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. 2024 May 9;19(5):e0294480.
doi: 10.1371/journal.pone.0294480. eCollection 2024.

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model

Sumit Aggarwal  1 , Lucky Singh  2 , Umaer Alam  3 , Saurabh Sharma  2 , Shashi Kala Saroj  2 , Kamran Zaman  3   4 , Mohd Usman  2 , Rajni Kant  3 , Himanshu Kumar Chaturvedi  2
Affiliations

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model

Sumit Aggarwal et al. PLoS One. .

Abstract

Despite the significant success of India's COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models-the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a 'negative attitude towards the vaccine' showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of 'negative attitudes towards the vaccine' and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
A. COVID-19 vaccine hesitancy by the respondent’s knowledge about the COVID-19 vaccine, (N = 600). B. COVID-19 vaccine hesitancy by the respondent’s source of information about the COVID-19 vaccine. C. COVID-19 vaccine hesitancy by the respondent’s belief and thinking about the COVID-19 vaccine and its side-effects. D. COVID-19 vaccine hesitancy by the respondent’s health status.
Fig 2
Fig 2. COVID-19 vaccine hesitancy (%) by knowledge about the COVID-19 vaccine.
Fig 3
Fig 3. COVID-19 vaccine hesitancy (%) by knowledge about the COVID-19 vaccination process.
Fig 4
Fig 4. COVID-19 vaccine hesitancy (%) by the behavioral practices to prevent COVID-19.
Fig 5
Fig 5. COVID-19 vaccine hesitancy (%) by the conspiracy belief regarding the COVID-19 vaccine.
Fig 6
Fig 6. Major reasons for the COVID-19 vaccine hesitancy among people who were not planning for any dose of the COVID-19 vaccine.
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