Johannes Doerflinger

Objective: This study compares three models of parental human papillomavirus (HPV) vaccination intentions across United States, United Kingdom, and Germany: A model based on the theory of planned behavior (TPB), a model incorporating variables of the health belief model (HBM), and a model that adds factors identified in previous empirical research. We also examine whether these models predict vaccination behavior 1 year later in the United States and United Kingdom. The goal is to provide insights for designing targeted interventions. Method: A preregistered online study (February–March 2023) surveyed 1,088 parents from United States, United Kingdom, and Germany measuring variables related to the TPB (attitudes, subjective norms, and perceived behavioral control) and the HBM (risk and effectiveness perceptions), factors identified in previous empirical research (e.g., knowledge), and HPV vaccination intentions. One year later, 625 participants (United States and United Kingdom) were recontacted to assess vaccination behavior. Results: Structural equation modeling revealed that TPB accounted for 77% of the variance of vaccination intentions. HBM variables were associated with attitudes (85% variance accounted for). Vaccination intentions, trust in science, and HPV vaccination knowledge predicted vaccination behavior 1 year later (25% variance accounted for). Conclusions: TPB was strongly associated with parental HPV vaccination intentions, with attitudes and norms as key correlates. HBM variables were associated with attitudes but did not improve behavior predictions. Trust in science and HPV knowledge directly predicted vaccination behavior 1 year later. These findings suggest that interventions should target TPB and HBM variables to shape intentions and attitudes while fostering vaccination knowledge to sustain long-term behavior.

Vaccine hesitancy is a major threat to public health worldwide. Debates about vaccines are often moralized; however, how ethics and ethical judgments relate to vaccination intention remains underexplored. Here, we identify ethically relevant concerns from the academic literature that we operationalize for a pre-registered survey to study how ethical judgments relate to parents’ intentions to vaccinate their children against HPV. We also investigate potential sociocultural influences on ethical judgments: we compare parents from the US, the UK, and Germany. We find that parents’ ethical judgments in all countries are strongly associated with vaccination intention. We also find cross-cultural differences in how their trust in science, physicians, and institutions relates to perceived sociomoral pressure. Still, in the three countries trust moderates the negative correlation between perceived health risks and vaccination intention. These results suggest that campaigns highlighting ethical aspects of vaccination and targeting relevant moral concerns could be effective against hesitancy.

Policy regulations of ethically controversial genetic technologies should, on the one hand, be based on ethical principles. On the other hand, they should be socially acceptable to ensure implementation. In addition, they should align with ethical theory. Yet to date we lack a reliable and valid scale to measure the relevant ethical judgements in laypeople. We target this lacuna. We developed a scale based on ethical principles to elicit lay judgments: the Genetic Technologies Questionnaire (GTQ). In two pilot studies and a pre-registered main study, we validated the scale in a representative sample of the US population. The final version of the scale contains 20 items but remains highly reliable even when reduced to five. It also predicts behaviour; for example, ethical judgments as measured by the GTQ predicted hypothetical donations and grocery shopping. In addition, the GTQ may be of interest to policymakers and ethicists because it reveals coherent and ethically justified judgments in laypeople. For instance, the GTQ indicates that ethical judgments are sensitive to possible benefits and harms (in line with utilitarian ethics), but also to ethical principles such as the value of consent-autonomy. In conclusion, the GTQ can be recommended for research in both experimental psychology and applied ethics, as well as a tool for ethically and empirically informed policymaking.