Understanding the predictors of the willingness to get vaccinated against COVID-19 may aid in the resolution of current and future pandemics. We investigate how the readiness to believe conspiracy theories and the three dimensions of health locus of control (HLOC) affect the attitude toward vaccination. A cross-sectional study was conducted based on the data from an online survey of a sample of Czech university students (n = 866) collected in January 2021, using the multivariate linear regression models and moderation analysis. The results found that 60% of Czech students wanted to get vaccinated against COVID-19. In addition, 40% of the variance of willingness to get vaccinated was explained by the belief in the COVID-19-related conspiracy theories and the powerful others dimension of HLOC. One-sixth of the variance of the willingness to get vaccinated was explained by HLOC, cognitive reflection, and digital health literacy [eHealth Literacy Scale (EHEALS)]. HLOC and conspiracy mentality (CM) and its predictors are valid predictors of a hesitancy to get vaccinated against COVID-19. The campaigns promoting vaccination should target the groups specifically vulnerable to the conspiracy theories and lacking HLOC related to powerful others.

Center of Physical Education and Sport Faculty of Education University of West Bohemia Pilsen Czechia

Department of Psychiatry Faculty of Medicine University Hospital in Pilsen Charles University Pilsen Czechia

Department of Psychology Faculty of Social Studies Masaryk University Brno Czechia

Institute for Postgraduate Medical Education Prague Czechia

International Clinical Research Center St Anne's University Hospital Brno Brno Czechia

Memory Clinic Department of Neurology 2nd Faculty of Medicine Motol University Hospital Charles University Prague Czechia

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Abalakina-Paap M., Stephan W. G., Craig T., Gregory W. L. (1999). Beliefs in conspiracies. Polit. Psychol. 20:3. 10.1111/0162-895X.00160 DOI

Agranov M., Elliott M., Ortoleva P. (2021). The importance of Social Norms against strategic effects: the case of Covid-19 vaccine uptake. Econ. Lett. 206:109979. 10.1016/j.econlet.2021.109979 PubMed DOI PMC

Aharon A. A., Nehama H., Rishpon S., Baron-Epel O. (2018). A path analysis model suggesting the association between health locus of control and compliance with childhood vaccinations. Hum. Vaccin. Immunother. 14 1618–1625. 10.1080/21645515.2018.1471305 PubMed DOI PMC

Armitage J. C. (2003). The relationship between multidimensional health locus of control and perceived behavioural control: how are distal perceptions of control related to proximal perceptions of control? Psychol. Health 18 723–738.

Bailis D. S., Segall A., Chipperfield J. G. (2010). Age, relative autonomy and change in health locus of control beliefs: a longitudinal study of members of a health-promotion facility. J. Health Psychol. 15 326–338. 10.1177/1359105309342296 PubMed DOI

Bierwiaczonek K., Kunst J. R., Pich O. (2020). Belief in COVID-19 conspiracy theories reduces social distancing over time. Appl. Psychol. Health Well Being 12 1270–1285. 10.1111/aphw.12223 PubMed DOI

Brincks A. M., Feaster D. J., Burns M. J., Mitrani V. B. (2010). The influence of health locus of control on the patient-provider relationship. Psychol. Health Med. 15 720–728. 10.1080/13548506.2010.498921 PubMed DOI PMC

Bruder M., Haffke P., Neave N., Nouripanah N., Imhoff R. (2013). Measuring individual differences in generic beliefs in conspiracy theories across cultures: conspiracy mentality questionnaire. Front. Psychol. 4:225. 10.3389/fpsyg.2013.00225 PubMed DOI PMC

Capraro V., Barcelo H. (2021). Telling people to “rely on their reasoning” increases intentions to wear a face covering to slow down COVID-19 transmission. Appl. Cogn. Psychol. 35 693–699. 10.1002/acp.3793 PubMed DOI PMC

Chapman G. B., Coups E. J. (1999). Predictors of influenza vaccine acceptance among healthy adults. Prev. Med. 29 249–262. PubMed

Charlton E. (2014). Conspiracy Theories and Dissociative Experiences: The Role of Personality and Paranormal Beliefs. Ph.D. thesis. London: Metropolitan University.

Douglas K. M. (2021). COVID-19 conspiracy theories. Group Process. Intergroup Relat. 24 270–275. 10.1177/1368430220982068 DOI

Douglas K. M., Sutton R. M., Callan M. J., Dawtry R. J., Harvey A. J. (2016). Someone is pulling the strings: hypersensitive agency detection and belief in conspiracy theories. Think. Reason. 22 57–77. 10.1080/13546783.2015.1051586 DOI

Douglas K. M., Uscinski J. E., Sutton R. M., Deravi F. (2019). Understanding conspiracy theories. Polit. Psychol. 40 3–35. 10.1111/pops.12568 DOI

Fletcher T. D. (2012). QuantPsyc: Quantitative Psychology Tools. R Package. Available online at: https://cran.r-project.org/package=QuantPsyc. (accessed April 5, 2021).

