COVID-19, vaccination is an effective way to protect health. Therefore, individuals’ perceived selfefficacy on the positive outcome of this behavior can stimulate their vaccination intention. Therefore, we propose the following hypothesis: H3: Perceived self-efficacy has a positive significant impact on vaccination intention. Impacts of intention stage on behavior stage Previous studies have demonstrated that social positive cues have a significant positive impact on an individual’s behavioral intentions [21, 22]. In the context of COVID-19, the doctor’s recommendations and vaccination reports are social positive cues to vaccine adoption. In accordance with the conclusions of existing research, we argue that social positive cues can motivate the public to vaccinate and to promote behavioral intention conducive to vaccination. Therefore, we propose the following hypothesis: H4: Social positive cues have a positive significant impact on vaccination intention. VH theory believes that VH is a comprehensive manifestation of individual gender, age, culture, religious beliefs, and other factors [23]. In recent years, with the rise of various anti-vaccine behaviors, VH has also produced a non-negligible influence on vaccination intention. At present, studies have shown that VH has a negative significant effect on behavior intention [13, 24]. In the context of COVID-19, Sallam et al. (2021) [23] indicated that VH was related to the COVID-19 vaccination. The similar conclusion was also confirmed by the research of Kwok et al. (2021) [25]. Therefore, based on the above argument, we propose the following hypothesis: H5: VH has a negative significant impact on vaccination intention. The HAPA model proves that intention has a positive significant impact on behavior [4]. In fact, the effect from intention to behavior is also a specific process from individual decision-making to implementation, and there is an inevitable connection between the two phases [26]. Moreover, the positive impact of intention on behavior can be supported by other classic theories and models, such as the Theory of Planned Behavior [27]. In terms of vaccination, we also believe that vaccination intention can positively affect vaccination behavior. Therefore, we propose the following hypothesis: Page 7/22 H6: Vaccination intention has a positive significant impact on vaccination behavior. Impacts in the behavior stage In the ECM, confirmation can have a direct impact on perceived usefulness and satisfaction [5]. Moreover, many previous studies have also verified that confirmation can positively affect perceived usefulness [28] and satisfaction [29]. The actual behavior can achieve the comparison of individual expectations and experiences, and it is a process by which individual expectations are confirmed in the actual process [30]. We believe that this argument can also be applied to COVID-19. The public compares their own experience of vaccination with their own expectations after vaccination behavior. If their expectations are confirmed, they will feel that the vaccination is useful and be satisfied with vaccination. Therefore, we propose the following hypotheses: H7: Vaccination behavior has a positive significant impact on perceived usefulness. H8: Vaccination behavior has a positive significant impact on satisfaction. In the ECM, when individuals adopt a certain behavior, they will continuously evaluate their perception of their own behavior then guide their emotions and subsequent behaviors [5]. Bhattacherjee, Perols, and Sanford (2008) [31] believed that perceived usefulness was regarded as a degree of utilitarianism to improve work performance, which was a long-term belief that combined expectations. According to this point of view, given that individuals have the tendency to subconsciously pursue behaviors or strive for external rewards, perceived usefulness is the decisive factor influencing individual emotions and subsequent behaviors. At present, most studies have demonstrated that perceived usefulness has a direct impact on individual satisfaction [32] and continuous behaviors [33]. As far as vaccination is concerned, if the public has a high evaluation of the perceived usefulness of vaccination, then their satisfaction with vaccination will increase and they are likely to continue vaccination. Therefore, we propose the following hypotheses: H9: Perceived usefulness has a positive significant impact on satisfaction. H10: Perceived usefulness has a positive significant impact on continuous vaccination. The ECM believes that satisfaction is an important variable for predicting continued use intentions and behaviors [5]. Many scholars, working in various fields, have proven that satisfaction has a positive effect on continued use intentions and behaviors [28, 34]. In addition, from the perspective of rational people, individuals are more willing to continue to use products or services that are useful to them and that satisfy them [35]. We believe that this evidence can also be applied in the context of COVID-19. The more satisfied the public is with vaccination, the more they tend to continue vaccination. Therefore, we propose the following hypothesis: H11: Satisfaction has a positive significant impact on continuous vaccination. In view of the above hypotheses, we construct the theoretical model of this study in Fig. 1. Page 8/22 Methods Participants We selected as