Evidence map›Paper›PMID 40841900›Full record

ArticleBMC public health2025

Decoding vaccine hesitancy: a health belief model-driven comparative study of vaccination awareness dynamics in COVID-19 vaccination intentions.

Zeming Li, Xinying Sun

Abstract readComparative Study
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Zeming LiDepartment of Social Medicine, School of Public Health, Guangxi Medical University, Guangxi, Nanning, 530021, China.
Xinying SunDepartment of Social Medicine and Health Education, School of Public Health, Peking University, NO. 38 College Road Haidian District, Beijing, China. xysun@bjmu.edu.cn.

Funding

the National Social Science Fund of China 22AZD077
6 · The paper itself

Abstract

objectiveThe COVID-19 vaccination is a key strategy to control the pandemic; however, complex factors, including health awareness and social cognition, influence public intention to vaccinate. The Health Belief Model (HBM) provides a theoretical framework for understanding vaccination behavior, but how Vaccination awareness (VA) dynamically moderates the relationship between HBM domains and vaccination intentions remains unclear. This study aims to compare the characteristics of different VA classifications and explore the key factors influencing their future COVID-19 vaccination intentions based on the HBM.

methodsUsing three-wave longitudinal cohort data from 500 adults in mainland China, participants were divided into four groups based on VA states: persistent awareness (Group 1), early-only awareness (Group 2), late-emerging awareness (Group 3), and persistently unaware (Group 4). ANOVA, chi-square tests, and binary logistic regression were used to analyze the relationships between HBM constructs, social cues, and vaccination intentions.

resultsGroup 1 (31.40%) had the highest education level, the COVID-19 vaccination rate (48.35%), and future vaccination intention (36.98%), with significantly higher HBM scores (perceived severity, self-efficacy, benefits) than other groups (all p < 0.001). Group 4 (27.00%) had the highest proportion of unvaccinated individuals (40.31%) and the highest perceived barriers score (M = 2.39 ± 0.73). Logistic regression showed that Group 1's future COVID-19 vaccination intention was driven by medical expert advice (OR = 3.08, 95% CI: 1.47-6.45) and self-efficacy (OR = 3.68, 95% CI: 1.53-8.87), while Group 4 relied on government advice (OR = 1.56, 95% CI: 1.02-2.40), perceived severity (OR = 1.97, 95% CI: 1.12-3.46), and self-efficacy (OR = 3.68, 95% CI: 1.77-5.84). Trust in social media significantly reduced Group 3's vaccination intention (OR = 0.08, 95% CI: 0.02-0.35).

conclusionsVaccination awareness states influence vaccination decisions by moderating HBM domains and social cues. Targeted interventions should address group-specific differences, such as enhancing self-efficacy (for Group 1, Group 2, and Group 4), correcting social media misinformation ( for Group 3), and strengthening government communication (for Group 4).

Indexed as

COVID-19COVID-19 VaccinesHealth Belief ModelHealth Knowledge, Attitudes, PracticeVaccination HesitancyAdultChinaFemaleHumansIntentionLongitudinal StudiesMaleMiddle AgedYoung AdultCOVID-19 VaccinesCOVID-19Health belief modelVaccinationVaccination awareness

Identifiers

PMID40841900
PMCPMC12369092

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.