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Table 4 Factors that can influence uptake of vaccine for pandemic influenza identified in the study using COM-B

From: Public preferences for vaccination and antiviral medicines under different pandemic flu outbreak scenarios

CAPABILITY MOTIVATION OPPORTUNITY
The capacity to engage in the behaviour Brain processes that energise and direct behaviour Factors lying outside the individual that act as barriers or promoters of behaviour
Psychological Automatic Physical
Capacity to engage in necessary thought processes Emotions and impulses Physical opportunity in the environment
Knowledge of the disease Emotion: Fear Access
• Pandemic influenza is a novel strain • Expressed not just numerically but in terms of physical and emotional proximity • to treatments
• Awareness of morbidity, mortality and transmission rates   • to professional advice
Memory Habitual behaviour Able to book to see GP
• Media exaggeration of last pandemic • Being vaccinated for seasonal influenza and taking medicines in general Avoiding ‘hubs of infection’
Physical Reflective Social
Capacity to engage in necessary physical processes Evaluation and plans Cultural milieu that affects what we think about things
• Not salient/not mentioned Beliefs about consequences Social influences
  • Pandemic influenza is not more serious than seasonal influenza • Respected others are being vaccinated
  • The vaccine has not been adequately tested and may be unsafe or ineffective • Believing that it is unacceptable to put others at risk
  Omission bias Trust
  • Believing that the risks of being vaccinated outweigh the risk of being ill with pandemic influenza • Recommendation from trusted health professional
   • Respected others recommend
  Identity (health) Group identity
  • Believing that a healthy lifestyle confers immunity • Being part of an at-risk support group
  Optimistic bias  
  • Tending to the view that they will not be infected or will make an easy recovery from pandemic influenza  
  Social role  
  • Responsibility for other family members, including unborn  
  Anticipated regret  
  • Concern that the outbreak could be more serious than expected and have not been vaccinated