Frederick S. (2005). Cognitive reflection and decision making. J. Econ. Perspect. 19 25–42. 10.1257/089533005775196732 DOI

Graupensperger S., Abdallah D. A., Lee C. M. (2021). Social norms and vaccine uptake: college students’ COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine. Vaccine 39 2060–2067. 10.1016/j.vaccine.2021.03.018 PubMed DOI PMC

Grotz M., Hapke U., Lampert T., Baumeister H. (2011). Health locus of control and health behaviour: results from a nationally representative survey. Psychol. Health Med. 16 129–140. 10.1080/13548506.2010.521570 PubMed DOI

Hartman T., Marshall M., Stocks T., McKay R., Bentall R. (2020). Different conspiracy theories have different psychological and social determinants: comparison of three theories about the origins of the COVID-19 virus in a representative sample. PsyArXiv [Preprint]. 10.31234/OSF.IO/MZ5SW DOI

Imhoff R., Bruder M. (2013). Speaking (Un-)truth to power: conspiracy mentality as a generalised political attitude. Eur. J. Pers. 20 25–43. 10.1002/per.1930 DOI

Imhoff R., Lamberty P. (2020). A bioweapon or a hoax? the link between distinct conspiracy beliefs about the coronavirus disease (COVID-19) outbreak and pandemic behavior. Soc. Psychol. Pers. Sci. 11 1110–1118. 10.1177/1948550620934692 PubMed DOI PMC

Jolley D., Douglas K. M. (2014). The effects of anti-vaccine conspiracy theories on vaccination intentions. PLoS One 9:e89177. 10.1371/journal.pone.0089177 PubMed DOI PMC

Kan T., Ai J., Zhang J., Liu X. (2018). Predictors of seasonal influenza vaccination behaviour among nurses and implications for interventions to increase vaccination uptake: a cross-sectional survey. Int. J. Nurs. Stud. 79 137–144. 10.1016/j.ijnurstu.2017.12.003 PubMed DOI

Kourlaba G., Kourkouni E., Maistreli S., Tsopela C.-G., Molocha N.-M., Triantafyllou C., et al. (2021). Willingness of Greek general population to get a COVID-19 vaccine. Glob. Health Res. Policy 6:3. 10.1186/s41256-021-00188-1 PubMed DOI PMC

Lau R. R. (1982). Origins of health locus of control beliefs. J. Pers. Soc. Psychol. 42 322–334. 10.1037/0022-3514.42.2.322 PubMed DOI

Lehmann B. A., Ruiter R. A. C., Chapman G., Kok G. (2014). The intention to get vaccinated against influenza and actual vaccination uptake of Dutch healthcare personnel. Vaccine 32 6986–6991. 10.1016/j.vaccine.2014.10.034 PubMed DOI

Lorini C., Santomauro F., Donzellini M., Capecchi L., Bechini A., Boccalini S., et al. (2018). Health literacy and vaccination: a systematic review. Hum. Vaccin. Immunother. 14 478–488. 10.1080/21645515.2017.1392423 PubMed DOI PMC

Lüdecke D. (2021). sjPlot: Data Visualization for Statistics in Social Science. Available online at: https://cran.r-project.org/package=sjPlot. (accessed April 5, 2021).

Luo S., Xin M., Wang S., Zhao J., Zhang G., Li L., et al. (2021). Behavioural intention of receiving COVID-19 vaccination, social media exposures and peer discussions in China. Epidemiol. Infect. 149:E158. 10.1017/S0950268821000947 PubMed DOI PMC

Machingaidze S., Wiysonge C. S. (2021). Understanding COVID-19 vaccine hesitancy. Nat. Med. 27 1338–1339. 10.1038/s41591-021-01459-7 PubMed DOI

Mathieu E., Ritchie H., Ortiz-Ospina E., Roser M., Hasell J., Appel C., et al. (2021). A global database of COVID-19 vaccinations. Nat. Hum. Behav. 5 947–953. 10.1038/s41562-021-01122-8 PubMed DOI

Murphy J., Vallières F., Bentall R. P., Shevlin M., McBride O., Hartman T. K., et al. (2021). Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat. Commun. 12:29. 10.1038/s41467-020-20226-9 PubMed DOI PMC

MZCR (2021). COVID-19: Pøehled Aktuální Situace v ÈR. Available online at: https://onemocneni-aktualne.mzcr.cz/covid-19 (accessed August 29, 2021).

