How do anticipated worry and regret predict seasonal influenza vaccination uptake among Chinese adults?

Objectives: To test two hypothesized models of how anticipated affect, cognitive risk estimate and vaccination intention might influence vaccination uptake against seasonal influenza.

Methods: The study collected baseline and follow-up data during the main influenza seasons (January-March) of 2009 and 2010, respectively, among 507 university students and staff of a university in Hong Kong. Following logistic regression to determine eligible variables, two mediation models of cognitive risk estimate, anticipated affect, vaccination intention and vaccination uptake against seasonal influenza were tested using structural equation modeling.

Results: Mediation analyses found that anticipated worry if not vaccinated influenced seasonal influenza vaccination uptake through its effects on either perceived probability of influenza infection (β=0.45) or intention (β=0.45) while anticipated regret if not vaccinated influenced vaccination uptake through its effect on intention (β=0.45) only; anticipated regret if vaccinated impeded vaccination uptake indirectly through its effect on vaccination intention (β=-0.26) or directly (β=-0.20); perceived probability of influenza infection influenced vaccination uptake through its effect on intention (β=0.20) or directly (β=0.22); and finally, intention influenced vaccination uptake directly (β=0.58).

Conclusion: The results suggest that anticipated affect seems to drive risk estimates related to seasonal influenza vaccination rather than vice versa and intention remains an important mediator of the associations of anticipated affect and cognitive risk estimate with vaccination uptake against seasonal influenza.