Justice, perceived threat and vaccination intention in the USA

Guided by the Extended Parallel Process Model, this experiment demonstrates how perceived fairness in health resource policy decisions can influence both the protective action and denial-oriented health threat responses of policy affected individuals. Students from a large urban university in the Midwestern USA (n = 127) read about a purported illness and were told about a vaccination that would soon be available to them through their university. The out-of-pocket cost of vaccination was manipulated (distributive justice), as was the fairness of procedures used to determine this cost (procedural justice). When vaccination was low cost, procedural justice resulted in greater intention to be vaccinated and also diminished reporting of compensatory health behaviors that could purportedly supplant the need for vaccination. Ironically however, procedural justice resulted in lower vaccination intention and exaggerated compensatory health behavior reporting when vaccination was high cost. Crucially, this experiment demonstrates that perceived fairness may encourage both action-oriented and fear control health threat response, and that health promotion behaviors such as vaccination may be affected through interactive relationships of distributive and procedural justice that stem from health policy decisions.