Understanding RSV Vaccine Hesitancy: Exploring Decision-Making Pathways

This study investigated factors that contribute to RSV vaccine hesitancy via two decision-making pathways: deliberate consideration guided by reasons and rationales, and cognitive heuristics. Belief in vaccine pseudo-information (e.g. mis/disinformation, conspiracy theories) and individual ethical orientations (IEO; teleology vs. deontology) were introduced as epistemic and normative factors, respectively, that influence cognitive processes when people make decisions to receive RSV vaccinations. Omission bias attributable to cognitive heuristics was examined. Two online surveys were conducted to gather data from two population groups recommended to receive RSV vaccines: adults aged 60 and older, and pregnant women to protect their unborn infants. The data were analyzed separately to examine the association of these factors with each group's reluctance to receive an RSV vaccination, as well as the interactions between these factors. Belief in pseudo-information was associated significantly and positively with RSV vaccine hesitancy across both groups of potential RSV vaccine recipients. Among pregnant women, omission bias attributable to severe symptoms (e.g. death) was associated significantly and positively with RSV vaccination hesitancy. Significant interactions were found between belief in vaccine pseudo-information and IEO, as well as between pseudo-information and omission bias, both of which were associated with RSV vaccination reluctance on the part of pregnant women. Significant group differences were observed when these associations were compared. Implications, limitations, and suggestions for future research are discussed based upon these findings.