Discussion
DISEASES
The COVID-19 pandemic has highlighted the vital role of vaccination in preventing life-threatening diseases and the overload of health care systems. Yet the uptake of COVID-19 vaccination—and even more so of booster shots—remains insufficient in many countries. Against this backdrop, every single person who overcomes vaccine hesitancy counts. In our cross-sectional study of 1255 COVID-19 unvaccinated, vaccine-hesitant residents of Germany, we found that conventional text-based information formats may be less helpful in reaching vaccine-hesitant people than interactive risk ratio simulations; a significantly higher proportion of vaccine-hesitant individuals exposed to the interactive format showed positive change in their intention to receive the COVID-19 vaccine and assessment of the vaccination’s benefits and harms. Considering that more respondents in the interactive simulation group initially thought that the harms of the vaccination outweighed its benefits and expressed dissatisfaction with the government’s COVID-19 containment strategies—a factor negatively associated with the likelihood of a positive intentional change—the study’s results may even underestimate what interactive risk simulations can potentially contribute to fighting vaccination hesitancy.The outcomes of behavioral interventions in increasing the understanding and/or uptake of vaccination have been tested previously, also in the context of COVID-19 vaccine.We also observed some negative changes in vaccination intention and benefit-to-risk assessment in both groups. Because reasons for change were not assessed, we can only speculate as to why this occurred. Evidence from a large study with representative samples of US residents and Danes (with more than 13,000 participants)Finally, our results suggest that those who have not yet been convinced to get vaccinated by current communication campaigns should probably not be required to do so by law. Whereas respondents from the health care sector were particularly likely to show positive change in their assessment of the vaccination’s benefits and harms after intervention, they were particularly unlikely to show positive change in vaccination intention.