Department of Business Analytics, Sunway Business School, Sunway University, Selangor, Malaysia.
Sunway Institute for Global Strategy and Competitiveness, Sunway University, Selangor, Malaysia.
PLoS One. 2024 Apr 30;19(4):e0301383. doi: 10.1371/journal.pone.0301383. eCollection 2024.
Vaccination has been one of the most effective preventive strategies to contain the COVID-19 pandemic. However, as the COVID-19 vaccines' effect wanes off after some time and given their reduced level of protection against mutation strains of the virus, the calls for boosters and second boosters signal the need for continuous vaccination for the foreseeable future. As Malaysia transitions into the endemic phase, the nation's ability to co-exist with the virus in the endemic phase will hinge on people's continuance intention to be vaccinated against the virus. Adapting the expectations confirmation model (ECM) to the public health context and in a developing country, this study integrates the ECM with the health belief model (HBM) and the theory of reasoned action (TRA) to examine the inter-relationships of the predictors of people's continuance intention to vaccinate against COVID-19.
Data were collected using self-administered questionnaires from 1,914 respondents aged 18 and above by a marketing consulting firm via its online panel. The partial least squares structural equation modeling (PLS-SEM) technique was used to analyze the data.
Out of the 1,914 respondents, 55.9% reported having a continuance intention to vaccinate against COVID-19, similar to other developing countries. The multivariate analysis revealed that perceived usefulness and satisfaction significantly influenced individuals' continuance intention to vaccinate against COVID-19. Additionally, attitude was found to play a key role in influencing behavioral change among individuals towards their perceptions of continuously getting vaccinated against COVID-19.
By integrating three theoretical frameworks (i.e., HBM, TRA and ECM), this study showed that behavioral characteristics could provide insights towards continuance vaccination intention. Hence, policymakers and key stakeholders can develop effective public health strategies or interventions to encourage vaccine booster uptake by targeting behavioral factors such as perceived usefulness, attitude, satisfaction, and subjective norms.
接种疫苗是遏制 COVID-19 大流行的最有效预防策略之一。然而，随着 COVID-19 疫苗的效果在一段时间后减弱，并且它们对病毒突变株的保护水平降低，因此需要加强针和第二针加强针，这表明在可预见的未来需要持续接种疫苗。随着马来西亚进入流行后期阶段，该国在流行后期阶段与病毒共存的能力将取决于人们继续接种疫苗以预防该病毒的意愿。本研究将期望确认模型（ECM）应用于公共卫生领域，并应用于发展中国家，将 ECM 与健康信念模型（HBM）和理性行动理论（TRA）相结合，检验人们继续接种 COVID-19 疫苗意愿的预测因素之间的相互关系。
数据是通过一家营销咨询公司通过其在线小组，使用 1914 名 18 岁及以上受访者的自填式问卷收集的。使用偏最小二乘结构方程建模（PLS-SEM）技术分析数据。
在 1914 名受访者中，55.9%表示有继续接种 COVID-19 疫苗的意愿，这与其他发展中国家相似。多元分析显示，感知有用性和满意度显著影响个人继续接种 COVID-19 疫苗的意愿。此外，态度被发现是影响个人对持续接种 COVID-19 疫苗的看法转变为行为改变的关键因素。
通过整合三个理论框架（即 HBM、TRA 和 ECM），本研究表明行为特征可以为继续接种疫苗的意愿提供深入了解。因此，政策制定者和利益相关者可以通过针对感知有用性、态度、满意度和主观规范等行为因素，制定有效的公共卫生策略或干预措施，鼓励接种加强针。
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