COM-B template to understand vaccine hesitancy

If you have never worked with the COM-B framework before, we recommend reading Behaviour change: guides for national and local government and partners before using this material.

Physical capability

Physical strength, coordination and stamina:

• Are individuals able to walk, take a bus, drive or use another means of transport to get to the vaccination centre and back?

Psychological capability

Knowledge, cognition, interpersonal skills, self-regulation:

• Do they understand the personal risks of contracting COVID-19?
• Do they understand the potential severity of the implications of COVID-19 upon their health?
• Do they understand the risks they pose to others if they contract COVID-19?
• Do they understand why it is important to be vaccinated (for themselves, others, and their community)?
• Do they know that the vaccine is safe and effective?
• Do they know how to get the vaccine (where to go, how to get there, when to go)?
• Do they have the skills required to access the vaccine (e.g., using an online booking system to book a test)?
• Do they know that two doses are required to achieve immunity?
• Do they remember to receive both the first and second dose?
• If they have been exposed to misinformation, do they know it is fake and not to be trusted?

Environmental opportunity

Triggers/prompts, space/time, location/services:

• Do they have the time to go and get vaccinated?
• Are vaccination sites easily accessible (location and operating hours)?
• Is there adequate social and practical support for people to attend a vaccination appointment? For example, some organisations support their staff by releasing them to take up the vaccine.

Social opportunity

Peer pressure, social norms, culture, credible models:

• Are they aware that most people in their community are planning on taking the vaccine?
• Do they see examples of other (influential) people in their community getting the vaccine?
• Is receiving the vaccination seen as ‘the right thing to do’ by the majority of people in their peer group, and they are aware of this?
• Are relevant social and cultural narratives within the individual’s community supportive of vaccination?

Reflective motivation

Plans, intentions, beliefs, identity:

• Do they see contracting COVID-19 as a severe risk to their health?
• Do they have an intention to be vaccinated and believe that doing so is within their control?
• Do they feel that being vaccinated is important for themselves, family and friends, and/or the community?
• Do they believe that the vaccination will protect them from contracting the virus and that they will not suffer harm from having it?
• Do they know that people with whom they share a common identity are also choosing to be vaccinated?
• Do they know that receiving a vaccination is consistent with their religious beliefs?
• Are they able to make specific plans to receive the vaccine?

Automatic motivation

Emotions, desires, impulses, habits:

• Do they experience overwhelming feelings of fear, anxiety, or worry about taking the vaccine?

References

• WHO (2020). Behavioural considerations for acceptance and uptake of COVID-19 vaccines
• Hertfordshire Behavioural insights unit (2020). COVID-19 Vaccination: Reducing vaccine hesitancy
• Brewer et al. (2017). Increasing Vaccination: Putting Psychological Science Into Action

This information was developed based on materials used by local authorities applying COM-B to increase vaccination take up.