Why not get vaccinated? A study on psychological reasons

Santo F. Di Nuovo, Chiara Moschetto, Valeria Narzisi, Rossana Smeriglio


The article deals with the psychological reasons pro or against vaccination. After a review of the literature, a study was conducted aimed at evaluating the differences in some psychological characteristics between people who have definitely consented to vaccination and persons opposed to vaccines. Two groups were selected pro or against vaccination (n = 54 each), balanced by gender, age, education and work activity. The research was conducted using an online form, including opinion, attitude and motivation questionnaires, test on stress and attribution of control in health issues, and the 10-item Big Five Inventory Test.

The results show that a less favorable attitude toward vaccines correlates with a lack of confidence in institutions, linked to external Locus of Control of Health, and to the perception that the actual risk is artificially increased for hidden reasons in vaccination campaigns; while the personality variables seem to have less influence.

These results could be helpful for addressing the vaccination campaign to specific targets, and overcoming psychological biases and prejudices.


Vaccines; No-Vax; Psychological attitudes; Personality; Health Locus of Control.

Full Text:



Abalakina-Paap, M., Stephan, W.G., Craig, T., & Gregory, W.L. (1999). Beliefs in Conspiracies. Political Psychology, 20: 637–647. https://doi.org/10.1111/0162-895X.00160 .

Al-Amer, R., Maneze, D., Everett, B., Montayre, J., Villarosa, A. R., Dwekat, E., & Salamonson, Y. (2021). COVID-19 vaccination intention in the first year of the pandemic: A systematic review. Journal of Clinical Nursing, 31(1–2), 62–86. https://doi.org/10.1111/jocn.15951

Attwell, K., Leask, J., Meyer, S. B., Rokkas, P., & Ward, P. (2016). Vaccine rejecting parents’ engagement with expert systems that inform vaccination programs. Journal of Bioethical Inquiry, 14(1), 65–76. https://doi.org/10.1007/s11673-016-9756-7

Aw, J., Seng, J. J. B., Seah, S. S. Y., & Low, L. L. (2021). COVID-19 Vaccine hesitancy—a scoping review of literature in high-income countries. Vaccines, 9(8), 900. https://doi.org/10.3390/vaccines9080900

Bucchi M., & Saracino B. (2021). Gli italiani si affidano ai medici di famiglia per informarsi sui vaccini COVID-19. (Italians turn to family doctors for information on COVID-19 vaccines). Nature Italy, 8: 18. https://doi.org/10.1038/d43978-021-00100-y

Cascini, F., Pantovic, A., Al-Ajlouni, Y., Failla, G., & Ricciardi, W. (2021). Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review. EClinicalMedicine, 40, 101113. https://doi.org/10.1016/j.eclinm.2021.101113

Chou, W. Y. S., & Budenz, A. (2020). Considering Emotion in COVID-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence. Health Communication, 35(14), 1718–1722. https://doi.org/10.1080/10410236.2020.1838096

Dror, A.A., Eisenbach, N., Taiber, S., Morozov, N.G., Mizrachi, M., Zigron, A., Srouji, S., & Sela, E. (2020). Vaccine hesitancy: The next challenge in the fight against COVID-19. European Journal of Epidemiology, 35: 775–779. https://doi.org/10.1007/s10654-020-00671-y

Fisher, K. A., Bloomstone, S. J., Walder, J., Crawford, S., Fouayzi, H., & Mazor, K. M. (2020). Attitudes toward a potential SARS-CoV-2 vaccine. Annals of Internal Medicine, 173(12), 964–973. https://doi.org/10.7326/m20-3569

Giuliani, M., Ichino, A., Bonomi, A., Martoni, R., Cammino, S., & Gorini, A. (2021). Who is willing to get vaccinated? A study into the psychological, socio-demographic, and cultural determinants of Covid-19 vaccination intentions. Vaccines, 9(8), 810. https://doi.org/10.3390/vaccines9080810

Goldman, R. D., Yan, T. D., Seiler, M., Parra Cotanda, C., Brown, J. C., Klein, E. J., Hoeffe, J., Gelernter, R., Hall, J. E., Davis, A. L., Griffiths, M. A., Mater, A., Manzano, S., Gualco, G., Shimizu, N., Hurt, T. L., Ahmed, S., Hansen, M., Sheridan, D., . . . Staubli, G. (2020). Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey. Vaccine, 38(48), 7668–7673. https://doi.org/10.1016/j.vaccine.2020.09.084

Gori, A., Topino, E., Craparo, G., Lauro Grotto, R., Caretti, V. (2021). An empirical model for understanding the threat responses at the time of COVID-19. Mediterranean Journal of Clinical Psychology, 9(1). https://doi.org/10.6092/2282-1619/mjcp-2916

Graffigna G. (2021). Quello che la pandemia ci ha insegnato sulla psicologia della prevenzione. Il Pensiero Scientifico.

