Association of vaccine intention against COVID-19 using the 5C Scale and its constructs: a Pima County, Arizona cross-sectional survey

PeerJ. 2024 Dec 6:12:e18316. doi: 10.7717/peerj.18316. eCollection 2024.

Abstract

Background: Vaccine hesitancy has been ranked as one of the top 10 threats to global health by the World Health Organization. The 5C model (Confidence, Calculation of risk, Complacency, Collective Responsibility, and Constraints) and an accompanying tool to measure vaccine hesitancy, summarize several significant explanatory variables, and move beyond the most common explanatory variable, Confidence.

Methods: From January to May 2021, we administered a cross-sectional survey among adults in Pima County, Arizona in collaboration with the local health department to assess psychological antecedents to (i.e., psychological factors that lead to) COVID-19 vaccination using the 5C Scale. Participants were recruited virtually for the survey using multiple recruitment methods. Unadjusted and adjusted hierarchical ordinal logistic regressions were conducted to determine if the 5C variables had an association with intention to vaccinate (or intent to vaccinate) against COVID-19.

Results: Of the 1,823 participants who responded to the survey, 924 (76%) were included in the final analyses. Respondents were White (71%), non-Hispanic (59%), Female (68%), Liberal (37%) and Married (46%). The average age of the participants was 43.9 (±1.3) years. Based on the 5C Scale, Confidence (adjOR:3.64, CI [3.08-4.29]), Collective Responsibility (adjOR:1.94, CI [1.57-2.39]) and Complacency (adjOR:0.64, CI [0.51-0.80]) were significantly associated with intention to vaccinate against COVID-19.

Conclusion: Three of the five 5C variables were associated with the intention to vaccinate, two positively and one negatively. A limitation of the study was that the sample was not weighted to be representative of Pima County. Future research should focus on determining which interventions can bolster Confidence and Collective Responsibility attitudes in communities, while dampening Complacency, to better promote vaccine uptake.

Keywords: Acceptability; COVID-19; COVID-19 vaccine; Intentions; Patient acceptance of health care; Vaccination; Vaccination refusal.

MeSH terms

  • Adult
  • Arizona / epidemiology
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intention*
  • Male
  • Middle Aged
  • SARS-CoV-2 / immunology
  • Surveys and Questionnaires
  • Vaccination / psychology
  • Vaccination Hesitancy* / psychology
  • Young Adult

Substances

  • COVID-19 Vaccines

Grants and funding

This study was conducted using Purnima Madhivanan’s start-up funds. Purnima Madhivanan is supported by the GHES training grant from NIH/FIC under award number D43 TW010540. The Pima County Health Department provided some funds to aid data collection. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Maiya Block Ngaybe was supported by the National Institutes of Health, Fogarty International Center/Global Health Equity Scholars Fellowship (D43TW010540). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.