Investigating Factors Associated with COVID-19 Vaccination Attitudes

Vaccines are essential in preventing and managing diseases, such as COVID-19. However, vaccine hesitancy remains a concern in public health as it can hinder the effective control and eradication of life-threatening diseases. Understanding relevant factors that can facilitate vaccination are essential to support strategies aimed at addressing the negative effect of pandemics, epidemics, and Pathogen X. My thesis aimed to investigate factors linked to attitudes towards COVID-19 vaccination. The first study of my thesis was a systematic review on vaccination willingness during the current pandemic, uncovering a lack of cross-country exploration of the complex interplay between biopsychosocial variables and vaccination attitudes. Current research is also predominantly relying on ordinal scores that lack precision. Therefore, seven studies included in my thesis used advanced methods such as Rasch analysis to cross-culturally adapt, validate, and improve scales assessing psychological constructs relevant to vaccination attitudes and public health. All validated psychometric measures (e.g., measures of vaccination attitudes, compassion, and life orientation) demonstrated good reliability and validity across countries for assessing relevant constructs. Acceptable parameters for each measure facilitated the development of conversion algorithms to transform ordinal scores into interval-level scores for each scale, thereby enhancing their precision and suitability for parametric statistical analysis. Further, three studies of the thesis applied novel network analysis and stepwise regression to examine the interactive networks of biological, psychological, and social factors linked to vaccination attitudes. These studies adopted the biopsychosocial model and used the enhanced scales to ensure reliability and validity of the results. The network analysis showed that COVID-19 origin-related infodemics promoted vaccination attitudes, while religious-related infodemics negatively impacted vaccination attitudes. The results also demonstrated that psychological factors, controlling for country of residence, significantly influenced individual attitudes towards vaccination. Positive psychological factors acted as a buffer against negative emotions, which, in turn, were linked to better self-reported immune status, emphasising their protective role in shaping vaccination attitudes and potentially enhancing immune resistance to infectious diseases. The impact of sociodemographic variables, however, displayed inconsistent patterns across countries, suggesting unique cultural influences on vaccination attitudes. Overall, this thesis analysed data from nearly 2,000 participants from four countries across four continents. Studies included in my thesis offer practical solutions and novel approaches for improving the reliability and validity of psychometric measures, and for investigating psychological factors related to vaccination and public health research. This thesis underscores the importance of public health campaigns in promoting emotional well-being during pandemics, epidemics, and Pathogen X, and highlights the need to counter misinformation and identify contextual factors affecting vaccination attitudes. These efforts are vital for minimising the negative effects of health crises and promoting individual well-being.