsp.2009.0041
Ren, X., Geoffroy, E., Tiako, M. J., et al. (2018) 'Knowledge, attitudes, and behaviours of nurses and physicians towards vaccinations in Cameroon: A cross-sectional study', Human Vaccines & Immunotherapeutics, 14(11), pp. 2538–2544. https://doi.org/10.1080/21645515.2018.1483809
Repalust, A., Šević, S., Šepić Golubić, M., et al. (2017) 'Parental refusal of childhood vaccination: Associated socio-demographic factors in Croatia', Vaccine, 35(36), pp. 4751–4756. https://doi.org/10.1016/j.vaccine.2017.07.025
Rey, D., Fressard, L., Cortaredona, S., et al. (2018) 'Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk–benefit balance', Eurosurveillance, 23(17), pp. 1–10. https://doi.org/10.2807/1560-7917.ES.2018.23.17.17-00816
Rogers, R. W. (1975) 'A protection motivation theory of fear appeals and attitude change', The Journal of Psychology, 91(1), pp. 93–114. https://doi.org/10.1080/00223980.1975.9915803
Rogers, R. W. (1983) 'Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation', in Cacioppo, J. and Petty, R. E. (eds.) Social psychophysiology: A sourcebook. New York: Guilford Press, pp. 153–176.
Rogers, R. W. and Prentice-Dunn, S. (1997) 'Protection motivation theory', in Gochman, D. S. (ed.) Handbook of health behaviour research I: Personal and social determinants. New York: Springer, pp. 113–132.
Rovetta, A. and Castaldo, L. (2021) 'Influence of COVID-19 infodemic on web users’ vaccination attitude: Italian nationwide study', JMIR Infodemiology, 1(1), e29929. https://doi.org/10.2196/29929
Rubin, G. J., Amlôt, R., Page, L. and Wessely, S. (2009) 'Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: Cross sectional telephone survey', BMJ, 339, b2651. https://doi.org/10.1136/bmj.b2651
Ryu, H. S., Kim, H. S., Kim, H. and Choi, S. (2022) 'Parents’ intentions to vaccinate children against COVID-19: A protection motivation theory-based study in South Korea', BMC Public Health, 22, 1322. https://doi.org/10.1186/s12889-022-13677-0
Schmid, P., Rauber, D., Betsch, C., Lidolt, G. and Denker, M. L. (2017) 'Barriers of influenza vaccination intention and behaviour – A systematic review of influenza vaccine hesitancy, 2005–2016', PLoS ONE, 12(1), e0170550. https://doi.org/10.1371/journal.pone.0170550
Sharifirad, G., Yarmohammadi, P., Sharifabad, M. A. and Rahaei, Z. (2014) 'Determinants of fast food consumption among Iranian high school students based on the theory of planned behaviour', Journal of Obesity & Weight Loss Therapy, 4(2), pp. 1–6. https://doi.org/10.4172/2165-7904.1000226
Shiloh, S., Peleg, S. and Nudelman, G. (2021) 'Vaccination intention among adults with chronic conditions: The role of risk perception and health behaviour theories', Health Psychology and Behavioural Medicine, 9(1), pp. 674–695. https://doi.org/10.1080/21642850.2021.1942029
Siegrist, M., Luchsinger, L. and Bearth, A. (2021) 'The impact of trust and risk perception on the acceptance of measures to reduce COVID-19 cases', Risk Analysis, 41(5), pp. 787–800. https://doi.org/10.1111/risa.13675
Sloan, L. and Quan-Haase, A. (2017) The SAGE handbook of social media research methods. London: SAGE Publications.
Smith, L. E., Amlôt, R., Weinman, J., Yiend, J. and Rubin, G. J. (2017) 'A systematic review of factors affecting vaccine uptake in young children', Vaccine, 35(45), pp. 6059–6069. https://doi.org/10.1016/j.vaccine.2017.09.046
Smith, P. J., Humiston, S. G., Parnell, T., et al. (2011) 'The association between intentional delay of vaccine administration and timely childhood vaccination coverage', Public Health Reports, 126(Suppl 2), pp. 39–49. https://doi.org/10.1177/00333549111260S207
Strelitz, B., Gritjenko, S., Gritzman, L., et al. (2016) 'Parental vaccine hesitancy and acceptance of seasonal influenza vaccine in children, Colorado, USA', Preventive Medicine Reports, 3, pp. 235–240. https://doi.org/10.1016/j.pmedr.2016.02.004
Teasdale, E., Yardley, L., Schlotz, W. and Michie, S. (2012) 'The importance of coping appraisal in behavioural responses to pandemic flu', British Journal of Health Psychology, 17(1), pp. 44–59. https://doi.org/10.1111/j.2044-8287.2011.02017.x
Thunstrom, L., Ashworth, M., Finnoff, D. and Newbold, S. (2020) 'Hesitancy towards a COVID-19 vaccine and prospects for herd immunity', SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3593098
Tomietto, M., Simonetti, V., Comparcini, D., et al. (2022a) 'Nursing students’ knowledge, attitudes and behaviours on COVID-19 self-protective measures: A multi-centre cross-sectional study', Nurse Education in Practice, 56, 103197. https://doi.org/10.1016/j.nepr.2021.103197
