Factors Affecting Reluctance to Malaysian Adults’ COVID-19 Vaccine Booster Doses

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Published: Aug 3, 2026
DOI: https://doi.org/10.56741/bikk.v5i02.2467
Keywords:
5C Vaccination, Attitude, COVID-19, Decision-Making, Theory Of Planned Behavior, Vaccination Intention, Vaccine Booster

Main Article Content

Nadhiah Abd Rahman
INTI International University
https://orcid.org/0009-0006-8876-1382
Hemaloshinee Vasudevan
Universiti Tun Abdul Razak
https://orcid.org/0000-0002-2767-8044
Heinko Dona Madon
Universiti Tun Abdul Razak
Noorseha Ayob
Universiti Tun Abdul Razak
https://orcid.org/0009-0002-3285-3262

Abstract

This study examines the factors that affect COVID-19 booster vaccine hesitancy among Malaysian adults, utilizing the 5C Vaccination Decision-Making Framework and a modified Theory of Planned Behavior (TPB). Malaysia's rollout of booster doses faces significant hesitancy, indicating a need to explore the underlying reasons. The research identifies key physical and psychological determinants influencing vaccine intentions, particularly emphasizing confidence, constraints, complacency, calculation, and collective responsibility, while highlighting the mediating role of attitude. Data from 100 Malaysian adults were collected through a cross-sectional web-based survey and analyzed using SPSS and structural equation modeling (SEM) with SmartPLS. The findings indicate that confidence in vaccine efficacy is a strong predictor of positive attitudes and intentions, while constraints have a moderate influence, and complacency exerts a negative impact on attitudes. Calculation does not significantly relate to attitudes, indicating that factual information has limited effects in the context of misinformation and trust issues. This research underscores the mediating influence of attitudes on the interplay between confidence, constraints, complacency, calculation, and collective responsibility concerning vaccination intentions, highlighting the importance of promoting positive vaccine perceptions. The study recommends comprehensive strategies to enhance confidence, reduce barriers, combat complacency, provide accurate information, and promote collective responsibility to improve COVID-19 booster vaccine uptake.

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How to Cite
Abd Rahman, N., Vasudevan, H., Madon, H. D., & Ayob, N. (2026). Factors Affecting Reluctance to Malaysian Adults’ COVID-19 Vaccine Booster Doses. Buletin Ilmu Kebidanan Dan Keperawatan, 5(02), 116–132. https://doi.org/10.56741/bikk.v5i02.2467
Issue
Vol. 5 No. 02 (2026): Buletin Ilmu Kebidanan dan Keperawatan
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Articles
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This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Author Biographies

Nadhiah Abd Rahman, INTI International University

is a doctoral candidate at INTI International University with research interests in entrepreneurship, women’s participation, innovation ecosystems and organisational development. She is currently Head of Business Development and Stakeholder Management at UEM Edgenta Berhad (email: nadhiah.ar@gmail.com).

Hemaloshinee Vasudevan, Universiti Tun Abdul Razak

received her PhD in General and a major in Organizational Behaviour from the University of Technology Malaysia (UTM). She is currently a faculty member at UNIRAZAK. She had 16 years’ experience in the education line and 2 ½ years in the industrial field. She had published in various journals in the business and management field. However, she also has experience in reviewing journals and has been an associate editor at an international journal for more than 5 years. She has published many articles, including research papers, review papers, and narrative case studies on platforms like International, National journals, Scopus, and Web of Science. She is therefore interested in performing research in various areas. Her areas of interest include marketing, artificial intelligence, training, organizational behaviour, sociology, criminology, and business management. (email: hemaloshinee25@gmail.com).

Heinko Dona Madon, Universiti Tun Abdul Razak

is a multidisciplinary professional with experience in civil engineering, construction, property development, banking, risk management, and institutional decision-making. He holds a Civil Engineering degree from Purdue University, USA, and an MBA from Universiti Tun Abdul Razak. His background combines technical construction knowledge with banking exposure in financing, credit evaluation, risk assessment, monitoring, governance, and compliance. He also co-authored Asphalt Paving Operation during his Purdue studies and contributed to the VBIAF Sectoral Guide: Construction & Infrastructure in a project management and support role representing Bank Rakyat Malaysia. He is currently pursuing a PhD at Universiti Tun Abdul Razak, focusing on decision quality dimensions and procedural justice in Malaysian Islamic banking. His work reflects strong interest in governance, institutional fairness, sustainable development, organisational trust, and quality decision-making. (email: heinkom@gmail.com).

Noorseha Ayob, Universiti Tun Abdul Razak

currently serves as the Dean of Tun Razak Graduate School and the Interim Programme Director for the Master in Management at UNIRAZAK. With extensive experience in academic leadership, teaching, and research, Dr. Noorseha is deeply engaged in advancing management education, social entrepreneurship, and innovation. She earned her PhD in Social Innovation from Glasgow Caledonian University, Scotland building on her MBA and Bachelor of Business Administration with Honours (Finance) from Universiti Teknologi MARA (UiTM). Her scholarly work is published internationally, reflecting her commitment to impactful research and quality teaching. Through her leadership, she continues to shape the school’s strategic direction and nurture future leaders equipped with the competencies to excel in a rapidly evolving business landscape. (email: noorseha@unirazak.edu.my).

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Received 2026-06-30
Accepted 2026-07-29
Published 2026-08-03

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