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The role of health beliefs in COVID-19 vaccination acceptance: A Meta-analysis

  • Ruobing Li
  • , Michail Vafeiadis
  • , Fuyuan Shen
  • , Zhihui Hou
  • Auburn University
  • Pennsylvania State University

Research output: Contribution to journalReview articlepeer-review

Abstract

This study employed a meta-analytic approach to examine the relationships between the Health Belief Model (HBM) constructs and COVID-19 vaccination acceptance. A comprehensive literature search identified 77 eligible studies with a combined sample size of 83,995 participants. Quantitative synthesis of the extracted data revealed that perceived benefits (r = 0.40) was the strongest positive predictor of individuals' vaccine acceptance, indicating a medium-to-large effect. Perceived severity (r = 0.17) and susceptibility (r = 0.18) to COVID-19 were also significant positive predictors, each with small-to-medium effect sizes. Cues to action (r = 0.11) and self-efficacy (r = 0.10) were also positively associated with vaccine acceptance, although the effects were small. In contrast, perceived barriers to vaccination (r = −0.25) were negatively associated with vaccine acceptance, approaching a medium effect in size. Several of these associations were moderated by study characteristics, including how the variables were operationalized (intention, hesitancy, refusal, etc.), the vulnerability of the study sample, the respondent type (parents vaccinating children vs. adults vaccinating themselves), the vaccine development stage, and the variant phase. Overall, these findings contribute to a deeper understanding of the psychological mechanisms underlying vaccine acceptance and hesitancy, and offer practical implications for developing targeted communication strategies to promote COVID-19 and other vaccinations.

Original languageEnglish
Article number128379
JournalVaccine
Volume77
DOIs
StatePublished - Apr 2 2026

Keywords

  • COVID-19
  • Health belief model
  • meta-analysis
  • Vaccine acceptance
  • Vaccine hesitancy

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