Background: Adequate immunity to COVID-19 apparently cannot be attained in Germany by voluntary vaccination alone, and therefore the introduction of mandatory COVID-19 vaccination is still under consideration. We present findings on the potential acceptance of such a requirement by the German population, and we report on the reasons given for accepting or rejecting it and how these reasons vary according to population subgroup. -/- Methods: We used representative data from the Socio-Economic Panel for the period January to December 2021. We (...) linked the respondents’ answers concerning mandatory COVID-19 vaccination to information about their sociodemographic characteristics, state of health, political attitudes, and degree of confidence in the judicial and political systems. We analyzed these data using univariate, bivariate, and multivariate statistical methods. -/- Results: Just over half of the respondents (50.44% [49.08%; 51.79%]) favored mandatory COVID-19 vaccination. Among the supporters, the reason most frequently given (95.22% [94.45; 96.00]) was that, without such a requirement, not enough people would be vaccinated. Among the opponents of mandatory COVID-19 vaccination (49.56% [48.21%; 50.92%]), by far the most common reason given for opposing it was a desire to uphold individual freedom (91.36% [90.31%; 92.40%]). Persons supporting mandatory COVID-19 vaccination, on average, older than those who opposed it; they less commonly had an education beyond secondary school, were less healthy, tended to have no children, had centrist political views, and expressed more confidence in the political system. The largest difference between the two groups was that about 90% of supporters of mandatory COVID-19 vaccination were themselves vaccinated, compared to only about 62% of opponents. -/- Conclusion: The lack of consensus on this issue among politicians and physicians in Germany is reflected in a similar lack of consensus in the German population as a whole. A discussion of the appropriate understanding of individual freedom would be the most promising way to widen the acceptance of mandatory COVID-19 vaccination. A commonly expressed conception of freedom that permits the deliberate endangerment of other people’s health seems morally questionable. -/- DOI: 10.3238/arztebl.m2022.0174. (shrink)

Several vaccines against COVID-19 have now been developed and are already being rolled out around the world. The decision whether or not to get vaccinated has so far been left to the individual citizens. However, there are good reasons, both in theory as well as in practice, to believe that the willingness to get vaccinated might not be sufficiently high to achieve herd immunity. A policy of mandatory vaccination could ensure high levels of vaccination coverage, but its legitimacy is doubtful. (...) We investigate the willingness to get vaccinated and the reasons for an acceptance (or rejection) of a policy of mandatory vaccination against COVID-19 in June and July 2020 in Germany based on a representative real time survey, a random sub-sample (SOEP-CoV) of the German Socio-Economic Panel (SOEP). Our results show that about 70 percent of adults in Germany would voluntarily get vaccinated against the coronavirus if a vaccine without side effects was available. About half of residents of Germany are in favor, and half against, a policy of mandatory vaccination. The approval rate for mandatory vaccination is significantly higher among those who would get vaccinated voluntarily (around 60 percent) than among those who would not get vaccinated voluntarily (27 percent). The individual willingness to get vaccinated and acceptance of a policy of mandatory vaccination correlates systematically with socio-demographic and psychological characteristics of the respondents. We conclude that as far as people’s declared intentions are concerned, herd immunity could be reached without a policy of mandatory vaccination, but that such a policy might be found acceptable too, were it to become necessary. (shrink)

Background: According to Gelfand et al., COVID-19 infection and case mortality rates are closely connected to the strength of social norms: “Tighter” cultures that abide by strict social norms are more successful in combating the pandemic than “looser” cultures that are more permissive. However, countries with similar levels of cultural tightness exhibit big differences in mortality rates. We are investigating potential explanations for this fact. Using data from Germany and Japan—two “tight” countries with very different infection and mortality rates—we examined (...) how differences in socio-demographic and other determinants explain differences in individual preventive attitudes and behaviors. Methods: We compared preventive attitudes and behaviors in 2020 based on real-time representative survey data and used logit regression models to study how individual attitudes and behaviors are shaped by four sets of covariates: individual socio-demographics, health, personality, and regional-level controls. Employing Blinder-Oaxaca regression techniques, we quantified the extent to which differences in averages of the covariates between Japan and Germany explain the differences in the observed preventive attitudes and behaviors. Results: In Germany and Japan, similar proportions of the population supported mandatory vaccination, avoided travel, and avoided people with symptoms of a cold. In Germany, however, a significantly higher proportion washed their hands frequently and avoided crowds, physical contact, public transport, peak-hour shopping, and contact with the elderly. In Japan, a significantly higher proportion were willing to be vaccinated. We also show that attitudes and behaviors varied significantly more with covariates in Germany than in Japan. Differences in averages of the covariates contribute little to explaining the observed differences in preventive attitudes and behaviors between the two countries. Conclusion: Consistent with tightness-looseness theory, the populations of Japan and Germany responded similarly to the pandemic. The observed differences in infection and fatality rates therefore cannot be explained by differences in behavior The major difference in attitudes is the willingness to be vaccinated, which was much higher in Japan. Furthermore, the Japanese population behaved more uniformly across social groups than the German population. This difference in the degree of homogeneity has important implications for the effectiveness of policy measures during the pandemic. (shrink)