An assessment of the health belief model, vaccine hesitancy, and credible sources of health messages during flu season

Saud A. Alsulaiman 1 * , Ezaddeen S. Almutairi 1
More Detail
1 Department of Mass Communication, College of Humanities and Social Sciences, King Saud University, Riyadh, SAUDI ARABIA
* Corresponding Author
Online Journal of Communication and Media Technologies, Volume 16, Issue 4, Article No: e202647. https://doi.org/10.30935/ojcmt/19268
OPEN ACCESS   12 Views   6 Downloads   Published online: 17 Sep 2026
Download Full Text (PDF)

ABSTRACT

This study incorporated the World Health Organization’s adult vaccine hesitancy scale and the health belief model to determine the relationships between vaccine hesitancy, individual perceptions, and vaccine uptake during the flu season between September 2023 and March 2024 at a large university in Saudi Arabia. The study also investigated information-seeking behaviors, the credibility of flu messages disseminated by health authorities, and adherence to flu preventive measures among individuals. This quantitative study used a purposive online survey sent via research email service to students, faculty, and staff (N = 1,130) at a large university in Riyadh, Saudi Arabia. Multiple statistical tests were conducted, including multiple linear regression, Kruskal-Wallis, and Mann-Whitney tests. Findings indicated that 45% of individuals first turned to Internet search engines for health information about the flu and believed that public health authorities were credible sources compared to other sources, such as traditional and social media. Findings also showed that the HBM and age significantly predicted vaccine hesitancy. Age and sex did not predict vaccine uptake among participants. Respondents reported strong health beliefs, low vaccine hesitancy, and perceived flu messages as credible. Although individuals reported high health beliefs and low vaccine hesitancy, the flu vaccine uptake in Saudi Arabia remains a concern. The study highlighted the discrepancy between positive health beliefs and actual vaccination behavior, shedding light on effective strategies for tackling the issue of suboptimal vaccine uptake in the country.
Keywords: health belief model, vaccine hesitancy, information-seeking, credibility of flu messages, preventive measures

CITATION

Alsulaiman, S. A., & Almutairi, E. S. (2026). An assessment of the health belief model, vaccine hesitancy, and credible sources of health messages during flu season. Online Journal of Communication and Media Technologies, 16(4), e202647. https://doi.org/10.30935/ojcmt/19268

REFERENCES

  • Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T
  • Alalag, Z. A., Al-Jumaili, A. A., & Al-Hamadani, F. Y. (2022). A comprehensive review of drivers influencing flu vaccine acceptance in the Middle East over the last six years using the health belief model. International Journal of Pharmacy Practice, 30(1), 5-16. https://doi.org/10.1093/ijpp/riab063
  • Alenazi K. A. (2022). Parents’ knowledge, attitude and practice towards seasonal influenza vaccination in Riyadh region, Saudi Arabia. Journal of Infection in Developing Countries, 16(10), 1623-1629. https://doi.org/10.3855/jidc.15151
  • Al-Ghamdi, S. M., Alshahrani, A. A., & Alrasheed, A. (2021). Knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers in Saudi Arabia. Journal of Infection and Public Health, 14(4), 563-570.
  • Alharbi, F. A., Alghamdi, A. H., & Alhossan, A. A. (2021). Knowledge, attitudes, and practices regarding influenza vaccination among the general public in Saudi Arabia: A cross-sectional study. Vaccine, 39(3), 493-500.
  • Alhatim, N., Al-Bashaireh, A. M., & Alqudah, O. (2022). Knowledge, attitude, and practice of seasonal influenza and influenza vaccine immunization among people visiting primary healthcare centers in Riyadh, Saudi Arabia. PLoS ONE, 17(4), Article e0266440. https://doi.org/10.1371/journal.pone.0266440
  • Alkazemi, M. F., Guidry, J. P. D., Almutairi, E., & Messner, M. (2022). #Arabhealth on Instagram: Examining public health messages to Arabian Gulf State audiences. Health Communication, 37(1), 39-47. https://doi.org/10.1080/10410236.2020.1816283
  • Al-Mohaimeed, A., Alshammari, T. S., & Almutairi, A. F. (2019). Knowledge, attitudes, and beliefs regarding influenza vaccination among healthcare workers in Saudi Arabia. BMC Health Services Research, 19(1), 1-10.
