Search

Ending the COVID-19 pandemic will require rapid large-scale uptake of vaccines against the disease. Mandating vaccination is discussed as a suitable strategy to increase uptake. In a series of cross-sectional quota-representative surveys and two preregistered experiments conducted in Germany and the US (total N=4629), we investigated (i) correlates of individual preferences for mandatory (vs voluntary) COVID-19 vaccination policies; (ii) potential detrimental effects of mandatory policies; and (iii) interventions potentially counteracting them. Results indicate that reactance elicited by mandates can cause detrimental effects, such as decreasing the intention to vaccinate against influenza and adhere to COVID-19 related protective measures. Ending the COVID-19 pandemic will require rapid large-scale uptake of vaccines against the disease. Mandating vaccination is discussed as a suitable strategy to increase uptake. In a series of cross-sectional quota-representative surveys and two preregistered experiments conducted in Germany and the US (total N = 4629), we investigated (i) correlates of individual preferences for mandatory (vs voluntary) COVID-19 vaccination policies; (ii) potential detrimental effects of mandatory policies; and (iii) interventions potentially counteracting them. Results indicate that reactance elicited by mandates can cause detrimental effects, such as decreasing the intention to vaccinate against influenza and adhere to COVID-19 related protective measures.

In this preregistered experiment (see https://aspredicted.org/nx6ib.pdf), we tested whether presenting evidence-based information about the actual risk of COVID-19 can indeed reduce the optimistic bias.

There are many reasons why people do not vaccinate. The 5C model by Betsch et al. (2018) extends existing models on vaccine acceptance with psychological profiles. The underlying reasons for vaccine acceptance – namely, the 5C antecedents of vaccination – are complacency (lack of risk perceptions), constraints (structural barriers), collective responsibility (herd immunity vs. free-riding), confidence (trust in safety of vaccines) and calculation (weighing of pros and cons). It is hypothesized that when these reasons are specifically addressed, as well as vaccination should change accordingly. In the current COVID-19 pandemic, a vaccination is available since Feb 2021. Even though vaccination appointments are as easy to get as never before, there are currently about 30-40% of the German population who did not yet get their shot. In the German COVID-19 Snapshot Monitoring (COSMO), the study group is investigating the development of vaccination intentions and 5C antecedents since the beginning of the pandemic in 2020. Current data collections (COSMO, Wave 49) show, that unvaccinated participants lack confidence. A qualitative analyses of open-ended questions revealed two arguments, that participants with low vaccination intentions stated most: (1) the development of vaccines against COVID-19 was too fast for them to have confidence in the safety, and (2) the lack of effectiveness of the vaccines (vaccinated people could theoretically still get infected) This study tests two educational posters addressing vaccination ((1) history of COVID-19 and mRNA vaccine development and (2) vaccine effectiveness as the most effective prevention) against one poster addressing regular handwashing as a health topic that does not include vaccination. The educational posters are framed within a dialogue between a vaccinated and unvaccinated person. It is designed to resemble a smartphone app chat situation. This model of a conversation about vaccination in an environment that is very familiar for people who have a smartphone, might motivate participants who are already vaccinated to speak about vaccination (with people who are hesitant).

During a pandemic, demand for intensive care often exceeds availability. Experts agree that allocation should maximize benefits and must not be based on whether patients could have taken preventive measures. However, intensive care units (ICUs) are often overburdened by individuals with severe COVID-19 who have chosen not to be vaccinated to prevent the disease. This article reports an experiment that investigated the German public's prioritization preferences during the fourth wave of the coronavirus pandemic ( N = 1014). In a series of scenarios, participants were asked to decide on ICU admission for patients who differed in terms of health condition, expected treatment benefits, and vaccination status. The results reveal an in-group bias, as vaccinated individuals preferred to allocate more resources to the vaccinated than to the unvaccinated. Participants also favored admitting a heart attack patient rather than a COVID-19 patient with the same likelihood of benefiting from ICU admission, indicating a preference for maintaining regular ICU services rather than treating those with severe COVID-19. Finally, participants were more likely to admit a patient to intensive care when this meant withholding rather than withdrawing care from another patient. The results indicate that lay prioritizations violate established allocation principles, presaging potential conflicts between those in need of intensive care and those who provide and allocate it. It is therefore recommended that allocation principles should be explained to enhance public understanding. Additionally, vaccination rates should be increased to relieve ICUs and reduce the need for such triage decisions.

Background: During the COVID-19 pandemic, public perceptions and behaviours have had to adapt rapidly to new risk scenarios and radical behavioural restrictions.Aim: To identify major drivers of acceptance of protective behaviours during the 4-week transition from virtually no COVID-19 cases to the nationwide lockdown in Germany (3–25 March 2020).Methods: A serial cross-sectional online survey was administered weekly to ca 1,000 unique individuals for four data collection rounds in March 2020 using non-probability quota samples, representative of the German adult population between 18 and 74 years in terms of age × sex and federal state (n = 3,910). Acceptance of restrictions was regressed on sociodemographic variables, time and psychological variables, e.g. trust, risk perceptions, self-efficacy. Extraction of homogenous clusters was based on knowledge and behaviour.Results: Acceptance of restrictive policies increased with participants’ age and employment in the healthcare sector; cognitive and particularly affective risk perceptions were further significant predictors. Acceptance increased over time, as trust in institutions became more relevant and trust in media became less relevant. The cluster analysis further indicated that having a higher education increased the gap between knowledge and behaviour. Trust in institutions was related to conversion of knowledge into action.Conclusion: Identifying relevant principles that increase acceptance will remain crucial to the development of strategies that help adjust behaviour to control the pandemic, possibly for years to come. Based on our findings, we provide operational recommendations for health authorities regarding data collection, health communication and outreach.

Supplemental material, sj-pdf-7-hpq-10.1177_13591053211044535 for Vaccination policy reactance: Predictors, consequences, and countermeasures by Philipp Sprengholz, Lisa Felgendreff, Robert Böhm and Cornelia Betsch in Journal of Health Psychology

Supplemental material, sj-pdf-10-hpq-10.1177_13591053211044535 for Vaccination policy reactance: Predictors, consequences, and countermeasures by Philipp Sprengholz, Lisa Felgendreff, Robert Böhm and Cornelia Betsch in Journal of Health Psychology

Supplemental material, sj-pdf-9-hpq-10.1177_13591053211044535 for Vaccination policy reactance: Predictors, consequences, and countermeasures by Philipp Sprengholz, Lisa Felgendreff, Robert Böhm and Cornelia Betsch in Journal of Health Psychology