From Needle-Related Fear to Lower Vaccination Intention: Exploring the Mediating Role of Vaccination Fear and Conspiracy Beliefs

Background: Needle fear (NF), vaccination fear (VF), and conspiracy beliefs (CB) have been negatively associated with vaccination intention (VI), although the mechanisms linking these variables remain unclear. The aim of this cross-sectional exploratory study was to shed light on these relationships. Methods: The sample comprised 777 adults from the educational community in Pakistan (M = 23.39 years, SD = 6.83; 72.6% female), including students, academic/research staff, and administrative/support personnel. Descriptive and correlational analyses were conducted, followed by structural equation modelling (SEM) to examine the direct and indirect relationships among the study variables. Results: NF was not directly associated with VI. The best-fitting SEM model was the sequential model NF → VF → CB → VI. These findings suggest that the relationship between NF and VI is indirect through VF and CB. However, due to the cross-sectional design, the temporal direction of the associations cannot be established, and alternative explanations remain possible. Conclusions: These findings suggest that the relationship between NF and VI is indirect and is manifested through VF and CB. However, given the exploratory nature of this study and the use of ad hoc measures, further research is needed to determine whether VF and CB stem from NF or, alternatively, may serve as cognitive justifications for it.