How to solve sandwich generation's conundrum on vaccination decisions for self, children, and parents? An empirical analysis by integrating social cognitive and social influence perspectives.

This article investigates how two types of social influence—compliance (adhering to authoritative mandates) and conformity (aligning with social norms)—moderate the sandwich generation's self-efficacy regarding vaccination decisions for themselves, their children, and their elderly parents in China. Using data from 590 adults responsible for both older and younger family members, the study finds that perceptions of vaccine safety, effectiveness, and trust differentially affect vaccination intentions across these groups. Compliance positively strengthens the relationship between self-efficacy and vaccination intention for oneself and parents but not for children, while conformity generally weakens this relationship across all groups, though it also directly promotes vaccination intention. The findings highlight the complex role of social cognitive and social influence theories in family vaccination decisions and suggest tailored public health strategies that consider the sandwich generation's unique decisional roles and cultural context.