Abstract
Since the onset of the COVID-19 pandemic, vaccinations have been identified as the most effective mitigation strategy against the deadly virus. This has led developed nations to accelerate research and shorten the licensure process for COVID-19 vaccines, but these changes have caused widespread concerns about vaccine safety. Research literature has long indicated that citizens' perceptions of protective actions will determine their behaviors, and thus, the relationship between vaccine perception and vaccination intention needs to be assessed. To better understand vaccination willingness, especially in rural populations, this study surveyed 492 households from six townships in the Ya'an region of China's Sichuan Province in November 2020. The survey followed the Protective Action Decision Model (PADM) framework for collecting perceptions about the influenza and COVID-19 vaccines as protective actions, information sources, emergency preparedness, emotional response, and demographic characteristics. The results showed that influenza vaccine perceptions significantly affected people's COVID-19 vaccination perceptions and intentions. Unlike previous vaccination willingness and other COVID-19 studies, this study found that perceptions of resource-related attributes and health-related attributes both affected COVID-19 vaccination intentions, but the former were slightly stronger than the latter. Moreover, these effects were strongest among respondents who had the most positive perceptions of their influenza vaccine experience. This study's findings will benefit local authorities in designing appropriate policies and measures (e.g., hazard education, risk communication, vaccination convenience enhancement) for increasing vaccination compliance for the current and future pandemics.