Associations Between Psychosocial Influence, Positive Thinking, and Vaccine Attitudes in Patients with Schizophrenia During the COVID-19 Pandemic.

Background: The rate of vaccination is lower in patients with schizophrenia than in the general population, and therefore, further investigation into the psychosocial impact of COVID-19 on these patients and their vaccine attitudes is warranted. In this study, we investigated factors influencing vaccine attitudes in patients with schizophrenia and explored the interactions among these factors. Methods: Cross-sectional, self-report surveys were conducted among Taiwanese patients with schizophrenia to collect data on vaccine attitudes and associated variables. Our sample was drawn from the largest psychiatric specialty hospital in Taiwan. As of December 1, 2022, 88% of the Taiwanese population had received at least two doses of the COVID-19 vaccine. Factors influencing vaccine attitudes and potential moderators were investigated through correlation analyses, hierarchical regression, and Hayes' Process Macro. Results: This study included 457 patients. Our results revealed that social anxiety and social desirability were respectively positively and negatively correlated with vaccine attitudes. Positive thinking moderated the overall effect of social influence on vaccine attitudes. Low levels of positive thinking intensified the effect of social influence on vaccine hesitancy. Conclusion: This study clarified the association of social influence with vaccine attitudes and the moderating effect of positive thinking on this association. Reputable medical centers can enhance patients' confidence in vaccination policies and foster positive thinking to increase vaccine acceptance among patients with schizophrenia.