  • Alolayan, A., Almotairi, B., Alshammari, S., Alhearri, M., & Alsuhaibani, M. (2019). Seasonal influenza vaccination among Saudi children: Parental barriers and willingness to vaccinate their children. International Journal of Environmental Research and Public Health, 16(21), Article 4226. https://doi.org/10.3390/ijerph16214226
  • Alqurashi, A. M., Alharthi, F. H., & Alshahrani, A. F. (2022). Knowledge, attitudes, and practices regarding influenza vaccination among university students in Saudi Arabia. BMC Public Health, 22(1), 1-9.
  • Alrajeh, A. M., Daghash, H., Buanz, S. F., Altharman, H. A., & Belal, S. (2021). COVID-19 vaccine hesitancy among the adult population in Saudi Arabia. Cureus, 13(12), Article e20197. https://doi.org/10.7759/cureus.20197
  • Alsubaie, S. S., Gosadi, I. M., Alsaadi, B. M., Albacker, N. B., Bawazir, M. A., Bin-Daud, N., Almanie, W. B., Alsaadi, M. M., & Alzamil, F. A. (2019). Vaccine hesitancy among Saudi parents and its determinants. Saudi Medical Journal, 40(12), 1242-1250. https://doi.org/10.15537/smj.2019.12.24653
  • Alsulaiman, S. A. (2023). A cross-sectional study of perceptions of COVID-19 and adherence to preventive measures among Saudi college students using the health belief model. Online Journal of Communication and Media Technologies, 13(4), Article e202357. https://doi.org/10.30935/ojcmt/13783
  • Alsulaiman, S. A., & Rentner, T. L. (2018). The health belief model and preventive measures: A study of the Ministry of Health campaign on coronavirus in Saudi Arabia. Journal of International Crisis and Risk Communication Research, 1(1), 27-56.
  • Alsulaiman, S. A., & Rentner, T. L. (2021). The use of the health belief model to assess U.S. college students’ perceptions of COVID-19 and adherence to preventive measures. Journal of Public Health Research, 10(4), Article 2273. https://doi.org/10.4081/jphr.2021.2273
  • Alsulaiman, S. A., Rentner, T. L. (2022) Information seeking behaviors and media credibility among college students during the COVID-19 pandemic. Atlantic Journal of Communication, 30(5), 549-569. https://doi.org/10.1080/15456870.2021.1981330
  • Alsuwailem, S. I., Okmi, E. A., Alkhaldi, E. H., Almutairi, K. S., Alshamari, W. K., & Alshamari, W. K. (2023). Determinants of flu vaccine uptake among the general population in Saudi Arabia: A study based on the health belief model. Cureus, 15(7), Article e41277. https://doi.org/10.7759/cureus.41277
  • Alwazzeh, M. J., Telmesani, L. M., Al Enazi, A. S., Buohliqah, L. A., Halawani, R. T., Jatoi, N. A., & Almuhanna, F. A. (2021). Seasonal influenza vaccination coverage and its association with COVID-19 in Saudi Arabia. International Medical University, 27, Article 100809. https://doi.org/10.1016/j.imu.2021.100809
  • Alzahrani, A. M., Felix, H. C., & Al-Etesh, N. S. (2023). Low uptake of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Saudi Pharmaceutical Journal, 31(5), 687-691. https://doi.org/10.1016/j.jsps.2023.03.009
  • Austin, E. W., & Dong, Q. (1994). Source v. content effects on judgments of news believability. Journalism Quarterly, 71(4), 973-983. https://doi.org/10.1177/107769909407100420
  • Barry, M. A., Aljammaz, K. I., & Alrashed, A. A. (2020). Knowledge, attitude, and barriers influencing seasonal influenza vaccination uptake. Canadian Journal of Infectious Diseases and Medical Microbiology. https://doi.org/10.1155/2020/7653745
