Worry, risk perception, vaccine perception, and vaccine acceptance: Testing three competing path models in the context of COVID-19.

Background: Although previous studies have identified worry about COVID-19 as an important determinant of COVID-19 vaccine-related intentions and behaviors, the exact mechanism by which worry influences these intentions and behaviors is still being investigated.

Design and method: An online survey was conducted among 310 U.S. university students from mid-June to mid-July 2021, measuring worry about COVID-19, COVID-19 risk perception (perceived probability and perceived severity), vaccine perception (perceived vaccine safety and perceived vaccine effectiveness), and vaccine acceptance, along with demographics. Three models were tested using structural equation modeling (SEM): (1) worry, risk-perception, and vaccine-perception variables influence vaccine acceptance simultaneously; (2) worry partially mediates the relationships between risk/vaccine-perception variables and vaccine acceptance; (3) risk- and vaccine-perception variables partially mediate the relationship between worry and vaccine acceptance. All models are the originally specified models.

Results: Results of SEM analyses suggest that Model (3) fit the data best (CFI = 1.000, TLI = 1.000, and RMSEA = 0.000). SEM analysis for Model (3) found that perceived probability of contracting COVID-19 is negatively, worry about COVID-19 is positively, and perceived vaccine safety (the strongest predictor) is positively associated with vaccine acceptance. Perceived severity of contracting COVID-19 and perceived vaccine effectiveness are non-significant predictors. Worry indirectly affects vaccine acceptance through perceived probability (negative) and perceived vaccine safety (positive).

Conclusions: COVID-19 vaccine campaigns targeting college students should emphasize vaccine safety, use reasonable worry as an emotional cue, and avoid overemphasizing the likelihood of contracting COVID-19.