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Vaccine . Recent enough to matter: Perceived temporal proximity, anxiety, and COVID-19 vaccine intent

tetano

Editor, Senior Moderator
Vaccine


. 2026 May 19:85:128717.
doi: 10.1016/j.vaccine.2026.128717. Online ahead of print.
Recent enough to matter: Perceived temporal proximity, anxiety, and COVID-19 vaccine intent

Anna Powell[SUP] 1 [/SUP], Halina Suwalowska[SUP] 2 [/SUP], Osman Sankoh[SUP] 3 [/SUP], Chunlan Guo[SUP] 4 [/SUP], Emily Ying Yang Chan[SUP] 4 [/SUP], Sharifah Sekalala[SUP] 5 [/SUP], Laura Salisbury[SUP] 6 [/SUP], Patricia Kingori[SUP] 2 [/SUP], Cara Wilkins[SUP] 2 [/SUP]; After the End Team[SUP] 7 [/SUP]; Ruth Ogden[SUP] 8 [/SUP]


Affiliations
Abstract

Background: Vaccine hesitancy undermines vaccination strategies and is shaped by non-modifiable contextual and individual/group factors, and potentially modifiable cognitive processes. The Health Belief Model (HBM) offers a framework for understanding health decision-making, including the role of threat perception, which is influenced by perceived proximity to a threat. Construal Level Theory (CLT) suggests that psychologically distant events are construed more abstractly, reducing perceived urgency. While spatial and social proximity (physical closeness and effects on one's social network) have been widely studied, temporal proximity (nearness or distance in time) has been explored less. Given research that the pandemic affected time perception, this study examined whether perceived temporal proximity predicts future COVID-19 vaccine intent, and whether this relationship is statistically mediated by COVID-19 anxiety.
Methods: A cross-sectional survey assessed whether temporal proximity was associated with future vaccine intent (less vs. more likely to vaccinate) using multivariable binary logistic regression. Mediation analysis tested whether COVID-19 anxiety explained this relationship. Covariates included age, gender, direct COVID impact/risk variables, and trust in government. In total, 696 individuals were included in analyses (345 women; mean age = 47.27 ± 15.53 years).
Results: Greater temporal proximity predicted greater intention to receive a future COVID-19 vaccine. There was also evidence of a significant indirect association via COVID-19 anxiety: greater perceived proximity was associated with higher anxiety, and higher anxiety was associated with greater vaccination intent. Significant covariates included perceived vulnerability to COVID-19, and trust in government.
Conclusions: Findings support evidence that proximity influences threat perception and behavioural intentions, demonstrating that temporal proximity functions similarly in a real-world preventative healthcare context. The observed indirect association via anxiety, considered alongside the HBM and CLT, is discussed as a possible mechanism underlying the proximity-intention link. Longitudinal research is needed to assess causality and inform communication strategies using temporal framing.

Keywords: COVID-19; Coronavirus; Temporal proximity; Threat perception; Vaccine hesitancy.

 
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