Applying the health belief model (HBM) to understand COVID-19 vaccine uptake among youth and young adults: Findings from a 6-month follow-up study in the United States

Abstract

Background: Vaccination is one of the most effective strategies for COVID-19 prevention. Monitoring and increasing vaccine uptake among youth and young adults (YYA) not only prevents the spread of the disease but also protects their health and well-being from serious COVID-19 illness. This study applied the health belief model (HBM) to understand the predictors of COVID-19 vaccine uptake among YYA in the United States.

Methods: In early 2021, we conducted a national, online survey among diverse YYA aged 14 to 24 years in the United States. Between July 2021 and September 2022, this study followed participants who were not vaccinated for six months to learn about their vaccine status and prevention behaviors (N = 245). We explored the prevalence of COVID-19 vaccination among YYA by age, race/ethnicity, and sexual and gender identities. Multivariable logistic regression models were performed to estimate associations between HBM constructs and COVID-19 vaccination.

Results: The majority of participants had received a vaccine. (80.8 %). We observed significant differences in COVID-19 vaccination uptake by age; those aged 18 to 21 years were over 3 times as likely to report receiving a vaccine. Regarding the HBM constructs, we found that health motivation, perceived benefits, and protection self-efficacy were significantly associated with vaccine uptake among YYA.

Conclusion: This study highlights the effectiveness of HBM in understanding COVID-19 vaccine uptake among YYA in the United States. The findings suggest that health motivation, perceived benefits of vaccination, and protection self-efficacy are key factors driving vaccine uptake in this demographic. Significant age differences in vaccination rates indicate that targeted interventions for younger age groups, particularly those aged 14 to 17 years, may be necessary to increase vaccination coverage. These insights can inform future public health strategies to improve vaccine acceptance and uptake, ensuring better health outcomes and protection against future public health crises in YYA populations.

Keywords: Adolescents; COVID-19 vaccine; Health belief model; Prevention.