Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out

Athina Manoli; Maria Kyprianidou; Demetris Lamnisos; Jelena Lubenko; Giovambattista Presti; Valeria Squatrito; Marios Constantinou; Christiana Nicolaou; Savvas Papacostas; Gökçen Aydin; Yuen Yu Chong; Wai Tong Chien; Ho Yu Cheng; Francisco Ruiz; Maria Belen Garcia-Martin; Diana P. Obando-Posada; Miguel Segura-Vargas; Vasilis S. Vasiliou; Louise McHugh; Stefan Höfer; Adriana Baban; David Dias Neto; Ana Nunes Da Silva; Jean Louis Monestès; Javier Alvarez-Galvez; Marisa Paez-Blarrina; Francisco Montesinos; Sonsoles Valdivia-Salas; Dorottya Ori; Bartosz Kleszcz; Raimo Lappalainen; Iva Ivanović; David Gosar; Frederick Dionne; Rhonda Merwin; Maria Karekla; Andrew Gloster; Angelos Kassianos

doi:10.1371/journal.pgph.0005668

Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out

Athina Manoli (First Author)
, Maria Kyprianidou (Second Author)
, Demetris Lamnisos (Third Author)
, Jelena Lubenko (Fourth Autor)
, Giovambattista Presti (Fifth Author)
, Valeria Squatrito
, Marios Constantinou
, Christiana Nicolaou
, Savvas Papacostas
, Gökçen Aydin
, Yuen Yu Chong
, Wai Tong Chien
, Ho Yu Cheng
, Francisco Ruiz
, Maria Belen Garcia-Martin
, Diana P. Obando-Posada
, Miguel Segura-Vargas
, Vasilis S. Vasiliou
, Louise McHugh
, Stefan Höfer

Adriana Baban, David Dias Neto, Ana Nunes Da Silva, Jean Louis Monestès, Javier Alvarez-Galvez, Marisa Paez-Blarrina, Francisco Montesinos, Sonsoles Valdivia-Salas, Dorottya Ori, Bartosz Kleszcz, Raimo Lappalainen, Iva Ivanović, David Gosar, Frederick Dionne, Rhonda Merwin, Maria Karekla, Andrew Gloster, Angelos Kassianos (Correspondent Author)

Cyprus University of Technology
Queen Mary University of London
University of Cyprus
European University Cyprus
Riga Stradins University
Kore University of Enna
University of Nicosia
Cyprus Institute of Neurology and Genetics
TED University
Chinese University of Hong Kong, Faculty of Medicine
Fundación Universitaria Konrad Lorenz
Loyola University Andalusia
Royal Holloway University of London
University College Dublin
Innsbruck Medical University
Babes-Bolyai University
Institute of Applied Psychology
University of Lisbon
University Grenoble Alpes
University of Cádiz
Instituto ACT
Universidad Europea
University of Zaragoza
Semmelweis University
Heim Pal National Pediatric Institute
Behawioralnie
University of Jyväskylä
University of Montenegro
Ljubljana University Medical Centre
University of Ljubljana
Université du Québec à Trois-Rivières
Duke University
University of Lucerne

Research output: Contribution to journal › Article › peer-review

Abstract

Understanding the drivers of COVID-19 vaccination intentions remains relevant as public health systems prepare for future pandemics. This study examined how emotional and social-cognitive factors influence COVID-19 vaccination intentions during two key phases of the COVID-19 pandemic: before (April-June 2020) and after (January-February 2021) vaccination rollout. A total of 586 adults completed an online survey assessing beliefs about COVID-19, self-efficacy to adhere to protective behaviours, perceived stress, affect, psychological flexibility, and prosociality. Self-efficacy, prosociality, psychological flexibility and positive affect significantly declined after vaccination rollout. Higher self-efficacy and perceived severity of the disease consistently predicted stronger vaccination intentions across time points. Perceived susceptibility was negatively associated with vaccination intention before, but not after rollout. The psychological variables were not significant predictors of intentions. These findings underscore the importance of social-cognitive factors, especially self-efficacy and perceived severity, in shaping vaccination-related decisions, with implications for designing effective communication strategies in future health emergencies.

