Overcoming covid-19 vaccine hesitancy: Insights from an online population-based survey in the United States

Hoda Badr, Xiaotao Zhang, Abiodun Oluyomi, Lechauncy D. Woodard, Omolola E. Adepoju, Syed Ahsan Raza, Christopher I. Amos

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


This study sought to identify individual-level determinants of COVID-19 vaccine hesitancy based on the Health Belief Model (HBM) and Theory of Planned Behavior (TPB). An online population-based survey was distributed in English and Spanish. Data were derived from 1208 U.S. adults (52% female; 38.7% minorities), 43.5% of whom reported vaccine hesitancy. Multivariable analysis revealed that unemployed individuals were more likely (OR = 1.78, 95% CI: 1.16–2.73, p = 0.009) and married (OR = 0.57, 95% CI: 0.39–0.81, p = 0.002) and higher income individuals (OR = 0.52, 95% CI 0.32–0.84, p = 0.008) were less likely to be hesitant. Individuals with greater perceived susceptibility to COVID-19 (OR = 0.82, 95% CI: 0.71–0.94, p = 0.006), who perceived vaccination as being convenient (OR = 0.86, 95% CI: 0.74–1.00, p = 0.047), and who afforded greater importance to cues to action from government (OR = 0.84, 95% CI: 0.74–0.95, p = 0.005), public health (OR = 0.70, 95% CI: 0.59–0.82, p < 0.001), and healthcare experts (OR = 0.59, 95% CI: 0.50–0.69, p < 0.001) were also less likely to be hesitant. Findings suggest that HBM and TPB constructs may be useful in informing strategies to improve COVID-19 vaccine uptake. Specifically, framing appeals based on perceptions of COVID-19 susceptibility, making vaccination convenient, and rebuilding trust through unified cues to action may help to overcome vaccine hesitancy.

Original languageEnglish
Article number1100
Issue number10
StatePublished - Oct 2021
Externally publishedYes


  • COVID-19
  • Health Belief Model
  • Theory of Planned Behavior
  • Vaccine hesitancy


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