  • Bundorf, M. K., Wagner, T. H., Singer, S. J., & Baker, L. C. (2006). Who searches the Internet for health information? Health Services Research, 41(3), 819-836. https://doi.org/10.1111/j.1475-6773.2006.00510.x
  • Cai, Z., Hu, W., Zheng, S., Wen, X., & Wu, K. (2022). Cognition and behavior of COVID-19 vaccination based on the health belief model: A cross-sectional study. Vaccine, 10(4), Article 544. https://doi.org/10.3390/vaccines10040544
  • Calnan, M. (1984). The health belief model and participation in programmes for the early detection of breast cancer: A comparative analysis. Social Science & Medicine, 19(8), 823-830. https://doi.org/10.1016/0277-9536(84)90399-X
  • CDC. (2024a). About influenza. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/index.html
  • CDC. (2024b). Vaccines effectiveness: How well do flu vaccines work? Centers for Disease Control and Prevention. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
  • Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6(3), 73-85. https://doi.org/10.1097/00012272-198404000-00011
  • Champion, V. L. (1993). Instrument refinement for breast cancer screening behaviors. Nursing Research, 42(3), 139-143. https://doi.org/10.1097/00006199-199305000-00003
  • Champion, V. L., & Scott, C. R. (1997). Reliability and validity of breast cancer screening belief scales in African American women. Nursing Research, 46(6), 331-337. https://doi.org/10.1097/00006199-199711000-00006
  • Champion, V. L., & Skinner, C. S. (2008). The health belief model. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (4th ed., pp. 45-65). Jossey-Bass/Wiley.
  • Chapin, J. (2001). It won’t happen to me: The role of optimistic bias in African American teens’ risky sexual practices. Howard Journal of Communication, 12(1), 49-59. https://doi.org/10.1080/10646170151143370
  • Cheney, M. K., & John, R. (2013). Underutilization of influenza vaccine: A test of the health belief model. SAGE Open, 3(2). https://doi.org/10.1177/2158244013484732
  • Cummings, K. M., Jette, A. M., Brock, B. M., & Haefner, D. P. (1979). Psychosocial determinants of immunization behavior in a swine influenza campaign. Medical Care, 17, 639-649. https://doi.org/10.1097/00005650-197906000-00008
  • Dillman, D. A., Smyth, J. D., & Christian, L. M. (2014). Internet, phone, mail, and mixed-mode surveys: The tailored design method. John Wiley & Sons, Inc. https://doi.org/10.1002/9781394260645
  • Donohue, J. M., Huskamp, H. A., Wilson, I. B., & Weissman, J. (2009). Whom do older adults trust most to provide information about prescription drugs? American Journal of Geriatric Pharmacotherapy, 7(2), 105-116. https://doi.org/10.1016/j.amjopharm.2009.04.005
  • Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. (2013). Vaccine hesitancy: An overview. Human Vaccines & Immunotherapeutics, 9(8), 1763-1773. https://doi.org/10.4161/hv.24657
  • Dutta-Bergman, M. (2003). Trusted online sources of health information: Differences in demographics, health beliefs, and health-information orientation. Journal of Medical Internet Research, 5(3), Article e21. https://doi.org/10.2196/jmir.5.3.e21
  • Fadhel, F. H. (2023). Vaccine hesitancy and acceptance: An examination of predictive factors in COVID-19 vaccination in Saudi Arabia. Health Promotion International, 38(4), Article daab209. https://doi.org/10.1093/heapro/daab209