Original language	English
Article number	e0005668
Journal	PLOS Global Public Health
Volume	6
Issue number	1 January
DOIs	https://doi.org/10.1371/journal.pgph.0005668
State	Published - Jan 2026

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Vida Humana Plena (Vita)

Article Classification

Full research article

Indexación Internacional (Artículo)

ISI Y SCOPUS

Scopus-Q Quartil

Q2

ISI- Q Quartil

Q2

Categoría Publindex

A1

Access to Document

10.1371/journal.pgph.0005668

Cite this

Manoli, A., Kyprianidou, M., Lamnisos, D., Lubenko, J., Presti, G., Squatrito, V., Constantinou, M., Nicolaou, C., Papacostas, S., Aydin, G., Chong, Y. Y., Chien, W. T., Cheng, H. Y., Ruiz, F., Garcia-Martin, M. B., Obando-Posada, D. P., Segura-Vargas, M., Vasiliou, V. S., McHugh, L., ... Kassianos, A. (2026). Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out. PLOS Global Public Health, 6(1 January), Article e0005668. https://doi.org/10.1371/journal.pgph.0005668

@article{96259445487440f8a101abfbc3a5a3b2,

title = "Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out",

abstract = "Understanding the drivers of COVID-19 vaccination intentions remains relevant as public health systems prepare for future pandemics. This study examined how emotional and social-cognitive factors influence COVID-19 vaccination intentions during two key phases of the COVID-19 pandemic: before (April-June 2020) and after (January-February 2021) vaccination rollout. A total of 586 adults completed an online survey assessing beliefs about COVID-19, self-efficacy to adhere to protective behaviours, perceived stress, affect, psychological flexibility, and prosociality. Self-efficacy, prosociality, psychological flexibility and positive affect significantly declined after vaccination rollout. Higher self-efficacy and perceived severity of the disease consistently predicted stronger vaccination intentions across time points. Perceived susceptibility was negatively associated with vaccination intention before, but not after rollout. The psychological variables were not significant predictors of intentions. These findings underscore the importance of social-cognitive factors, especially self-efficacy and perceived severity, in shaping vaccination-related decisions, with implications for designing effective communication strategies in future health emergencies.",

author = "Athina Manoli and Maria Kyprianidou and Demetris Lamnisos and Jelena Lubenko and Giovambattista Presti and Valeria Squatrito and Marios Constantinou and Christiana Nicolaou and Savvas Papacostas and G{\"o}k{\c c}en Aydin and Chong, \{Yuen Yu\} and Chien, \{Wai Tong\} and Cheng, \{Ho Yu\} and Francisco Ruiz and Garcia-Martin, \{Maria Belen\} and Obando-Posada, \{Diana P.\} and Miguel Segura-Vargas and Vasiliou, \{Vasilis S.\} and Louise McHugh and Stefan H{\"o}fer and Adriana Baban and Neto, \{David Dias\} and Silva, \{Ana Nunes Da\} and Monest{\`e}s, \{Jean Louis\} and Javier Alvarez-Galvez and Marisa Paez-Blarrina and Francisco Montesinos and Sonsoles Valdivia-Salas and Dorottya Ori and Bartosz Kleszcz and Raimo Lappalainen and Iva Ivanovi{\'c} and David Gosar and Frederick Dionne and Rhonda Merwin and Maria Karekla and Andrew Gloster and Angelos Kassianos",

note = "Publisher Copyright: {\textcopyright} 2026 Manoli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2026",

month = jan,

doi = "10.1371/journal.pgph.0005668",

language = "Ingl{\'e}s",

volume = "6",

journal = "PLOS Global Public Health",

issn = "2767-3375",

publisher = "Public Library of Science",

number = "1 January",

}

Manoli, A, Kyprianidou, M, Lamnisos, D, Lubenko, J, Presti, G, Squatrito, V, Constantinou, M, Nicolaou, C, Papacostas, S, Aydin, G, Chong, YY, Chien, WT, Cheng, HY, Ruiz, F, Garcia-Martin, MB , Obando-Posada, DP, Segura-Vargas, M, Vasiliou, VS, McHugh, L, Höfer, S, Baban, A, Neto, DD, Silva, AND, Monestès, JL, Alvarez-Galvez, J, Paez-Blarrina, M, Montesinos, F, Valdivia-Salas, S, Ori, D, Kleszcz, B, Lappalainen, R, Ivanović, I, Gosar, D, Dionne, F, Merwin, R, Karekla, M, Gloster, A & Kassianos, A 2026, 'Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out', PLOS Global Public Health, vol. 6, no. 1 January, e0005668. https://doi.org/10.1371/journal.pgph.0005668

