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Introduction
Vaccine hesitancy is a major roadblock to ending the COVID-19 pandemic. A systematic review and meta-analysis of large nationally representative samples published in early 2021 showed that only 60% of people intended to vaccinate against COVID-19 (1). Research has shown that there is more vaccine acceptance in low- and middle-income countries compared with places such as the United States and Russia (2). A meta-analysis of data published in August 2022 concluded that the estimated global proportion of COVID-19 hesitancy was 25% (3).
The Russian Federation has one of the largest COVID-19 epidemics in the world. By the end of 2022 there were 21.49 million cumulative cases confirmed in the country (4). Officially, there were 385,789 deaths by the end of 2022 (4). However, by the end of the previous year (2021) excess deaths were already closer to one million in Russia (5). As anticipated there was a surge in early 2022 that peaked in mid-February, and the country did not report any such high subsequent peaks (4).
Russia was the first country to announce that it had developed a vaccine against COVID, in August 2020 (6). However, Russia has one of the lowest COVID-19 vaccination rates in the Eastern Europe/Central Asia region (7). Russia rolled out its public vaccination campaign in December 2020 with Sputnik V, an adenovirus vaccine, being offered free of charge to citizens. The vaccination program prioritized populations such as medical care workers, teachers, and those over 60 years of age. By January 2021, the general adult population was eligible for vaccination and soon after there were three domestic vaccines with emergency approval used in Russia, including Sputnik V, EpiVacCorona, and CoviVac. Only Russian-made vaccines received approval for use in Russia. By the end of 2021, 51% of the adult population had received at least one dose of a COVID-19 vaccine in Russia (4). More information is needed to understand what factors influenced vaccine acceptance in Russia.
The Health Belief Model (HBM) is a useful theoretical framework for analyzing individuals’ decisions about the uptake of preventative health services, such as vaccinations (8). The constructs of the HBM include perceived severity of the illness, perceived susceptibility to the illness, perceived benefits of vaccination, perceived barriers to vaccination, cues to action, and self-efficacy....