Abstract
BACKGROUND: The effectiveness of public health efforts and vaccination campaigns depends on the level of trust that the population has, which in turn depends on the population's confidence in health information sources and organizations. This study aims to assess post-pandemic compliance with vaccine information sources and their influence on future pandemic preparedness in Iran and to identify the underlying factors related to adherence. METHODS: This cross-sectional study was conducted using an online questionnaire among Iranian adults in 2024. The instrument used in this study was rooted in the Health Belief Model and the 3 C Model of Vaccine Hesitancy, and was developed according to previous literature, objectives of the study, and inputs from experts in this field. Validity and reliability of the questionnaire were further evaluated using face, content and construct validity, and Cronbach's alpha. We applied multiple linear regression to identify independent predictors of compliance with national and international vaccination guidelines and future pandemic preparedness. RESULTS: Among 457 Iranian adults who participated in our study, approximately 75% reported favorable attitudes toward adherence to vaccination guidelines and pandemic preparedness. Mean adherence scores were higher for international (4.06 ± 0.76) than for national (3.81 ± 0.81) vaccination guidelines. Multiple linear regression revealed that trust in health authorities, favorable vaccine perceptions, and self-efficacy were the strongest predictors of adherence to both national and international vaccination guidelines. Notably, trust in national health authorities was negatively associated with adherence to international vaccination guidelines (B: -0.137, 95% CI: -0.198 -0.076). In addition, individuals with a personal or family history of COVID-19 scored significantly higher in adherence to international vaccination guidelines by an average of 0.31 points (95% CI: 0.11-0.51). CONCLUSIONS: Enhancing vaccine perceptions, trust in health organizations, and self-efficacy improves public compliance and pandemic preparedness.