Are psychological attitudes towards vaccination an expression of personality? A cross-sectional study on COVID-19 vaccination in France

Background The capacity of the 7C model's psychological antecedents, which include confidence in vaccines, complacency, convenience, calculation, collective responsibility, confidence in the wider system, and social conformism, to explain variance in COVID-19 vaccine intentions and behaviours has been documented. However, it remains unclear whether the attitudes represented by the 7C psychological antecedents are specific to vaccination or if they are, in fact, an expression of underlying personality traits. Methods From February to June 2022, French adults completed self-administered questionnaires assessing COVID-19 vaccination history, the 7C antecedents, and personality traits ("ComCor" and "Cognitiv" studies). Vaccination behaviours were studied through three outcomes: at-least-one-dose vaccination status by 2022 (N = 49,019), up-to-date vaccination status (N = 46,566), and uptake speed of first dose (N = 25,998). Personality traits were evaluated using the French version of the Big Five Inventory (BFI-Fr). Multivariable logistic regressions and Cox models predicting vaccine behaviours were run with the 7C antecedents, both with and without personality traits. Results Among the 49,019 participants, 95.0% reported receipt of at least one dose and 89.8% were up to date with recommendations. All 7C antecedents were significantly associated with the outcomes. The inclusion of personality traits did not substantially alter the effect estimates of the association between the 7C antecedents and vaccination behaviours, with differences between effect sizes of models with and without personality traits being < 5%. Conclusions Our results suggest that the 7C psychological antecedents of vaccination are not the mere expression of personality and that their impact on vaccine behaviours is independent of personality traits. As such, the 7C antecedents may be modifiable by appropriate information and vaccine promotion. Trial registration The "ComCor" study received ethical approval by the Comit & eacute; de Protection des Personnes Sud Ouest et Outre Mer 1 on 21/09/2020. The addition of the "Cognitiv" questionnaire received ethical approval by the Comit & eacute; de Protection des Personnes Sud Ouest et Outre Mer 1 on 01/02/2022. The data protection authority Commission Nationale de l'Informatique et des Libert & eacute;s (CNIL) authorised the processing of data on 21/10/2020. The study is registered with ClinicalTrials.gov under the identifier NCT04607941.