Taking stock of the pre-pandemic patterns of demographic and psychological antecedents of vaccination intention and behaviour – Results from representative surveys in 2016 and 2018

Background : There are many reasons why people decide for or against vaccination. Besides socio-demographic characteristics, the 5C antecedents of vaccination (confidence, complacency, constraints, calculation and collective responsibility) are a helpful tool for identifying target groups and the public’s broader informational needs. In this study, the 5C antecedents were used to explain vaccination behaviour (a) in general over the last five years, (b) for specific vaccines and (c) for target groups, such as the elderly, parents, and healthcare workers. The intention to get an influenza vaccination was also analysed for certain target groups. Methods : The 5C antecedents of vaccination, self-reported vaccination behaviour and intention to vaccinate were collected in two representative telephone surveys – one in 2016 (n 1 = 5,012) and another in 2018 (n 2 = 5,054). Logistic regressions reveal the predictive value of socio-demographic variables and psychological antecedents for vaccination behaviour and intention. Results : Confidence in safety and effectiveness was always an important predictor. Furthermore, complacency (the underestimation of risk) and even structural barriers were important psychological predictors of vaccination behaviour. Overall, psychological antecedents had higher explanatory power than socio-demographic variables. Conclusions : The pattern of vaccine hesitancy slightly differed between vaccinations and target groups, and an understanding of pre-pandemic patterns is urgently needed to detect changes in vaccine hesitancy patterns caused by the pandemic and to target vaccination deficits that it has caused.