Predictors of COVID-19 vaccination intention and behavior among young people in Slovenia: A cross-sectional study (Preprint)

BACKGROUND Decision-making regarding protective measures against COVID-19 is complex, and it has been suggested that younger populations act differently than older population groups. Young population groups have shown a lower willingness to be vaccinated against COVID-19, also in Slovenia. Although COVID-19 vaccination behavior has been studied extensively, research often does not focus comprehensively on the specific population groups of young people and their vaccination intention and behavior in relation to COVID-19. There is still a gap in research and knowledge about the different factors influencing vaccination behavior and differences between different groups of young people in relation to COVID-19 vaccination. OBJECTIVE This study investigates socio-psychological factors influencing COVID-19 vaccination intention and behavior among Slovenian young people by integrating constructs from two health behavior theories - Health Belief Model (HBM) and Theory of Planned Behavior (TPB). The influence of the main constructs on vaccination behavior (vaccine uptake and vaccine refusal) and intention (delayed vaccination and vaccine hesitancy) is controlled by several cognitive, affective and behavioral contextual factors (e.g. trust in science, health status, previous vaccinations) and demographic characteristics of the studied population. METHODS An online survey panel was conducted in August 2021 among Slovenian young people aged between 15 and 30 years. A total of 507 respondents completed the survey. Bivariate analyses and multinomial logistic regression analyses were performed to analyze the data. RESULTS The results showed that the majority of respondents had been vaccinated against COVID-19 (45.8%), 30% refused vaccination, 12.4% were hesitant and 11.8% reported that they intended to be vaccinated against COVID-19 (i.e. delayers). Multinomial logistic regression revealed that younger adults, those with lower education, and those whose mothers had lower education were more likely to delay or hesitate towards vaccination. Perceived health consequences of COVID-19, negative attitudes towards vaccines, and weaker subjective norms were associated with increased likelihood of delaying vaccination or refusing it altogether. CONCLUSIONS The study enhances the body of research that explores the decision-making processes within distinct groups of young people. By doing so, the study provides a deeper insight into the various factors that influence the vaccination related behaviors of young individuals regarding COVID-19 vaccination. The study’s findings can inform health policy makers and health professionals to optimize the management of vaccine uptake in young people and apply insights into other vaccinations, future outbreaks of infectious diseases and the establishment of necessary preventive measures.