  • Fox, S. (2011). Profiles of health information seekers. Pew Research Center. https://www.pewresearch.org/internet/2011/02/01/profiles-of-health-information-seekers/
  • Fox, S., & Purcell, K. (2010). Half of U.S. adults living with chronic disease are e-patients. Pew Research Center. https://www.pewresearch.org/internet/2010/03/24/health-information/
  • Freeman, D., Loe, B. S., Chadwick, A., Vaccari, C., Waite, F., Rosebrock, L., Jenner, L., Petit, A., Lewandowsky, S., Vanderslott, S., Innocenti, S., Larkin, M., Giubilini, A., Yu, L. M., McShane, H., Pollard, A. J., & Lambe, S. (2022). COVID-19 vaccine hesitancy in the UK: The Oxford coronavirus explanations, attitudes, and narratives survey (oceans) II. Psychological Medicine, 52(14), 3127-3141. https://doi.org/10.1017/S0033291720005188
  • Funk, C., Kennedy, B., & Johnson, C. (2020). Trust in medical scientists has grown in the U.S., but mainly among Democrats. Pew Research Center. https://www.pewresearch.org/science/2020/05/21/trust-in-medical-scientists-has-grown-in-u-s-but-mainly-among-democrats/
  • Gaziano, C. (1988). How credible is the credibility crisis? Journalism Quarterly, 65(2), 267-278. https://doi.org/10.1177/107769908806500202
  • Guilford, K., McKinley, E., & Turner, L. (2017). Breast cancer knowledge, beliefs, and screening behaviors of college women: Application of the health belief model. American Journal of Health Education, 48(4), 256-263. https://doi.org/10.1080/19325037.2017.1316694
  • Hochbaum, G. M. (1958). Public participation in medical screening programs: A socio-psychological study. PHS Publication No. 572, Government Printing Office.
  • Hornikx, J., & O’Keefe, D. J. (2009). Adapting consumer advertising appeals to cultural values: A meta-analytic review of effects on persuasiveness and ad liking. Journal of Marketing Communications, 15(4), 211-230.
  • Huang, H. Y., & Gerend, M. A. (2024). The role of trust, vaccine information exposure, and health belief model variables in COVID-19 vaccination intentions: Evidence from an HBCU sample. Journal of Health Psychology, 29(6), 621-632. https://doi.org/10.1177/13591053241227388
  • Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47. https://doi.org/10.1177/109019818401100101
  • Karimy, M., Bastami, F., Sharifat, R., Heydarabadi, A. B., Hatamzadeh, N., Pakpour, A. H., & Araban, M. (2021). Factors related to preventive COVID-19 behaviors using the health belief model among the general population: A cross-sectional study in Iran. BMC Public Health, 21, 1-8. https://doi.org/10.1186/s12889-021-11983-3
  • Kennedy, B., Tyson, A., & Funk, C. (2022). Americans’ trust in scientists, other groups declines. Pew Research Center. https://www.pewresearch.org/science/2022/02/15/americans-trust-in-scientists-other-groups-declines/
  • Khan, R., Ahmed, A., Zeitounie, R., & Khandekar, R. (2021). Impact of influenza vaccine on reduction of incidence and severity of influenza-like illness. Eastern Mediterranean Health Journal, 27(9), 884-891. https://doi.org/10.26719/emhj.21.041
  • Khedher, N. B., Ben Saad, H., & Aouicha, W. (2020). Knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers in Saudi Arabia: A cross-sectional study. BMC Public Health, 20(1), 1-9.
