Effect of knowledge, social and religious factors effecting the intention of Muslims in Pakistan to receive COVID-19 vaccination: mediating role of attitude towards COVID-19 vaccination
Authors: Aziz Sadia , Niazi Muhammad Abdullah Khan , Ghani Usman 
Published: May 2022

Purpose
This study aims to empirically examine the knowledge, social and religious factors effecting the intention to receive COVID-19 vaccination while considering the mediating role of attitude towards COVID-19 vaccination. The research explores how the Islamic ideologies shape Muslims’ knowledge, social and religious beliefs towards COVID-19 vaccination acceptance or refusal.

Design/methodology/approach
Theoretically, the study is based on the functional theory of attitudes. The model of the study is comprised of nine variables explaining the attitude and intention towards COVID-19 vaccination. Among nine variables, perceived Islamic religiosity, perceived behavioural control and Halal consciousness among Muslims are explained through the value-expressive function of attitude. Furthermore, the perceived risk of COVID-19, the perceived side effect of COVID-19 vaccination and the perceived efficacy of COVID-19 vaccination are considered in the model based on the utility function of attitude. Moreover, social influence for COVID vaccination, subjective norms and group conformity are abstracted from the social-adjustive function of attitude. This study used a quantitative survey research method to test the hypotheses. A total of 1,000 questionnaires were distributed to non-vaccinated Muslim respondents from five cities in Pakistan. The structural equation modelling (SEM) technique was used to test the relationship among the variables in the proposed model. The partial least square-SEM method explained the variances in the dependent variables. Moreover, to test the structure of data, different statistical tests, including exploratory factor analysis (EFA), factor loadings and average variance extracted, were used with the help of Statistical Package for the Social Sciences (SPSS) and analysis of a moment structures (AMOS) 23.0 version.

Findings
Results for direct effect showed a significant negative effect of Islamic religiosity, perceived behavioural control, halal consciousness, perceived side effect of COVID-19 vaccination, social influence, subjective norm and group conformity on attitude towards COVID-19 vaccination. In contrast, insignificant results showed no relationship of perceived risk from COVID-19 infection and perceived efficacy of COVID-19 vaccination with attitude towards COVID-19 vaccination. Results for mediating effect showed the significant negative mediating effect of attitude towards COVID-19 vaccination between Islamic religiosity, perceived behavioural control, halal consciousness, perceived side effect, social influence, subjective norm, group conformity and intention to receive COVID-19 vaccination. While results showed the insignificant mediation of attitude towards COVID-19 between perceived risk from COVID-19 infection, perceived efficacy of COVID-19 vaccination and intention to receive COVID-19 vaccination.

Research limitations/implications
Further studies are required to compare the attitude and intention among the temporary refusal group (those who will consider vaccination the future) and the permanent refusal group (those who will not consider vaccination the future). Comparing Muslim and non-Muslim groups can also explain differences in attitude and intention towards COVID-19 vaccination.

Originality/value
The area of acceptance and refusal of COVID-19 vaccination has been given limited attention in academic literature. Theoretically, this research has proposed a well-defined model to explain the attitude of Muslims towards COVID-19 vaccination. This model can helpf predict the attitude and intentions of Muslims towards vaccination or medicines. Moreover, this research is a unique contribution for the vaccination brands to consider the discussed factors before launching their brand in Muslim countries.