The Health Belief Model Predicts Intention to Receive the COVID-19 Vaccine in Saudi Arabia: Results from a Cross-Sectional Survey

Ilias Mahmud, Russell Kabir, Muhammad Aziz Rahman, Angi Alradie-Mohamed, Divya Vinnakota, Abdulrahman Al-Mohaimeed, Ilias Mahmud, Russell Kabir, Muhammad Aziz Rahman, Angi Alradie-Mohamed, Divya Vinnakota, Abdulrahman Al-Mohaimeed

Abstract

We examined the intention and predictors of accepting the COVID-19 vaccine in Saudi Arabia. We conducted a nation-wide, cross-sectional online survey between February and March 2021. A total of 1387 people (≥18 years) participated. Only 27.3% adults had a definite and 30.2% had a probable vaccination intent; 26.8% and 15.6% had a probable and definite negative vaccination intent. Older people (≥50 years) (p < 0.01), healthcare workers/professionals (p < 0.001), and those who received flu vaccine (p < 0.001) were more likely to have a positive intent. People from Riyadh were less likely to receive the vaccine (p < 0.05). Among the health belief model constructs, perceived susceptibility to and severity of COVID-19 (p < 0.001), and perceived benefit of the vaccine (p < 0.001) were positively associated with vaccination intent, whereas perceived barriers had a negative association (p < 0.001). Individuals were more likely to receive the vaccine after obtaining complete information (p < 0.001) and when the vaccine uptake would be more common amongst the public (p < 0.001).