  • Kim, Y. (2016). Trust in health information websites: A systematic literature review on the antecedents of trust. Journal of Health Informatics, 22(2), 355-369. https://doi.org/10.1177/1460458214559432
  • Larson, H. J., Jarrett, C., Schulz, W. S., Chaudhuri, M., Zhou, Y., Dube, E., Schuster, M., MacDonald, N. E., Wilson, R., & SAGE Working Group on Vaccine Hesitancy. (2015). Measuring vaccine hesitancy: The development of a survey tool. Vaccine, 33(34), 4165-4175. https://doi.org/10.1016/j.vaccine.2015.04.037
  • Limbu, Y. B., Gautam, R. K., & Pham, L. (2022). The health belief model applied to COVID-19 vaccine hesitancy: A systematic review. Vaccine, 10(6), Article 973. https://doi.org/10.3390/vaccines10060973
  • Little, R. J., & Rubin, D. B. (2019). Statistical analysis with missing data. John Wiley & Sons. https://doi.org/10.1002/9781119482260
  • MacDonald, N. E., & SAGE Working Group on Vaccine Hesitancy. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161-4164. https://doi.org/10.1016/j.vaccine.2015.04.036
  • Mackert, M., Lazard, A., Guadagno, M., & Hughes-Wagner, J. (2014). The role of implied motion in engaging audiences for health promotion: Encouraging naps on a college campus. Journal of American College Health, 62(8), 542-551. https://doi.org/10.1080/07448481.2014.944534
  • McCroskey, J. C., & Teven, J. J. (1999). Goodwill: A reexamination of the construct and its measurement. Communication Monographs, 66(1), 90-103. https://doi.org/10.1080/03637759909376464
  • Metzger, M. J., Flanagin, A. J., Eyal, K., Lemus, D. R., & McCann, R. M. (2003). Credibility for the 21st century: Integrating perspectives on source, message, and media credibility in the contemporary media environment. In P. J. Kalbfleisch (Ed.), Communication yearbook 27 (pp. 293-335). Lawrence Erlbaum Associates Publishers. https://doi.org/10.1080/23808985.2003.11679029
  • Meyer, P. (1988). Defining and measuring credibility of newspapers: Developing an index. Journalism Quarterly, 65(3), 567-574. https://doi.org/10.1177/107769908806500301
  • Miller, L. M. S., & Bell, R. A. (2012). Online health information seeking: The influence of age, information trustworthiness, and search challenges. Journal of Applied Health Communication, 24(3), 525-541. https://doi.org/10.1177/0898264311428167
  • Mitchell, B., Jurkowitz, M. J., Oliphant, B., & Shearer, E. (2020). Three months in, many Americans see exaggeration, conspiracy theories, and partisanship in COVID-19 news. Pew Research Center. https://www.journalism.org/2020/06/29/three-months-in-many-americans-see-exaggeration-conspiracy-theories-and-partisanship-in-covid-19-news/
  • MOH. (2015). Seasonal influenza vaccination: Questions and answers. Ministry of Health. https://moh.gov.sa/en/Flu/Pages/QA.aspx
  • MOH. (2020). MOH launches seasonal influenza vaccination campaign today. Ministry of Health. https://moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-09-28-007.aspx
  • MOH. (2023). MOH emphasizes the necessity of taking influenza vaccine to avoid its outbreak and complications. Ministry of Health. https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2023-10-02-001.aspx
  • Niu, Z., Qin, Z., Hu, P., & Wang, T. (2022). Health beliefs, trust in media sources, health literacy, and preventive behaviors among high-risk Chinese for COVID-19. Health Communication, 37(8), 1004-1012. https://doi.org/10.1080/10410236.2021.1880684
  • Norman, P., & Brain, K. (2005). An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer. British Journal of Health Psychology, 10(1), 1-16. https://doi.org/10.1348/135910704X24752
  • Nour, R., Powell, L., Alnakhi, W. K., Mamdouh, H., Zidoun, Y., Hussain, H. Y., Al Suwaidi, H., & Zary, N. (2022). Adult vaccine hesitancy scale in Arabic and French: Protocol for translation and validation in the World Health Organization Eastern Mediterranean Region. JMIR Research Protocols, 11(4), Article e36928. https://doi.org/10.2196/36928
