Background: Emergence of new coronavirus variants and waning immunity may necessitate regular COVID-19 vaccine boosters, but empirical data on population willingness for regular vaccination are limited., Methods: In August 2021, we surveyed 3,067 quota-sampled German-speaking adults residing in the D-A-CH region (Germany, Austria, Switzerland). Using multivariable adjusted ordered logistic regression models we calculated odds ratios (OR) and 95% confidence intervals (95% CIs) to assess factors associated with willingness to vaccinate annually against COVID-19., Findings: Among 2,480 participants vaccinated or planning to get vaccinated, 82·4% indicated willingness to receive annual COVID-19 boosters. This willingness was higher in Austria (OR=1·47, 95% CI, 1·19-1·82; p < 0·001) and Germany (OR=1·98, 95% CI, 1·60-2·45; p < 0·001) versus Switzerland and increased with age. Having voted in the last national election (OR opposition party voters =1·51, 95% CI=1·18-1·92; p = 0·001 and OR governing party voters =1·57, 95% CI=1·28-1·93; p < 0·001, versus non-voters) and not regularly participating in religious meetings (OR=1·37, 95% CI=1·08-1·73; p = 0·009, versus participation at least monthly) were significantly associated with willingness to vaccinate, as was partial (OR=1·97, 95% CI=1·43-2·72; p < 0·001) or total (OR=5·20, 95% CI=3·76-7·19; p < 0·001) approval of COVID-19 mitigation measures (versus non-approval). By country, Austrians showed the strongest association of voting behavior and mitigation measure approval with willingness to vaccinate., Interpretation: Targeted promotion programs informed by political and religious engagement and mitigation measure approval are needed to increase willingness to receive regular COVID-19 boosters., Funding: Medical University of Vienna, Department of Epidemiology, Danube University Krems, Department for Knowledge and Communication Management; Austrian Society of Epidemiology., Competing Interests: JW received funding from the Austrian Society of Epidemiology. BMB reports that her institution (Brigham and Women's Hospital, Boston, MA, USA) received research grant funding from the US National Institutes of Health and from the American Institute for Cancer Research (AICR) to support research projects that she leads and that are unrelated to this manuscript (cancer etiology studies). She is also has been an unpaid member of the Scientific Advisory Panel of the Oliver Foundation (Key Biscayne, FL) since 2015 to help guide their work on pediatric cancer prevention. IS reports royalties from book publications and Honoraria (about 2-3 times per year) for invited lectures not exceeding on the average € 1000 per year. MB reports to have received funding from the German Federal Ministry of Science and Education, German Federal Ministry of Economic affairs, Saxonian Ministry of Science and the Arts, EU H-2020 and honoraria for reviews from European public funding organizations. MB also reports patents DE102021115850.8; DE102020134133.4; DE102020107138.8; DE102018105449.1; and he is Member of the Executive committee of the Saxonian Academy of Sciences, Secretary General for the technical sciences in the Saxonian Academy of Sciences, Head of DECHEMA expert group “Raw Materials”, as well as Director of Recycling unit at Fraunhofer Institute for Ceramic Technologies and Systems IKTS; Fraunhofer Technology Center for High-Performance Materials THM, Am St.-Niclas-Schacht 13, 09599 Freiberg, Germany. LZ reports small shares in a stock portfolio < 500 EUR. MDL reports funding from the NSF (USA), small amounts of royalties for several published books, and he is Advisory boards (KLI; Complexity Science Hub, Vienna, TU Graz; TISE). ESS reports funding from the National Institute of Health, FFG, FWF, H-2020, and received honoraria (about 2-3 times per year, each never >1000 Euro) for invited lectures. She is member on the Advisory board of trustees of the FWF (Austrian Science Fund), and the Scientific Advisory Board for the Annual Houska Award; honorary board member of the Austrian Cancer Help; scientific advisory board member for Cochrane Austria; advisory board member of the Austrian Scientific Community and member of Board of Trustees “Sparkling Science” Funding, Ministry of Health Austria; as well as ad hoc NIH study section member and Horizon Europe Scientific Review Panel member., (© 2022 The Author(s).)