Leading public health organizations recommend audience segmentation to enhance vaccination campaign effectiveness, yet its application remains infrequent, inconsistent and often unsystematic. This study aims to explore the risk perception attitude (RPA) framework as a repeatable segmentation method for vaccine uptake campaigns, leveraging disease risk and vaccine efficacy perceptions—two psychographic factors consistently associated with vaccine uptake across multiple vaccine-preventable diseases.
A nationally representative UK survey population (n = 2,058) was segmented into RPA groups using k-means clustering. Binomial regression examined a priori factors associated with COVID-19 vaccine hesitancy, while multinomial logistic regression compared these factors across RPA segments.
The analysis identified four homogenous groups matching the RPA framework, demonstrating that vaccine hesitancy factor associations can vary in direction and effect size across risk and efficacy-based psychographic segments. The RPA Avoidance group, characterized by high-risk perception and low vaccine efficacy beliefs, had the highest prevalence of essential workers, individuals with religious affiliations, depressive symptoms and loneliness. These findings offer opportunities for RPA segment-specific upstream, midstream and downstream social marketing interventions to improve vaccine uptake.
This study suggests that RPA segmentation may be a practical, scalable, repeatable approach for other vaccine-disease contexts, encouraging its adoption in future health communication strategies.
