Understanding COVID-19 Vaccine Hesitancy: A Neuroscientific Protocol

Background: Vaccine hesitancy (VH) is a significant public health challenge, especially during the COVID-19 pandemic. Despite extensive research on the psychological and socio-political determinants of VH, its psychophysiological mechanisms remain unexplored. Grounded in the Somatic Marker Hypothesis, this study aims to investigate the neurophysiological and affective processes underlying VH. Methods: Two experiments will assess sensorimotor resonance and affective processes in VH. In the first experiment, motor-evoked potentials (MEPs) will be recorded from the deltoid and extensor carpi radialis muscles while participants view images of people receiving COVID-19 and influenza vaccines, as well as blood injections (Block 1), and images of vial containing the same substances (Block 2). Facial electromyographic (EMG) activity will measure disgust and fear responses. In the second experiment, skin conductance response (SCR) will be recorded during a virtual reality-based fear conditioning and extinction paradigm. Expected Outcomes: We hypothesize that vaccine-hesitant individuals will exhibit altered sensorimotor resonance, higher affective responses to vaccination stimuli, and impaired fear extinction learning. Psychological traits such as disgust sensitivity, paranoia, anxiety, and dogmatism are expected to be associated with VH. Conclusions: By identifying the psychophysiological mechanisms of VH, this study will contribute to developing effective vaccine promotion strategies to address future public health emergencies.