TY - JOUR

T1 - Beyond emotions

T2 - Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out

AU - Manoli, Athina

AU - Kyprianidou, Maria

AU - Lamnisos, Demetris

AU - Presti, Giovambattista

AU - Squatrito, Valeria

AU - Constantinou, Marios

AU - Nicolaou, Christiana

AU - Papacostas, Savvas

AU - Aydin, Gökçen

AU - Chong, Yuen Yu

AU - Chien, Wai Tong

AU - Cheng, Ho Yu

AU - Ruiz, Francisco

AU - Garcia-Martin, Maria Belen

AU - Obando-Posada, Diana P.

AU - Segura-Vargas, Miguel

AU - Vasiliou, Vasilis S.

AU - McHugh, Louise

AU - Höfer, Stefan

AU - Baban, Adriana

AU - Neto, David Dias

AU - Silva, Ana Nunes Da

AU - Monestès, Jean Louis

AU - Alvarez-Galvez, Javier

AU - Paez-Blarrina, Marisa

AU - Montesinos, Francisco

AU - Valdivia-Salas, Sonsoles

AU - Ori, Dorottya

AU - Kleszcz, Bartosz

AU - Lappalainen, Raimo

AU - Ivanović, Iva

AU - Gosar, David

AU - Dionne, Frederick

AU - Merwin, Rhonda

AU - Karekla, Maria

AU - Gloster, Andrew

AU - Kassianos, Angelos

A2 - Lubenko, Jelena

N1 - Publisher Copyright: © 2026 Manoli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2026/1

Y1 - 2026/1

N2 - Understanding the drivers of COVID-19 vaccination intentions remains relevant as public health systems prepare for future pandemics. This study examined how emotional and social-cognitive factors influence COVID-19 vaccination intentions during two key phases of the COVID-19 pandemic: before (April-June 2020) and after (January-February 2021) vaccination rollout. A total of 586 adults completed an online survey assessing beliefs about COVID-19, self-efficacy to adhere to protective behaviours, perceived stress, affect, psychological flexibility, and prosociality. Self-efficacy, prosociality, psychological flexibility and positive affect significantly declined after vaccination rollout. Higher self-efficacy and perceived severity of the disease consistently predicted stronger vaccination intentions across time points. Perceived susceptibility was negatively associated with vaccination intention before, but not after rollout. The psychological variables were not significant predictors of intentions. These findings underscore the importance of social-cognitive factors, especially self-efficacy and perceived severity, in shaping vaccination-related decisions, with implications for designing effective communication strategies in future health emergencies.

AB - Understanding the drivers of COVID-19 vaccination intentions remains relevant as public health systems prepare for future pandemics. This study examined how emotional and social-cognitive factors influence COVID-19 vaccination intentions during two key phases of the COVID-19 pandemic: before (April-June 2020) and after (January-February 2021) vaccination rollout. A total of 586 adults completed an online survey assessing beliefs about COVID-19, self-efficacy to adhere to protective behaviours, perceived stress, affect, psychological flexibility, and prosociality. Self-efficacy, prosociality, psychological flexibility and positive affect significantly declined after vaccination rollout. Higher self-efficacy and perceived severity of the disease consistently predicted stronger vaccination intentions across time points. Perceived susceptibility was negatively associated with vaccination intention before, but not after rollout. The psychological variables were not significant predictors of intentions. These findings underscore the importance of social-cognitive factors, especially self-efficacy and perceived severity, in shaping vaccination-related decisions, with implications for designing effective communication strategies in future health emergencies.

UR - https://www.scopus.com/pages/publications/105028936561

U2 - 10.1371/journal.pgph.0005668

DO - 10.1371/journal.pgph.0005668

M3 - Artículo

AN - SCOPUS:105028936561

SN - 2767-3375

VL - 6

JO - PLOS Global Public Health

JF - PLOS Global Public Health

IS - 1 January

M1 - e0005668

ER -

Beyond emotions: Social cognitive predictors of COVID-19 vaccination intentions before and after vaccine roll-out

Abstract

Strategic Focuses

Article Classification

Indexación Internacional (Artículo)

Scopus-Q Quartil

ISI- Q Quartil

Categoría Publindex

Access to Document

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