Honors Theses

Date of Award

Spring 5-8-2022

Document Type

Undergraduate Thesis



First Advisor

Aaron Lee

Second Advisor

Todd Smitherman

Third Advisor

Nicolaas Prins

Relational Format



The COVID-19 pandemic impacted many aspects of American’s lives causing over 79 million cases and over 950,000 deaths. Existing research shows severity of COVID-19 infection may be linked to number of underlying health conditions, known as comorbidities. The objective of this study was to determine if comorbidity burden was associated with intention to vaccinate against COVID-19. This relationship was looked at through the Health Belief Model (HBM) and its mediating variables of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Our sample was compromised of 350 individuals recruited from an online platform who were not already vaccinated against COVID-19. Respondents completed a survey with measures of sociodemographic characteristics, mediators of the HBM, intention to vaccinate, and behavioral intention. Two parallel mediation models were examined for both low and high-risk comorbidity burden on behavioral intentions for COVID-19 vaccination via perceived severity, perceived susceptibility, perceived benefits, and perceived barriers with controls for age and smoking status, established risk factors for COVID-19. Overall, our results showed the HBM model did not mediate intentions to vaccinated as related to comorbidity burden. There was one significant indirect effect across both models for low-risk comorbidity burden via perceived barriers (B = 0.20, 95%CI: -0.45, -0.02), indicating individuals with greater low-risk comorbidity burden have lower intention to be vaccinated against COVID-19. In conclusion, these results suggest that HBM may not fully account for attitudes and beliefs linking comorbidity related COIVD-19 risk and COVID vaccination intention. These findings suggest that targeted loss-framed messages focusing on patients’ comorbidity burden and related COVID susceptibility and severity may have little impact on individuals’ vaccination intentions. Gain framed messages emphasizing the benefits of COVID vaccination may be similarly ineffective for increase vaccination intentions.

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Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.



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