  • Park, J. S., & Ju, I. (2016). Prescription drug advertising, disease knowledge, and older adults’ optimistic bias about the future risk of Alzheimer’s disease. Health Communication, 31(3), 346-354. https://doi.org/10.1080/10410236.2014.957375
  • Petosa, R., & Jackson, K. (1991). Using the health belief model to predict safer sex intentions among adolescents. Health Education Quarterly, 18(4), 463-476. https://doi.org/10.1177/109019819101800405
  • QS Ranking. (2024). QS universities ranking. Top Universities. https://www.topuniversities.com/university-rankings
  • Rains, S. A. (2007). Perceptions of traditional information sources and use of the world wide web to seek health information: Findings from the health information national trends survey. Journal of Health Communication, 12(7), 667-680. https://doi.org/10.1080/10810730701619992
  • Raj, A., Singh, A. K., Wagner, A. L., & Boulton, M. L. (2023). Mapping the cognitive biases related to vaccination: A scoping review of the literature. Vaccine, 11(12), Article 1837. https://doi.org/10.3390/vaccines11121837
  • Rentner, T. L., & Alsulaiman, S. A. (2024). “Not me!”: Optimistic bias and college students’ perceived susceptibility, severity, benefits, and self-efficacy in following COVID-19 preventive guidelines. Journal of American College Health, 72(5), 1428-1437. https://doi.org/10.1080/07448481.2022.2079950
  • Rimmer, T., & Weaver, D. (1987). Different questions, different answers? Media use and media credibility. Journalism Quarterly, 64(1), 28-44. https://doi.org/10.1177/107769908706400104
  • Rosenstock, I. M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354-386. https://doi.org/10.1177/109019817400200405
  • Ross, T. P., Ross, L. T., Rahman, A., & Cataldo, S. (2010). The bicycle helmet attitudes scale: Using the health belief model to predict helmet use among undergraduates. Journal of American College Health, 59(1), 29-36. https://doi.org/10.1080/07448481.2010.483702
  • Rostad, C. A., & Anderson, E. J. (2021). Optimism and caution for an inactivated COVID-19 vaccine. Lancet Infectious Diseases, 21(5), 581-582. https://doi.org/10.1016/S1473-3099(20)30988-9
  • Sales, I. A., Syed, W., Almutairi, M. F., & Al Ruthia, Y. (2021). Public knowledge, attitudes, and practices toward seasonal influenza vaccine in Saudi Arabia: A cross-sectional study. International Journal of Environmental Research and Public Health, 18(2), Article 479. https://doi.org/10.3390/ijerph18020479
  • Santos, A. J., Kislaya, I., Machado, A., & Nunes, B. (2017). Beliefs and attitudes towards the influenza vaccine in high-risk individuals. Epidemiology and Infection, 145(9), 1786-1796. https://doi.org/10.1017/S0950268817000814
  • Sayed, A. A. (2022). Assessing the impact of use and trust in different sources of information on COVID-19 vaccination uptake in Saudi Arabia (SA) using the COVID-19 vaccine hesitancy and resistance in SA (CoV-HERSA) tool. Tropical Medicine and Infectious Disease, 7(11), Article 375. https://doi.org/10.3390/tropicalmed7110375
  • Sheeran, P. (2002). Intention-behavior relations: A conceptual and empirical review. European Review of Social Psychology, 12(1), 1-36. https://doi.org/10.1080/14792772143000003
  • Sheeran, P., & Webb, T. L. (2016). The intention-behavior gap. Social and Personality Psychology Compass, 10(9), 503-518. https://doi.org/10.1111/spc3.12265
  • Shepperd, J. A., Klein, W. M. P., Waters, E. A., & Weinstein, N. D. (2013). Taking stock of unrealistic optimism. Perspectives on Psychological Science, 8(4), 395-411. https://doi.org/10.1177/1745691613485247
  • Stanley-Clarke, N., Hay, A., Maris, R., Ryan, A., Knook, J., & Winder, L. (2024). Optimism bias as a barrier to accessing mental health support amongst tertiary students. Higher Education Research & Development, 43(7), 1602-1614. https://doi.org/10.1080/07294360.2024.2339838