Naeem B. S., Boulos K. M. N. (2021). COVID-19 misinformation online and health literacy: a brief overview. Int. J. Environ. Res. Public Health 2021:8091. 10.3390/ijerph18158091 PubMed DOI PMC

Náfrádi L., Nakamoto K., Schulz P. J. (2017). Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence. PLoS One 12:e0186458. 10.1371/journal.pone.0186458 PubMed DOI PMC

National Pandemic Alarm (2021). Representative Survey Monitoring Public Opinion, Emotions and Experience With Novelty Corona Virus Spread in Five Central European Countries. Available online at: https://www.nationalpandemicalarm.eu/en/2021-01-29?index=vaccination#global-timeline-index-wrapper. (accessed August 27, 2021).

Neumann-Böhme S., Varghese N. E., Sabat I., Barros P. P., Brouwer W., van Exel J., et al. (2020). Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur. J. Health Econ. 21 977–982. 10.1007/s10198-020-01208-6 PubMed DOI PMC

Nexøe J., Kragstrup J., Søgaard J. (1999). Decision on influenza vaccination among the elderly: a questionnaire study based on the health belief model and the multidimensional locus of control theory. Scand. J. Prim. Health Care 17 105–110. 10.1080/028134399750002737 PubMed DOI

Norman C. D., Skinner H. A. (2006). eHEALS: the eHealth literacy scale. J. Med. Internet Res. 8:e507. 10.2196/jmir.8.4.e27 PubMed DOI PMC

O’Hea E. L., Grothe K. B., Bodenlos J. S., Boudreaux E. D., White M. A., Brantley P. J. (2005). Predicting medical regimen adherence: the interactions of health locus of control beliefs. J. Health Psychol. 10 705–717. 10.1177/1359105305055330 PubMed DOI

Olagoke A. A., Olagoke O. O., Hughes A. M. (2021). Intention to vaccinate against the Novel 2019 coronavirus disease: the role of health locus of control and religiosity. J. Relig. Health 60 65–80. 10.1007/s10943-020-01090-9 PubMed DOI PMC

Pickles K., Cvejic E., Nickel B., McCaffery K. J. (2021). COVID-19 misinformation trends in Australia: prospective longitudinal national survey. J. Med. Internet Res. 23:e23805. 10.2196/23805 PubMed DOI PMC

Pisl V., Volavka J., Chvojkova E., Cechova K., Kavalirova G., Vevera J. (2021). Dissociation, cognitive reflection and health literacy have modest effect on belief in conspiracy theories about COVID-19. Int. J. Environ. Res. Public Health 18:5056. 10.3390/ijerph18105065 PubMed DOI PMC

Ptáček R., Bob P. (2009). Metody diagnostiky disociativních symptomů. Czech Slovak Psychiatry 105 163–172.

Pummerer L., Böhm R., Lilleholt L., Winter K., Zettler I., Sassenberg K. (2021). Conspiracy theories and their societal effects during the COVID-19 pandemic. Soc. Psychol. Personal. Sci. 10.1177/19485506211000217[Epub ahead of print]. DOI

Revelle W. (2020). psych: Procedures for Psychological, Psychometric, and Personality Research. R package. Available online at: https://cran.r-project.org/package=psych. (accessed April 5, 2021).

Robinson E., Jones A., Lesser I., Daly M. (2021). International estimates of intended uptake and refusal of COVID-19 vaccines: a rapid systematic review and meta-analysis of large nationally representative samples. Vaccine 39 2024–2034. 10.1016/j.vaccine.2021.02.005 PubMed DOI PMC

Romer D., Jamieson K. H. (2020). Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S. Soc. Sci. Med. 263:113356. 10.1016/j.socscimed.2020.113356 PubMed DOI PMC

Schwarzinger M., Watson V., Arwidson P., Alla F., Luchini S. (2021). COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics. Lancet Public Health 6 e210–e221. 10.1016/s2468-2667(21)00012-8 PubMed DOI PMC

Sieverding M., Zintel S., Schmidt L. I., Arbogast A. L., von Wagner C. (2021). Why do Women Report Lower Intentions to get Vaccinated Against COVID-19? The Mediating Role of Variables from the TPB and HBM. SSRN, 3826959. 10.2139/ssrn.3826959 DOI

Sigurvinsdottir R., Thorisdottir I. E., Gylfason H. F. (2020). The impact of COVID-19 on mental health: the role of locus on control and internet use. Int. J. Environ. Res. Public Health 17:6985. 10.3390/ijerph17196985 PubMed DOI PMC

Solís Arce S. A., Warren S. S., Meriggi N. F., Scacco A., McMurry N., Omer S. B. (2021). COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries. Nat. Med. 27 1385–1394. 10.1038/s41591-021-01454-y PubMed DOI PMC

Stoica C. A., Umbreş R. (2020). Suspicious minds in times of crisis: determinants of Romanians’ beliefs in COVID-19 conspiracy theories. Eur. Soc. 23 S246–S261. 10.1080/14616696.2020.1823450 DOI

Sullivan G. (2014). “Disasters, overview,” in Encyclopedia of Critical Psychology, ed. Teo T. (New York, NY: Springer Science + Busines Media; ), 445–448.

