A person-centered cross-sectional study of psychological drivers of vaccination attitudes

Abstract Although different profiles of vaccine-hesitant individuals have been hypothesized, most studies focus on isolated psychological factors, overlooking their interaction. Using data from an online survey of a representative sample of 807 Italian adults, we explored vaccination attitudes through a person-centered approach. An exploratory factor analysis of selected variables related to personal values, attitudes, and beliefs identified four psychological drivers: Eco-humanism (altruistic/biospheric values, connectedness to nature), Skeptical Perspective (distrust in science, conspiracy mentality, spirituality), Goal-Driven Positive Mindset (hope and optimism), and Self-Centered Attitude (hedonic/egoistic values). We assessed the effect of adherence to these drivers on negative vaccination attitudes (as measured by the VAX-I scale) via linear and quantile regression models. Overall, adherence to Eco-humanism was inversely related to negative attitudes (effect estimate: -0.375; 95% CI: -0.567 - -0.182 for the 5th vs. the 1st quintile, p for trend <0.01). A direct association emerged for Skeptical Perspective (effect estimate: 1.622; 95% CI: 1.427 - 1.817) and Self-Centered Attitude (effect estimate: 0.572; 95% CI: 0.385 - 0.759) in the 5th quintile. No association was found for Goal-Driven Positive Mindset. Eco-humanism correlated with lower mistrust of vaccine benefits and reduced concerns about pharmaceutical profiteering (p < 0.01). Goal-Driven Positive Mindset was directly associated with reduced mistrust of vaccine benefits (p < 0.01). Self-Centered Attitude was linked to greater concerns about pharmaceutical profiteering, fears of unforeseen future effects, and preference for natural immunity (p < 0.01). Skeptical Perspective was directly associated with all the aforementioned negative attitudes (p < 0.01). These findings suggest that distinct psychological drivers shape vaccination attitudes, pointing to the potential of tailored vaccination-promotion strategies.