Keywords: COVID-19; SARS-CoV-2; Saudi Arabia; health belief model; vaccine hesitancy.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020;382:727–733. doi: 10.1056/NEJMoa2001017.
    1. Adhikari S.P., Meng S., Wu Y.-J., Mao Y.-P., Ye R.-X., Wang Q.-Z., Sun C., Sylvia S., Rozelle S., Raat H., et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: A scoping review. Infect. Dis. Poverty. 2020;9:29. doi: 10.1186/s40249-020-00646-x.
    1. WHO WHO Coronavirus (COVID-19) Dashboard. [(accessed on 5 May 2021)]; Available online:
    1. Mahmud I., Al-Mohaimeed A. COVID-19: Utilizing local experience to suggest optimal global strategies to prevent and control the pandemic. Int. J. Health Sci. 2020;14:1–3.
    1. Obied D.A., Alhamlan F.S., Al-Qahtani A.A., Al-Ahdal M.N. Containment of COVID-19: The unprecedented response of Saudi Arabia. J. Infect. Dev. Ctries. 2020;14:699–706. doi: 10.3855/jidc.13203.
    1. McArthur L., Sakthivel D., Ataide R., Chan F., Richards J.S., Narh C.A. Review of Burden, Clinical Definitions, and Management of COVID-19 Cases. Am. J. Trop. Med. Hyg. 2020;103:625–638. doi: 10.4269/ajtmh.20-0564.
    1. Thanh Le T., Andreadakis Z., Kumar A., Gómez Román R., Tollefsen S., Saville M., Mayhew S. The COVID-19 vaccine development landscape. Nat. Rev. Drug Discov. 2020;19:305–306. doi: 10.1038/d41573-020-00073-5.
    1. WHO . DRAFT Landscape of COVID-19 Candidate Vaccines-20 April 2020. [Internet] WHO; Geneva, Switzerland: 2020.
    1. Mishra S.K., Tripathi T. One year update on the COVID-19 pandemic: Where are we now? Acta Trop. 2021;214:105778. doi: 10.1016/j.actatropica.2020.105778.
    1. WHO . WHO Lists Additional COVID-19 Vaccine for Emergency Use and Issues Interim Policy Recommendations. WHO; Geneva, Switzerland: 2021. [(accessed on 15 May 2021)]. Available online: .
    1. McGill University COVID19 Vaccine Tracker Team COVID-19 Vaccine Tracker: Saudi Arabia. [(accessed on 16 May 2021)]; Available online:
    1. Bartsch S.M., O’Shea K.J., Ferguson M.C., Bottazzi M.E., Wedlock P.T., Strych U., McKinnell J.A., Siegmund S.S., Cox S.N., Hotez P.J., et al. Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention. Am. J. Prev. Med. 2020;59:493–503. doi: 10.1016/j.amepre.2020.06.011.
    1. Iboi E., Ngonghala C.N., Gumel A.B. Will an imperfect vaccine curtail the COVID-19 pandemic in the U.S.? medRxiv. 2020;5:510–524. doi: 10.1016/j.idm.2020.07.006.
    1. Lazarus J.V., Ratzan S.C., Palayew A., Gostin L.O., Larson H.J., Rabin K., Kimball S., El-Mohandes A. A global survey of potential acceptance of a COVID-19 vaccine. Nat. Med. 2020;27:225–228. doi: 10.1038/s41591-020-1124-9.
    1. Qattan A.M.N., Alshareef N., Alsharqi O., Al Rahahleh N., Chirwa G.C., Al-Hanawi M.K. Acceptability of a COVID-19 Vaccine Among Healthcare Workers in the Kingdom of Saudi Arabia. Front. Med. 2021;8:644300. doi: 10.3389/fmed.2021.644300.
    1. Alfageeh E.I., Alshareef N., Angawi K., Alhazmi F., Chirwa G.C. Acceptability of a COVID-19 Vaccine among the Saudi Population. Vaccines. 2021;9:226. doi: 10.3390/vaccines9030226.
    1. Almaghaslah D., Alsayari A., Kandasamy G., Vasudevan R. COVID-19 Vaccine Hesitancy among Young Adults in Saudi Arabia: A Cross-Sectional Web-Based Study. Vaccines. 2021;9:330. doi: 10.3390/vaccines9040330.
    1. Daly M., Robinson E. Willingness to vaccinate against COVID-19 in the US: Longitudinal evidence from a nationally representative sample of adults from April–October 2020. medRxiv. 2020 doi: 10.1101/2020.11.27.20239970.
    1. Kabamba Nzaji M., Kabamba Ngombe L., Ngoie Mwamba G., Banza Ndala D.B., Mbidi Miema J., Luhata Lungoyo C., Lora Mwimba B., Cikomola Mwana Bene A., Mukamba Musenga E. Acceptability of Vaccination Against COVID-19 Among Healthcare Workers in the Democratic Republic of the Congo. Pragmatic Obs. Res. 2020;11:103–109. doi: 10.2147/POR.S271096.
    1. Roozenbeek J., Schneider C.R., Dryhurst S., Kerr J., Freeman A.L.J., Recchia G., van der Bles A.M., van der Linden S. Susceptibility to misinformation about COVID-19 around the world. R. Soc. Open Sci. 2020;7:201199. doi: 10.1098/rsos.201199.
    1. WHO . Ten Threats to Global Health. WHO; Geneva, Switzerland: 2021. [(accessed on 7 January 2021)]. Available online: .
    1. Larson H.J., Jarrett C., Eckersberger E., Smith D.M.D., Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine. 2014;32:2150–2159. doi: 10.1016/j.vaccine.2014.01.081.
    1. Al-Mohaithef M., Padhi B.K. Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey. J. Multidiscip. Healthc. 2020;13:1657–1663. doi: 10.2147/JMDH.S276771.
    1. Rosenstock I.M., Strecher V.J., Becker M.H. Social learning theory and the Health Belief Model. Health Educ. Q. 1988;15:175–183. doi: 10.1177/109019818801500203.