  • Streefland, P., Chowdhury, A. M. R., & Ramos-Jimenez, P. (1999). Patterns of vaccination acceptance. Social Science & Medicine, 49(12), 1705-1716. https://doi.org/10.1016/S0277-9536(99)00239-7
  • Tharkar, S., Alduraywish, S., Nishat, A. A., Alsuwailem, L., Alohali, L., Kahtani, M. K., & Aldakheel, F. M. (2023). The influence of the COVID-19 pandemic on seasonal influenza vaccine uptake among patients visiting a university hospital in Saudi Arabia. Cureus, 15(10), Article e47042. https://doi.org/10.7759/cureus.47042
  • Weinstein, N. D., & Lyon, J. E. (1999). Mindset, optimistic bias about personal risk, and health-protective behavior. British Journal of Health Psychology, 4(4), 289-300. https://doi.org/10.1348/135910799168641
  • Welch, V. L., Metcalf, T., Macey, R., Markus, K., Sears, A. J., Enstone, A., Langer, J., Srivastava, A., Cane, A., & Wiemken, T. L. (2023). Understanding the barriers and attitudes toward influenza vaccine uptake in the adult general population: A rapid review. Vaccine, 11(1), Article 180. https://doi.org/10.3390/vaccines11010180
  • West, M. D. (1994). Validating a scale for the measurement of credibility: A covariance structure modeling approach. Journalism Quarterly, 71(1), 159-168. https://doi.org/10.1177/107769909407100115
  • WHO. (2022). A Saudi Arabian journey in influenza surveillance. World Health Organization. https://www.who.int/news/item/13-12-2022-a-saudi-arabian-journey-in-influenza-surveillance
  • WHO. (2024a). Influenza (seasonal). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
  • WHO. (2024b). Open call for members and participants of the Europe infodemic preparedness and response alliance (EIPRA). World Health Organization. https://www.who.int/europe/news-room/articles/item/open-call-for-members-and-participants-of-the-europe-infodemic-preparedness-and-response-alliance-eipra
  • Wolff, K. (2021). COVID-19 vaccination intentions: The theory of planned behavior, optimistic bias, and anticipated regret. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.648289
  • Wolff, K. (2024). COVID-19 vaccination intentions and uptake pre- and post-vaccine availability: A cross-sectional comparison of theory of planned behavior, anticipated regret, and optimistic bias. Journal of Public Health, 33, 2137-2145. https://doi.org/10.1007/s10389-023-02189-5
  • Wong, L. P., Alias, H., Wong, P. F., Lee, H. Y., & Abu Bakar, S. (2020). The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Human Vaccines & Immunotherapeutics, 16(9), 2204-2214. https://doi.org/10.1080/21645515.2020.1790279
  • Xie, T., Grady, C., Cacciatore, M., & Nowak, G. (2019). Understanding flu vaccination acceptance among U.S. adults: The health belief model and media sources. In Proceedings of the International Crisis and Risk Communication Conference (pp. 35-37). Nicholson School of Communication and Media, University of Central Florida. https://doi.org/10.30658/icrcc.2019.10
  • Yang, X., Wei, L., & Liu, Z. (2022). Promoting COVID-19 vaccination using the health belief model: Does information acquisition from divergent sources make a difference? International Journal of Environmental Research and Public Health, 19(7), Article 3887. https://doi.org/10.3390/ijerph19073887
  • Yang, Z. J. (2015). Predicting young adults’ intentions to get the H1N1 vaccine: An integrated model. Journal of Health Communication, 20(1), 69-79. https://doi.org/10.1080/10810730.2014.904023
  • Zulman, D. M., Kirch, M., Zheng, K., & An, L. C. (2011). Trust in the Internet as a health resource among older adults: Analysis of data from a nationally representative survey. Journal of Medical Internet Research, 13(1), Article e1552. https://doi.org/10.2196/jmir.1552