The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review

Yam B. Limbu, Rajesh K. Gautam, Long Pham

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


This study systematically analyzes the research that used the Health Belief Model (HBM) as a theoretical basis to examine the influence of HBM constructs on COVID-19 vaccine hesitancy. Following PRISMA guidelines, PubMed, Web of Science, Google Scholar, and Scopus were searched for quantitative studies. Sixteen studies with 30,242 participants met inclusion criteria. The prevalence of COVID-19 vaccine hesitancy was 33.23% (95% CI 24.71–41.39%). Perceived barriers and perceived benefits were the most common HBM constructs that were significantly associated with vaccine hesitancy. While perceived benefits was inversely associated, a positive association was found between perceived barriers and vaccine hesitancy. Other HBM constructs that were frequently examined and inversely associated were perceived susceptibility, cues to action, perceived severity, and self-efficacy. The most common HBM modifying factor that was directly associated with COVID19 vaccine hesitancy was gender, followed by education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity; however, a few studies report inconsistent results. Other modifying variables that influenced vaccine hesitancy were knowledge of COVID-19, prior diagnosis of COVID-19, history of flu vaccination, religion, nationality, and political affiliation. The results show that HBM is useful in predicting COVID-19 vaccine hesitancy.

Original languageEnglish
Article number973
Issue number6
StatePublished - Jun 2022


  • COVID-19
  • cues to action
  • health belief model
  • perceived barriers
  • perceived benefits
  • perceived severity
  • perceived susceptibility
  • self-efficacy
  • systematic review
  • vaccine hesitancy


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