Publication Date


Date of Final Oral Examination (Defense)

March 2023

Type of Culminating Activity


Degree Title

Doctor of Philosophy in Public Policy and Administration


Public Administration

Major Advisor

Elizabeth Fredericksen, Ph.D.


Chris Birdsall, Ph.D.


Tedd McDonald, Ph.D.


COVID-19 and its mitigation through social distancing, masking, and preventative vaccination have impacted societies worldwide, leading to controversy regarding public health policy. This dissertation investigates the determinants of the vaccination behavior of 18-24-year-old college students in four-year public institutions in the United States, specifically concerning coronavirus. Of interest are reasons “why” or “why not” students would opt for or against the COVID-19 shot. Findings could aid in messaging public policy targeted toward a desired audience. Concepts related to policy, public health, beliefs, and their effects on the willingness to receive the coronavirus shot are explored. Prospect Theory – decision-making under risk and uncertainty – serves as the theoretical framework, including the theory’s key components of probability and severity. Existing data sets collected by the American College Health Association – the National College Health Assessment – for the survey periods Fall 2020, Spring 2021, and Fall 2021 – are utilized. The final data set comprises 62,267 cases, analyzed with binary nominal logistic regression. Of note is the unexpected finding that COVID-19 vaccination uptake outpaced flu and HPV shots by 20%. In addition, other findings did not align with previous research: male students, students with caregiver responsibilities, and those in relationships are less likely to participate in preventative health behaviors. Prior works also outlined that the risk component of Prospect Theory should be operationalized based on probability when applied to the health domain.

For this analysis, risk encompasses both severity (as the coronavirus disease may vary from person to person) and probability (the likelihood of infection with the disease). The odds ratio analysis finds that probability has a far more significant effect on the student’s willingness to receive the vaccine than the element of severity.

As a result of the analysis producing unexpected and expected findings, future research should include components that address political ideology and the politicization of the COVID-19 disease. In addition, targeted surveys could further explore the severity and probability elements in more detail.


Included in

Public Policy Commons