Predictors of dengue vaccination intention among adults in selected endemic areas of Peru: a PLS-SEM analysis

Background Dengue remains a major public health challenge in endemic settings. Evidence on the psychosocial predictors of dengue vaccination intention remains limited in Peru. This study aimed to identify predictors of dengue vaccination intention among adults in selected endemic areas of Peru using partial least squares structural equation modeling (PLS-SEM). Methods A cross-sectional study was conducted among 573 adults from selected provinces in Amazonas and Ancash, Peru, between June 2024 and December 2025. Data was collected using an adapted and validated multidimensional questionnaire. The model was estimated using SmartPLS 4.1.1.8 with 5,000 bootstrap resamples. Perceived benefit and attitude toward the dengue vaccine were integrated into a second-order construct termed favorable evaluation of the vaccine (FEV) to address their lack of discriminant validity. Results FEV was the strongest predictor of vaccination intention (β = 0.849, p < 0.001; f 2 = 1.749). Trust in key actors significantly predicted FEV (β = 0.557, p < 0.001) and perceived risk (β = 0.351, p < 0.001). Perceived risk did not significantly predict vaccination intention directly (β = −0.035, p = 0.237) but showed a significant positive indirect effect through FEV (β = 0.173, p < 0.001). Religiosity significantly predicted FEV and perceived risk, although its effect sizes were small. The model explained 69.2% of the variance in vaccination intention (R 2 = 0.692). Conclusions Favorable evaluation of the vaccine emerged as the strongest predictor of dengue vaccination intention in the structural model. Trust in key actors was an important predictor of favorable vaccine evaluation and perceived risk, whereas perceived risk predicted vaccination intention indirectly through FEV rather than directly. These findings may inform vaccination communication strategies in dengue-endemic settings.