REPLICATION MATERIAL to Trust in Science, Knowledge and Risk Perception as Predictors of COVID-19 Vaccination: Application of an Extended Theory of Planned Behavior Model in Hungary (Kopasz et al. 2026, BMC Public Health)

Kopasz, M., Papp, Zs., Zsigmond Cs., Husz, I. (2026) Trust in Science, Knowledge and Risk Perception as Predictors of COVID-19 Vaccination: Application of an Extended Theory of Planned Behavior Model in Hungary. <i>BMC Public Health</i>As with COVID-19, where vaccine uptake was a primary way to contain the pandemic, vaccination could be a crucial factor in similar health emergencies in the future. Numerous studies focus on the causes of vaccine hesitancy in national and comparative contexts. Given the huge variation in vaccine uptake across countries, it is essential to look at the determinants of vaccine uptake in as many contexts as possible. This allows for a better understanding of vaccine hesitancy and, hence, creates opportunities for a more effective and safer management of pandemics.Our study investigates the determinants of COVID-19 vaccine acceptance, with a special focus on trust in science. A number of works have shown the importance of some type of trust in vaccination decisions, including trust in government (e.g. Han et al. 2023), in the health system (e.g. Rozek et al. 2021), or confidence in the vaccine (Jennings et al. 2021). Despite its apparent importance in the context of the pandemic, trust in science specifically has only been investigated by a small number of studies (see Sapienza and Falcone 2023). With very few exceptions (e.g. Seddig et al. 2022; Barattucci et al. 2023), these studies did not rely on any established theoretical framework, and examined the direct effect of trust on vaccine acceptance. We contribute to this literature by using the Theory of Planned Behavior (TPB; Ajzen 1991) to explore the role of trust in science in COVID-19 vaccination. While the TPB originally predicts the <i>intention</i> to perform a behavior (i.e. intention to get vaccinated), it is also applicable to predict actual <i>behavior</i> (i.e. vaccine acceptance) (Sheeran 2002; Ali et al. 2023). In our modified TPB model, COVID-19 vaccine acceptance is the product of three factors: (1) attitudes towards vaccination, (2) subjective norms (i.e. an individual’s perceptions of what significant others think about vaccination, and (3) perceived behavioral control (i.e. perceived difficulty of performing the behavior). In this study, we extend the TPB model with further predictors of attitudes toward vaccination: trust in science, knowledge about COVID-19, and perceived risk of COVID-19. Additionally, given the importance of trust in science in COVID-19 vaccine acceptance, our study also aims to explore its determinants so that we can contribute to better-targeted health communication campaigns that aim at both increasing trust and encouraging vaccine uptake.For our empirical exercise, we select a case of a heavy progression of the pandemic coupled with low trust in science: <i>Hungary</i>. As of autumn 2022, Hungary registered more than 2 million COVID-19 cases and almost 50 thousand COVID-related deaths. This put Hungary fifth in the world regarding the number of COVID-19 deaths per 100,000 capita. Even though vaccines became widely accessible by May 2021, at the time of our data collection (November 2022), only 62% of the population had received at least one dosage. While this figure is on par with the world average (61%), it is within the lowest quarter of the EU. Hungary also demonstrates low levels of trust in science (Farkas et al.2022), and conspiracy theories easily find their audience (Bíró-Nagy and Szászi, 2023). This provides a fertile ground for vaccine skepticism, hampering pandemic-mitigation efforts.<b>Data provider: </b>Marketing Resolutions Ltd. (Hungary)<b>Replication code</b>: Zsófia Papp<b>Software</b>: R 4.4.0

Kopasz, M.、Papp, Zs.、Zsigmond Cs.、Husz, I.（2026）《信任科学、知识与风险感知作为新冠疫苗接种的预测因子：扩展计划行为理论模型在匈牙利的应用》，发表于《BMC公共卫生》（BMC Public Health）。
正如新冠疫情中疫苗接种是遏制大流行的核心手段之一，疫苗接种也将成为未来同类公共卫生紧急事件中的关键防控因素。现有大量研究围绕国家层面及比较研究框架下的疫苗犹豫成因展开。鉴于不同国家的疫苗接种率存在显著差异，在尽可能多的场景中探究疫苗接种的决定因素至关重要。这有助于深化对疫苗犹豫的认知，进而为更高效、更稳妥地开展大流行防控工作提供管理思路。
本研究旨在探究新冠疫苗接种接受度的决定因素，重点关注公众对科学的信任。已有多项研究表明，各类信任因素对疫苗接种决策具有重要影响，例如对政府的信任（Han等，2023）、对医疗体系的信任（Rozek等，2021）以及对疫苗本身的信心（Jennings等，2021）。尽管在大流行背景下对科学的信任看似至关重要，但专门针对该维度的研究仍较为有限（参见Sapienza与Falcone，2023）。除极少数例外（如Seddig等，2022；Barattucci等，2023），此类研究均未依托成熟的理论框架，仅直接考察了信任对疫苗接受度的影响。本研究借助计划行为理论（Theory of Planned Behavior，TPB；Ajzen，1991），探讨科学信任在新冠疫苗接种中的作用。计划行为理论最初用于预测个体的行为意向（即接种疫苗的意向），但同样可用于预测实际行为（即疫苗接受度）（Sheeran，2002；Ali等，2023）。在本研究的改进型TPB模型中，新冠疫苗接受度由三大因素决定：（1）对接种疫苗的态度；（2）主观规范（即个体对重要他人对疫苗接种态度的感知）；（3）感知行为控制（即个体对实施该行为的难易程度的感知）。本研究将科学信任、新冠相关知识以及新冠感知风险作为额外的疫苗态度预测因子，对TPB模型进行扩展。此外，鉴于科学信任对新冠疫苗接受度的重要性，本研究还将探究科学信任的决定因素，以期为兼顾提升公众科学信任与推动疫苗接种的精准健康宣传活动提供参考。
本研究的实证分析选取了疫情形势严峻且公众科学信任度较低的匈牙利作为研究场景。截至2022年秋季，匈牙利累计报告新冠确诊病例超200万例，新冠相关死亡病例近5万例，按每10万人口新冠死亡数计算，匈牙利位列全球第五。尽管疫苗自2021年5月起已广泛可及，但在本研究数据采集的2022年11月，仅有62%的民众完成至少一剂疫苗接种。这一数据虽与全球平均水平（61%）基本持平，但处于欧盟国家中最低的四分之一区间内。同时，匈牙利公众的科学信任度较低（Farkas等，2022），阴谋论也易于传播（Bíró-Nagy与Szászi，2023），这为疫苗怀疑论提供了滋生土壤，阻碍了疫情防控工作的开展。
**数据提供者：** 匈牙利Marketing Resolutions有限公司
**复现代码：** Zsófia Papp
**分析软件：** R 4.4.0