    1. Chen M.-F., Wang R.-H., Schneider J.K., Tsai C.-T., Jiang D.D.-S., Hung M.-N., Lin L.-J. Using the Health Belief Model to Understand Caregiver Factors Influencing Childhood Influenza Vaccinations. J. Commu. Health Nurs. 2011;28:29–40. doi: 10.1080/07370016.2011.539087.
    1. Nexøe J., Kragstrup J., Søgaard J. Decision on influenza vaccination among the elderly. A questionnaire study based on the Health Belief Model and the Multidimensional Locus of Control Theory. Scand. J. Prim. Health Care. 1999;17:105–110. doi: 10.1080/028134399750002737.
    1. Coe A.B., Gatewood S.B.S., Moczygemba L.R., Goode J.-V.K.R., Beckner J.O. The use of the health belief model to assess predictors of intent to receive the novel (2009) H1N1 influenza vaccine. Innov. Phar. 2012;3:1–11. doi: 10.24926/iip.v3i2.257.
    1. Mo P.K.H., Lau J.T.F. Influenza vaccination uptake and associated factors among elderly population in Hong Kong: The application of the Health Belief Model. Health Educ. Res. 2015;30:706–718. doi: 10.1093/her/cyv038.
    1. 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. Psychol. Health. 2018;33:746–764. doi: 10.1080/08870446.2017.1401623.
    1. Smith P.J., Humiston S.G., Marcuse E.K., Zhao Z., Dorell C.G., Howes C., Hibbs B. Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model. Public Health Rep. 2011;126:135–146. doi: 10.1177/00333549111260S215.
    1. Donadiki E.M., Jiménez-García R., Hernández-Barrera V., Sourtzi P., Carrasco-Garrido P., López de Andrés A., Jimenez-Trujillo I., Velonakis E.G. Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health. 2014;128:268–273. doi: 10.1016/j.puhe.2013.12.004.
    1. Alabbad A.A., Alsaad A.K., Al Shaalan M.A., Alola S., Albanyan E.A. Prevalence of influenza vaccine hesitancy at a tertiary care hospital in Riyadh, Saudi Arabia. J. Infect. Public Health. 2018;11:491–499. doi: 10.1016/j.jiph.2017.09.002.
    1. Wong L.P., Alias H., Wong P.F., Lee H.Y., 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. Vaccines Immunother. 2020;16:2204–2214. doi: 10.1080/21645515.2020.1790279.
    1. Zampetakis L.A., Melas C. The health belief model predicts vaccination intentions against COVID-19: A survey experiment approach. Appl. Psychol. Health Well-Being. 2021;13:469–484. doi: 10.1111/aphw.12262.
    1. Mercadante A.R., Law A.V. Will they, or Won’t they? Examining patients’ vaccine intention for flu and COVID-19 using the Health Belief Model. Res. Soc. Adm. Pharm. 2020;17:1596–1605. doi: 10.1016/j.sapharm.2020.12.012.
    1. Kabir R., Mahmud I., Chowdhury M.T.H., Vinnakota D., Jahan S.S., Siddika N., Isha S.N., Nath S.K., Hoque Apu E. COVID-19 Vaccination Intent and Willingness to Pay in Bangladesh: A Cross-Sectional Study. Vaccines. 2021;9:416. doi: 10.3390/vaccines9050416.
    1. Loomba S., de Figueiredo A., Piatek S.J., de Graaf K., Larson H.J. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat. Hum. Behav. 2021;5:337–348. doi: 10.1038/s41562-021-01056-1.
    1. Murphy J., Vallières F., Bentall R.P., Shevlin M., McBride O., Hartman T.K., McKay R., Bennett K., Mason L., Gibson-Miller J., et al. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat. Commun. 2021;12:29. doi: 10.1038/s41467-020-20226-9.
    1. Sallam M., Dababseh D., Eid H., Al-Mahzoum K., Al-Haidar A., Taim D., Yaseen A., Ababneh N.A., Bakri F.G., Mahafzah A. High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries. Vaccines. 2021;9:42. doi: 10.3390/vaccines9010042.
    1. Ward J.K., Alleaume C., Peretti-Watel P., Group C. The French public’s attitudes to a future COVID-19 vaccine: The politicization of a public health issue. Soc. Sci. Med. 2020;265:113414. doi: 10.1016/j.socscimed.2020.113414.
    1. Tran V.D., Pak T.V., Gribkova E.I., Galkina G.A., Loskutova E.E., Dorofeeva V.V., Dewey R.S., Nguyen K.T., Pham D.T. Determinants of COVID-19 vaccine acceptance in a high infection-rate country: A cross-sectional study in Russia. Pharm. Pract. 2021;19:2276. doi: 10.18549/PharmPract.2021.1.2276.
    1. Reno C., Maietti E., Fantini M.P., Savoia E., Manzoli L., Montalti M., Gori D. Enhancing COVID-19 Vaccines Acceptance: Results from a Survey on Vaccine Hesitancy in Northern Italy. Vaccines. 2021;9:378. doi: 10.3390/vaccines9040378.
    1. Wong M.C.S., Wong E.L.Y., Huang J., Cheung A.W.L., Law K., Chong M.K.C., Ng R.W.Y., Lai C.K.C., Boon S.S., Lau J.T.F., et al. Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine. 2021;39:1148–1156. doi: 10.1016/j.vaccine.2020.12.083.
    1. van der Linden S., Dixon G., Clarke C., Cook J. Inoculating against COVID-19 vaccine misinformation. EClinicalMedicine. 2021;33:100772. doi: 10.1016/j.eclinm.2021.100772.
    1. Bhartiya S., Kumar N., Singh T., Murugan S., Rajavel S., Wadhwani M. Knowledge, attitude and practice towards COVID-19 vaccination acceptance in West India. Int. J. Commun. Med. Public Health. 2021;8:7. doi: 10.18203/2394-6040.ijcmph20210481.

Source: PubMed

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