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COVID-19 vaccine hesitancy in eight European countries: prevalence, determinants and heterogeneity

Steinert, Janina I., Sternberg, Henrike, Prince, Hannah, Fasolo, Barbara ORCID: 0000-0002-4643-5689, Galizzi, Matteo M., Büthe, Tim and Veltri, Giuseppe A. (2022) COVID-19 vaccine hesitancy in eight European countries: prevalence, determinants and heterogeneity. Science Advances, 8 (17). eabm9825. ISSN 2375-2548

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Identification Number: 10.1126/sciadv.abm9825


We examine heterogeneity in COVID-19 vaccine hesitancy across eight European countries. We reveal striking differences across countries, ranging from 6.4% of adults in Spain to 61.8% in Bulgaria reporting being hesitant. We experimentally assess the effectiveness of different messages designed to reduce COVID-19 vaccine hesitancy. Receiving messages emphasizing either the medical benefits or the hedonistic benefits of vaccination significantly increases COVID-19 vaccination willingness in Germany, whereas highlighting privileges contingent on holding a vaccination certificate increases vaccination willingness in both Germany and the United Kingdom. No message has significant positive effects in any other country. Machine learning-based heterogeneity analyses reveal that treatment effects are smaller or even negative in settings marked by high conspiracy beliefs and low health literacy. In contrast, trust in government increases treatment effects in some groups. The heterogeneity in vaccine hesitancy and responses to different messages suggests that health authorities should avoid one-size-fits-all vaccination campaigns.

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Additional Information: © 2022 The Authors Funding Information: We thank everyone who helped with translating: W. Osika, Z. Georgieva, J. Raude, J. Garcia Fuentes, A. Glyk, and K. and M. Bartoszewski. We further wish to thank D. Biechl for support in conducting substantive background research on the surveyed countries. We thank V. Fedrigo, C. Heard, and J. G. Sanders for early discussion of the design of the U.K. survey experiment. We also wish to thank C. Becker for input on the content of the treatment messages and F. Schmidt for support with the design of treatment illustrations. We are further grateful to C. Cheng, F. Hagemeister, and L. Messerschmidt for input and guidance on identifying data sources for the extension of our heterogeneity analysis. Last, we are grateful for the input received from participants in the CEBI research group, Department of Social Policy and Intervention, University of Oxford, the Austrian Health Economics Association and the International Relations Chair research group at the TUM School of Social Sciences and Technology, Technical University of Munich. Funding: This research has been supported by the European Union’s Horizon 2020 research and innovation program, PERISCOPE: Pan European Response to the Impacts of COVID-19 and future Pandemics and Epidemics, under grant agreement no. 101016233 Publisher Copyright: Copyright © 2022 The Authors, some rights reserved;
Divisions: Management
Psychological and Behavioural Science
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 15 Mar 2022 10:33
Last Modified: 14 Jun 2024 16:24

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