Predictors of COVID-19 vaccine hesitancy in Germany: a cross-sectional, population-based study

Purpose of the study Achieving high COVID-19 vaccination rates is a key public health challenge. The study aims to investigate factors determining COVID-19 vaccine hesitancy and adherence to prevention measures, in German adults. Study design This cross-sectional study was conducted in Germany, from 21 February 2021 to 3 April 2021, during the strict lockdown period of the third COVID-19 wave. A total of 2029 adults (75.3% women and median age 38 years) participated in an online survey. Participants completed a questionnaire assessing sociodemographic and anthropometric characteristics, adherence to COVID-19 prevention measures and willingness to vaccinate. Health literacy (HL), perceived stress, life satisfaction and adherence to Mediterranean diet (MD) were also assessed. Multiple linear and logistic regression analysis were employed. Results The median score of COVID-19 adherence to the prevention measures tool, was 23.08 (3.83) (range 1-35). A total of 57.5% of the participants were willing to vaccinate against COVID-19, 12.1% were unwilling and 30.4% were undecided. Linear regression analysis revealed that women, obese participants, those with a chronic disease and those willing to vaccinate, reported higher adherence to prevention measures. Older age, higher levels of HL, life satisfaction and adherence to MD were also positively associated with higher adherence. Logistic regression revealed that being a woman decreases the odds of having the willingness whereas, older age, higher education and adherence to measures, increase the odds of willingness to vaccinate. Conclusion The results of the study could be used by practitioners, researchers and policy-makers working in the field of prevention and management of COVID-19.

Automated summary

The study investigated factors determining COVID-19 vaccine hesitancy and adherence to prevention measures in German adults, finding that women, obese participants, those with chronic diseases, and those willing to vaccinate tended to have higher adherence to prevention measures. Additionally, older age, higher health literacy, life satisfaction, and adherence to a Mediterranean diet were associated with higher adherence levels.