Tinsley B. J., Holtgrave D. R. (1989). Maternal health locus of control beliefs, utilization of childhood preventive health services, and infant health. J. Dev. Behav. Pediatr. 10 236–241. 10.1097/00004703-198910000-00003 PubMed DOI

Townshend I., Awosoga O., Kulig J., HaiYan F. (2015). Social cohesion and resilience across communities that have experienced a disaster. Nat. Hazards 76 913–938. 10.1007/s11069-014-1526-4 DOI

Van Bavel J. J., Baicker K., Boggio P. S., Willer R. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nat. Hum. Behav. 4 460–471. 10.1038/s41562-020-0884-z PubMed DOI

Velan B. (2016). Vaccine hesitancy as self-determination: an Israeli perspective. Isr. J. Health Policy Res. 5:13. 10.1186/s13584-016-0071-x PubMed DOI PMC

Wallston K. A. (2004). “Control and health,” in Encyclopedia of Health & Behavior, Vol. 1 ed. Anderson N. (Thousand Oaks, CA: Sage; ), 217–220.

Wallston K. A., Wallston B. S., DeVellis R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Educ. Behav. 6 160–170. 10.1177/109019817800600107 PubMed DOI

Wang Q., Yang L., Jin H., Lin L. (2021). Vaccination against COVID-19: a systematic review and meta-analysis of acceptability and its predictors. Prev. Med. 150:106694. 10.1016/j.ypmed.2021.106694 PubMed DOI PMC

West L. M., Theuma R. B., Cordina M. (2018). Health locus of control: its relationship with medication adherence and medication wastage. Res. Social Adm. Pharm. 14 1015–1019. 10.1016/j.sapharm.2017.12.003 PubMed DOI

Wickham H., Averick M., Bryan J., Chang W., McGowan L., François R., et al. (2019). Welcome to the Tidyverse. J. Open Source Softw. 4:1686. 10.21105/joss.01686 DOI

Williams S. (2021). The UK’s coronavirus policy still places too much responsibility–and blame–on the public. BMJ 373:1373. 10.1136/bmj.n1373 PubMed DOI

Williams-Piehota P., Schneider T. R., Pizarro J., Mowad L., Salovey P. (2004). Matching health messages to health locus of control beliefs for promoting mammography utilization. Psychol. Health 19 407–423. 10.1080/08870440310001652678 DOI

Winter K., Pummerer L., Hornsey M. J., Sassenberg K. (2021). Pro-vaccination subjective norms moderate the relationship between conspiracy mentality and vaccination intentions. Br. J. Health Psychol. 10.1111/bjhp.12550[Epub ahead of print]. PubMed DOI PMC

Wood M. J., Douglas K. M., Sutton R. M. (2012). Dead and alive. Soc. Psychol. Person. Sci. 3 767–773. 10.1177/1948550611434786 DOI

WHO (2013). Health Literacy: The Solid Facts. Available online at: https://apps.who.int/iris/bitstream/handle/10665/128703/e96854.pdf. (accessed April 5, 2021).

WHO (2014). Report of the Sage Working Group on Vaccine Hesitancy. Available online at: https://www.who.int/immunization/sage/meetings/2014/october/1_Report_WORKING_GROUP_vaccine_hesitancy_final.pdf. (accessed April 5, 2021).

WHO (2020). Novel Coronavirus. Situation Report–13. 2020. Available online at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200202-sitrep-13-ncov-v3.pdf. (accessed April 5, 2021).

Wu A. D., Zumbo B. D. (2008). Understanding and using mediators and moderators. Soc. Indic. Res. 87 367–392. 10.1007/s11205-007-9143-1 DOI

Zhang J., While A. E., Norman I. J. (2012). Seasonal influenza vaccination knowledge, risk perception, health beliefs and vaccination behaviours of nurses. Epidemiol. Infect. 140 1569–1577. 10.1017/S0950268811002214 PubMed DOI PMC

Zintel S., Flock C., Arbogast A. L., Forster A., von Wagner C., Sieverding M. (2021). Gender Differences in the Intention to get Vaccinated Against COVID-19-A Systematic Review and Meta-Analysis. SSRN, 3803323. 10.2139/ssrn.3803323 PubMed DOI PMC

Zivot behem pandemie (2021). S kolika lidmi byli respondenti v bližším kontaktu?. Available online at: https://zivotbehempandemie.cz/kontakty. (accessed August 27, 2021).