Responding to Measles Resurgence: A Behavioral Theory Comparison of Vaccine Hesitancy
Faculty Mentor
Dr. James Thomas
Location
Russell Union Ballroom
Type of Research
On-going
Session Format
Poster Presentation
College
Jiann-Ping Hsu College of Public Health
Department
Health Policy and Community Health
Abstract
Recent measles outbreaks in the United States highlight the renewed urgency of addressing vaccine hesitancy, even in settings with historically strong immunization systems. Declining MMR coverage and rising school-entry exemptions have created pockets of vulnerability that enable outbreaks, with national kindergarten exemption rates reaching 3.6% and MMR coverage falling to approximately 92.5%, below the 95% threshold needed to sustain community protection (Centers for Disease Control and Prevention [CDC], 2025). These trends underscore the need for theory-informed strategies that explain why vaccination decisions vary across contexts.
This research critically compares two widely used frameworks, the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), for predicting vaccine hesitancy. HBM focuses on perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy, offering a practical framework for risk-based messaging and barrier reduction (Champion & Skinner, 2008; Rosenstock, 1966). TPB explains behavior through attitudes, subjective norms, and perceived behavioral control, positioning intention as the most proximal predictor of uptake (Ajzen, 1991). Evidence suggests both models are useful, but their strengths vary by setting: in high-access contexts, social norms, misinformation, and trust may drive intention more strongly; in mixed-access contexts, competing influences shape both perceptions and control; and in low-resource settings, structural barriers and limited access may weaken the intention–behavior link despite positive attitudes (Shmueli, 2021; Limbu et al., 2022).
Drawing on empirical evidence from HPV, influenza, and COVID-19 contexts, the analysis evaluates each model’s predictive validity, construct overlap (e.g., perceived behavioral control vs. self-efficacy), and the consistency of construct measurement across studies (Brewer et al., 2017; Shmueli, 2021). The paper concludes that integrated models combining HBM and TPB constructs may offer the most robust pathway for designing culturally responsive interventions to strengthen vaccine confidence and protect communities from a resurgence of vaccine-preventable diseases.
Program Description
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Start Date
4-23-2026 10:00 AM
End Date
4-23-2026 12:00 PM
Recommended Citation
Ayo-Farai, Oluwatoyin; Obianyo, Checkwube; Ezeamii, Victor; Mosley, Sarah L.; and Menefield, Ragonda, "Responding to Measles Resurgence: A Behavioral Theory Comparison of Vaccine Hesitancy" (2026). GS4 Student Scholars Symposium. 42.
https://digitalcommons.georgiasouthern.edu/research_symposium/2026/2026/42
Responding to Measles Resurgence: A Behavioral Theory Comparison of Vaccine Hesitancy
Russell Union Ballroom
Recent measles outbreaks in the United States highlight the renewed urgency of addressing vaccine hesitancy, even in settings with historically strong immunization systems. Declining MMR coverage and rising school-entry exemptions have created pockets of vulnerability that enable outbreaks, with national kindergarten exemption rates reaching 3.6% and MMR coverage falling to approximately 92.5%, below the 95% threshold needed to sustain community protection (Centers for Disease Control and Prevention [CDC], 2025). These trends underscore the need for theory-informed strategies that explain why vaccination decisions vary across contexts.
This research critically compares two widely used frameworks, the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), for predicting vaccine hesitancy. HBM focuses on perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy, offering a practical framework for risk-based messaging and barrier reduction (Champion & Skinner, 2008; Rosenstock, 1966). TPB explains behavior through attitudes, subjective norms, and perceived behavioral control, positioning intention as the most proximal predictor of uptake (Ajzen, 1991). Evidence suggests both models are useful, but their strengths vary by setting: in high-access contexts, social norms, misinformation, and trust may drive intention more strongly; in mixed-access contexts, competing influences shape both perceptions and control; and in low-resource settings, structural barriers and limited access may weaken the intention–behavior link despite positive attitudes (Shmueli, 2021; Limbu et al., 2022).
Drawing on empirical evidence from HPV, influenza, and COVID-19 contexts, the analysis evaluates each model’s predictive validity, construct overlap (e.g., perceived behavioral control vs. self-efficacy), and the consistency of construct measurement across studies (Brewer et al., 2017; Shmueli, 2021). The paper concludes that integrated models combining HBM and TPB constructs may offer the most robust pathway for designing culturally responsive interventions to strengthen vaccine confidence and protect communities from a resurgence of vaccine-preventable diseases.