Guido G., Peluso A.M., Capestro M., & Miglietta, M. (2015). An Italian version of the 10-item Big Five Inventory: An application to hedonic and utilitarian shopping values. Personality and Individual Differences, 76: 135–140. https://doi.org/10.1016/j.paid.2014.11.053

Hornsey, M., Harris, E.A., & Fielding, K. (2018). The psychological roots of anti-vaccination attitudes: A 24-nation investigation. Health Psychology, 37: 307–315. https://doi.org/10.1037/hea0000586

Karlsson, L.C., Soveri, A., Lewandowsky, S., Karlsson, L., Karlsson, H., Nolvi, S., Karukivi, M., Lindfelt, M. & Antfolk, J. (2021). Fearing the disease or the vaccine: The case of COVID-19. Personality and Individual Differences, 172: 110590. https://doi.org/10.1016/j.paid.2020.110590

Larson, H. J. (2018). The biggest pandemic risk? Viral misinformation. Nature, 562(7727), 309. https://doi.org/10.1038/d41586-018-07034-4

Lazarus, J.V., Ratzan, S.C., Palayew, A., Gostin, L.O., Larson, H.J., Rabin, K., Kimball, S., & El-Mohandes, A. (2020). A global survey of potential acceptance of a COVID-19 vaccine. Nature Medicine, 27: 225–228. https://doi.org/10.1038/s41591-020-1124-9

Lin, C., Tu, P., & Beitsch, L. M. (2020). Confidence and receptivity for Covid-19 vaccines: A rapid systematic review. Vaccines, 9(1), 16. https://doi.org/10.3390/vaccines9010016

MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161-4164. https://doi.org/10.1016/j.vaccine.2015.04.036

Malas, O., Tolsá, M. D. (2021). Vaccination Fear Scale (VFS-6): Development and initial validation. Mediterranean Journal of Clinical Psychology, 9(2). https://doi.org/10.13129/2282-1619/mjcp-2971

Malik, A., McFadden, S.M., Elharake, J., & Omer, S.B. (2020). Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine, 26: 100495. https://doi.org/10.1016/j.eclinm.2020.100495 .

McCrae R.R., & Costa P.T. (1987). Validation of the five-factor model of personality across instruments and observers. Journal of Personality and Social Psychology, 52: 81–90. https://doi.org/10.1037/0022-3514.52.1.81.

Mheidly, N., & Fares, J. (2020). Leveraging media and health communication strategies to overcome the COVID-19 infodemic. Journal of Public Health Policy, 41(4), 410–420. https://doi.org/10.1057/s41271-020-00247-w

Moccia, G., Carpinelli, L., Savarese, G., & de Caro, F. (2022). Vaccine hesitancy and the green digital pass: a study on adherence to the Italian Covid-19 vaccination campaign. International Journal of Environmental Research and Public Health, 19(5), 2970. https://doi.org/10.3390/ijerph19052970

Moccia, G., Carpinelli, L., Savarese, G., Borrelli, A., Boccia, G., Motta, O., Capunzo, M., & de Caro, F. (2021). Perception of health, mistrust, anxiety, and indecision in a group of italians vaccinated against Covid-19. Vaccines, 9(6), 612. https://doi.org/10.3390/vaccines9060612

Murphy, J., Vallières, F., Bentall, R.P., Shevlin, M., McBride, O., Hartman, T.K., McKay, R., Bennett, K., Mason, L., Gibson-Miller, J., Levita, L., Martinez, A.P., Stocks, T.V.A., Karatzias, T. & Hyland, P. (2021). Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nature Communication, 12 (29):1-15. https://doi.org/10.1038/s41467-020-20226-9

Olagoke, A.A., Olagoke, O., & Hughes, A.M. (2021). Intention to Vaccinate Against the Novel 2019 Coronavirus Disease: The Role of Health Locus of Control and Religiosity. Journal of Religion & Health, 60: 65–80. https://doi.org/10.1007/s10943-020-01090-9

Palamenghi, L., Barello, S., Boccia, S., & Graffigna, G. (2020). Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy. European Journal of Epidemiology, 35(8), 785–788. https://doi.org/10.1007/s10654-020-00675-8

Palm, R., Bolsen, T., & Kingsland, J. T. (2021). The Effect of Frames on COVID-19 Vaccine Resistance. Frontiers in Political Science, 3. https://doi.org/10.3389/fpos.2021.661257

Razai, M. S., Chaudhry, U. A. R., Doerholt, K., Bauld, L., & Majeed, A. (2021). Covid-19 vaccination hesitancy. BMJ, n.1138. https://doi.org/10.1136/bmj.n1138

Rhodes, A., Hoq, M., Measey, M.A., & Danchin, M. (2020). Intention to vaccinate against COVID-19 in Australia. The Lancet Infectious Diseases, 21(5): E110. https://doi.org/10.1016/S1473-3099(20)30724-6

Rieger, M.O. (2020). Triggering altruism increases the willingness to get vaccinated against COVID-19. Social Health Behavior, 3: 78-82. https://doi.org/10.4103/SHB.SHB_39_20 .

