A New Look at Vaccination Behaviors and Intentions: The Case of Influenza

Reyna, Valerie F.; Edelson, Sarah M.; Garavito, David M. N.; Galindez, Michelle; Singh, Aadya; Fan, Julia; Suh, Jiwoo

doi:10.3390/bs15121645

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Open AccessArticle

A New Look at Vaccination Behaviors and Intentions: The Case of Influenza

by

Valerie F. Reyna

^*

,

Sarah M. Edelson

,

David M. N. Garavito

^†

,

Michelle Galindez

^‡

,

Aadya Singh

,

Julia Fan

^§ and

Jiwoo Suh

^‖

Department of Psychology, Cornell University, G331D Martha Van Rensselaer Hall, Ithaca, NY 14850, USA

^*

Author to whom correspondence should be addressed.

^†

Now at School of Law, University of Washington, Seattle, WA 98195, USA.

^‡

Now at Alpert Medical School, Brown University, Providence, RI 02903, USA.

^§

Now at College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43606, USA.

^‖

Now at Voya Financial, Austin, TX 78756, USA.

Behav. Sci. 2025, 15(12), 1645; https://doi.org/10.3390/bs15121645

Submission received: 24 September 2025 / Revised: 19 November 2025 / Accepted: 21 November 2025 / Published: 30 November 2025

(This article belongs to the Section Health Psychology)

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Abstract

Although viral outbreaks are increasing, vaccination rates are decreasing. Our aim was to explain this baffling behavior that seems to contradict rational self-interest, and, thus, be beyond the purview of rational choice theories. We integrated fuzzy-trace theory and major theoretical alternatives and applied them to influenza, testing theoretical predictions in two samples: young adults (who are major viral vectors), N = 722, and community members, N = 185. Controlling for prior knowledge and other psychosocial factors that influence vaccination, explained variance jumped significantly when key predictors from fuzzy-trace theory were added, reaching 62% and 80% for vaccination intentions and 37% and 59% for behavior for each sample, respectively. Single items assessing global gist perceptions of risks and benefits achieved remarkable levels of diagnosticity. Key predictors were intuitive in that they were gisty, imprecise, and non-analytical. In contrast, rational system 2 measures—numeracy and cognitive reflection—were not predictive. These results provide new insights into why individuals vaccinate or not and new avenues for interventions to improve shared clinical decision-making.

Keywords: vaccine hesitancy; rational choice; influenza vaccination; fuzzy-trace theory; gist; psychological measurement

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MDPI and ACS Style

Reyna, V.F.; Edelson, S.M.; Garavito, D.M.N.; Galindez, M.; Singh, A.; Fan, J.; Suh, J. A New Look at Vaccination Behaviors and Intentions: The Case of Influenza. Behav. Sci. 2025, 15, 1645. https://doi.org/10.3390/bs15121645

AMA Style

Reyna VF, Edelson SM, Garavito DMN, Galindez M, Singh A, Fan J, Suh J. A New Look at Vaccination Behaviors and Intentions: The Case of Influenza. Behavioral Sciences. 2025; 15(12):1645. https://doi.org/10.3390/bs15121645

Chicago/Turabian Style

Reyna, Valerie F., Sarah M. Edelson, David M. N. Garavito, Michelle Galindez, Aadya Singh, Julia Fan, and Jiwoo Suh. 2025. "A New Look at Vaccination Behaviors and Intentions: The Case of Influenza" Behavioral Sciences 15, no. 12: 1645. https://doi.org/10.3390/bs15121645

APA Style

Reyna, V. F., Edelson, S. M., Garavito, D. M. N., Galindez, M., Singh, A., Fan, J., & Suh, J. (2025). A New Look at Vaccination Behaviors and Intentions: The Case of Influenza. Behavioral Sciences, 15(12), 1645. https://doi.org/10.3390/bs15121645

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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A New Look at Vaccination Behaviors and Intentions: The Case of Influenza

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