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. 2021 Nov 3;7(11):e29789. doi: 10.2196/29789

Table 2.

Barriers and facilitators of COVID-19 vaccination, grouped according to the three components of the COM-B model.

COM-B modela component Barriers Facilitators
Capabilityb
  • Inaccurate information related to COVID-19 vaccines:

    • Vaccine misinformation (Topic 26)

    • Politicians’ claims about COVID-19 as a hoax (Topics 17 and 18)

    • The antivaccine movement and conspiracy claims (Topic 55)

  • Access to accurate information related to COVID-19 vaccines:

    • Accurate news reporting related vaccine development and approval (Topics 1, 10, 13, 23, and 25)

    • Accurate news reporting related to effectiveness of the vaccines against new strains of the COVID-19 virus (Topic 52)

    • Accurate news reporting on the impact of COVID-19 (Topics 35 and 56)

  • Having the right approach to delivering public education on COVID-19 vaccines:

    • Involving an expert panel in public education on COVID-19 vaccines (Topic 8)

    • Using various media (eg, radio and video) in public education on COVID-19 vaccines (Topics 9 and 22)

    • Providing simple explanations about vaccine-related issues (eg, efficacy of the vaccines, the mechanisms of how the vaccines may work, and how the vaccines can help in achieving herd immunity; Topics 7, 20, 34, and 51)

Opportunityc
  • Limited access to COVID-19 vaccines:

    • Insufficient supply of COVID-19 vaccines (Topic 12)

    • Inequitable access to the vaccines (Topic 33)

  • Poorly planned vaccination drives:

    • Delays in vaccination rollout (Topic 31)

  • Having sufficient access to COVID-19 vaccines:

    • Ensuring equitable access to the vaccines (eg, ethical principles of vaccine allocation and equitable access across various populations; Topics 3, 15, 21, and 39)

    • Ensuring timely shipment of the vaccines (Topic 49)

    • Having a coordinated distribution plan for the vaccines (Topics 38 and 57)

  • Having a well-planned vaccination drive:

    • Defining priority groups for vaccination, (eg, frontline workers, long-term care homes, and individuals with high-risk health conditions; Topics 4, 28, 45, and 46)

    • Engaging employers in facilitating COVID-19 vaccination (Topic 24)

    • Using appointment systems and multiple vaccination sites in vaccination rollouts (Topics 29 and 48)

    • Having a coordinated national plan for vaccination drives (Topics 32 and 44)

Motivationd
  • Public concerns related to COVID-19 vaccines:

    • Public concerns about death related to COVID-19 vaccines (Topic 19)

    • Public concerns about the impact of COVID-19 vaccines on fertility (Topic 11)

    • Concerns about COVID-19 vaccine safety in pregnancy and the vaccines’ use in children (Topic 43)

    • Public concerns about adverse events related to COVID-19 vaccines (Topics 5 and 50)

    • Public concerns about fitness for vaccination among individuals with medical conditions or allergies (Topic 6)

    • Public concerns about short development phases of COVID-19 vaccines (Topic 16)

    • Public concerns about the effectiveness of COVID-19 vaccines against new strains of COVID-19 (Topic 53)

    • Public concerns about vaccine scams regarding mining of personal and financial information (Topic 54)

    • Public concerns about COVID-19 causing false-positive results on HIV tests (Topic 41)

    • Mistrust among minority communities with regard to COVID-19 vaccination (Topic 36)

  • Public perception about the threat of COVID-19:

    • Voicing the importance of staying vigilant to keep control of COVID-19 (Topic 59)

    • Comparing COVID-19 and COVID-19 vaccination statistics to drive vaccination efforts (Topics 2, 27, and 47)

  • Public optimism about COVID-19 vaccines:

    • Hoping for COVID-19 vaccination in making the days ahead better (Topic 37)

    • Sharing of positive emotions related to receiving COVID-19 vaccines (Topic 30)

    • Feeling positivity regarding contributing to COVID-19 vaccination development (Topics 40 and 42)

    • Influence of public figures in instilling public trust (Topics 14 and 58)

aThe COM-B (capability, opportunity, and motivation components of behavior) model provides a framework to understand and change human behaviors in the context of public health.

bCapability refers to an individual’s psychological and physical capacity to make a behavior possible, such as having the necessary knowledge and skills to perform a target behavior.

cOpportunity refers to attributes that lie outside an individual, physically and socially, that make a behavior possible, such as environmental factors or social and cultural norms.

dMotivation refers to the automatic or reflective mental processes that energize and direct behavior, which can include a conscious thought process in deciding on a behavior or a less conscious thought process driven by desires or habits.