Tran, B. X., Vu, G. T., Pham, H. Q., et al. (2018) 'Understanding health literacy and health information-seeking behaviour of Vietnamese undergraduates in the digital age', International Journal of Environmental Research and Public Health, 15(4), 660. https://doi.org/10.3390/ijerph15040660
Tsuzuki, S., Saeki, K., Kuroda, M., et al. (2020) 'Determining the target population for coronavirus disease 2019 (COVID-19) vaccination in Japan: A modeling study', BMC Infectious Diseases, 20(1), 994. https://doi.org/10.1186/s12879-020-05623-x
Vaughan, E. and Tinker, T. (2009) 'Effective health risk communication about pandemic influenza for vulnerable populations', American Journal of Public Health, 99(S2), pp. S324–S332. https://doi.org/10.2105/AJPH.2009.162537
Verger, P., Fressard, L., Collange, F., et al. (2015) 'Vaccine hesitancy among general practitioners and its determinants during controversies: A national cross-sectional survey in France', EBioMedicine, 2(8), pp. 891–897. https://doi.org/10.1016/j.ebiom.2015.06.018
Victor, M. (2020) 'The psychology of parental vaccine decision-making: Vaccine decision-making for children’s health', Journal of Health Psychology, 25(12), pp. 1772–1781. https://doi.org/10.1177/1359105318770971
Wan, M., He, J., Zhou, T. and Liu, Y. (2021) 'Determinants of COVID-19 vaccination intention and behaviour among Chinese adolescents: A protection motivation theory perspective', Human Vaccines & Immunotherapeutics, 17(9), pp. 2865–2875. https://doi.org/10.1080/21645515.2021.1921936
Wang, J., Jing, R., Lai, X., et al. (2020) 'Acceptance of COVID-19 vaccination during the COVID-19 pandemic in China', Vaccines, 8(3), 482. https://doi.org/10.3390/vaccines8030482
Wang, Y., et al. (2021) 'The impact of vaccine conspiracy beliefs on parental willingness to vaccinate children against COVID-19', Vaccines, 9(6), 647. https://doi.org/10.3390/vaccines9060647
Wang, Y., McKee, M., Torbica, A. and Stuckler, D. (2019) 'Systematic literature review on the spread of health-related misinformation on social media', Social Science & Medicine, 240, 112552. https://doi.org/10.1016/j.socscimed.2019.112552
Weinstein, N. D., Kwitel, A., McCaul, K. D., et al. (2007) 'Risk perceptions: Assessment and relationship to influenza vaccination', Health Psychology, 26(2), pp. 146–151. https://doi.org/10.1037/0278-6133.26.2.146
Wheeler, M. and Buttenheim, A. M. (2013) 'Parental vaccine concerns, information source, and choice of alternative immunization schedules', Human Vaccines & Immunotherapeutics, 9(8), pp. 1782–1789. https://doi.org/10.4161/hv.25959
WHO (2020a) 'Coronavirus disease (COVID-19) pandemic'. World Health Organization. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Williams, S. E., Rothman, R. L., Offit, P. A., et al. (2015) 'A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: A pilot study', Academic Pediatrics, 15(5), pp. 481–486. https://doi.org/10.1016/j.acap.2015.03.010
Wölfel, R., Corman, V. M., Guggemos, W., et al. (2020) 'Virological assessment of hospitalized patients with COVID-2019', Nature, 581(7809), pp. 465–469. https://doi.org/10.1038/s41586-020-2196-x
Wu, J. T., Leung, K., Bushman, M., et al. (2022) 'Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China', Nature Medicine, 26(4), pp. 506–510. https://doi.org/10.1038/s41591-020-0822-7
Xu, B., Gutierrez, B., Mekaru, S., et al. (2020) 'Epidemiological data from the COVID-19 outbreak, real-time case information', Scientific Data, 7, 106. https://doi.org/10.1038/s41597-020-0448-0
Yaqub, O., Castle-Clarke, S., Sevdalis, N. and Chataway, J. (2014) 'Attitudes to vaccination: A critical review', Social Science & Medicine, 112, pp. 1–11. https://doi.org/10.1016/j.socscimed.2014.04.018
Youn, H., Lee, H. and Ha-Brookshire, J. E. (2021) 'Understanding consumer behaviour for sustainable apparel: Applying protection motivation theory', Sustainability, 13(4), 1955. https://doi.org/10.3390/su13041955
Zhang, X., Guo, Y., Yu, H. and Li, Y. (2021) 'Online health information seeking in the context of COVID-19: An empirical study of the Chinese population', Health Information & Libraries Journal, 38(3), pp. 230–241. https://doi.org/10.1111/hir.12333
Zheng, R., Zhou, Y., Qiu, M. and Yan, Y. (2022) 'Trust in government and health behaviour during the COVID-19 pandemic: Empirical evidence from China', Journal of Asian Public Policy, 15(1), pp. 58–77. https://doi.org/10.1080/17516234.2020.1797973
Zucco, R., Lavano, F., Anfosso, R., et al. (2018) 'Internet and social media use as a source of vaccine information and its impact on vaccination intention and confidence in Italy', Human Vaccines & Immunotherapeutics, 14(7), pp. 1572–1577. https://doi.org/10.1080/21645515.2018.1463943
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