Salali, G.D., & Uysal, M.S. (2020). COVID-19 vaccine hesitancy is associated with beliefs on the origin of the novel coronavirus in the UK and Turkey. Psychological Medicine, 19: 1–3. https://doi.org/10.1017/S0033291720004067

Sallam, M. (2021). COVID-19 Vaccine hesitancy worldwide: A concise systematic review of vaccine acceptance rates. Vaccines, 9(2), 160. https://doi.org/10.3390/vaccines9020160

Sherman, S.M., Smith, L.E., Sim, J., Amloˆt, R., Cutts, M., Dasch, H., Rubin, G.J., & Sevdalis, N. (2020). COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Human Vaccines & Immunotherapeutics, 17(6): 1–10. https://doi.org/10.1080/21645515.2020.1846397

Soares, P., Rocha, J. V., Moniz, M., Gama, A., Laires, P. A., Pedro, A. R., Dias, S., Leite, A., & Nunes, C. (2021). Factors associated with Covid-19 vaccine hesitancy. Vaccines, 9(3), 300. https://doi.org/10.3390/vaccines9030300

Spitzer, R.L., Kroenke, K., Williams, J.B., & Löwe B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archive International Medicine, 22, 166:1092-1097. https://doi.org/10.1001/archinte.166.10.1092

Steffens, M. S., Dunn, A. G., Wiley, K. E., & Leask, J. (2019). How organisations promoting vaccination respond to misinformation on social media: a qualitative investigation. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7659-3

Sweileh, W. M. (2020). Bibliometric analysis of global scientific literature on vaccine hesitancy in peer-reviewed journals (1990–2019). BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09368-z

Swinson, R.P. (2006). The GAD-7 scale was accurate for diagnosing generalised anxiety disorder. Evidence Based Medicine, 11(6):184. https://doi.org/10.1136/ebm.11.6.184

Van Prooijen, J.-W., Acker, M. (2015). The Influence of Control on Belief in Conspiracy Theories: Conceptual and Applied Extensions. Applied Cognitive Psychology, 29: 753–761. https://doi.org/10.1002/acp.3161 .

Veronese, G., Cavazzoni, F., Fiore, F., Pancake, R. (2021). Fear of COVID-19 mediates the relation between mental distress and at-risk health behaviours in Italian adults. Mediterranean Journal of Clinical Psychology, 9(3). https://doi.org/10.13129/2282-1619/mjcp-3145

Wallston, K.A. (2005). The validity of the Multidimensional Health Locus of Control Scales. Journal of Health Psychology, 10: 623–631. https://doi.org/10.1177/1359105305055304

Wallston, K.A., Strudler Wallston, B., DeVellis, R. (1978) Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs. 6(1):160-170. https://doi.org/10.1177/109019817800600107

Wang, H., Li, T., Barbarino, P., Gauthier, S., Brodaty, H., Molinuevo, J.L., Xie, H., Sun, Y., Yu, E., Tang, Y., et al. (2020). Dementia care during COVID-19. Lancet, 395: 1190–1191. https://doi.org/10.1016/S0140-6736(20)30755-8

Wang, Q., Yang, L., Jin, H., & Lin, L. (2021). Vaccination against COVID-19: A systematic review and meta-analysis of acceptability and its predictors. Preventive Medicine, 150, 106694. https://doi.org/10.1016/j.ypmed.2021.106694

Wismans, A., Thurik, R., Baptista, R., Dejardin, M., Janssen, F., & Franken, I. (2021). Psychological characteristics and the mediating role of the 5C Model in explaining students' COVID-19 vaccination intention. PloS One, 16(8), e0255382. https://doi.org/10.1371/journal.pone.0255382

World Health Organization (2019). Ten threats to global health in 2019. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019

Yoda, T., & Katsuyama, H. (2021). Willingness to receive Covid-19 vaccination in Japan. Vaccines, 9(1), 48. https://doi.org/10.3390/vaccines9010048

DOI: https://doi.org/10.13129/2282-1619/mjcp-3441


  • There are currently no refbacks.