Predictors of vaccine hesitancy during the COVID-19 pandemic in Austria A population-based cross-sectional study

Background Unwillingness to get vaccinated against the coronavirus disease 2019 (COVID-19) is a major barrier in managing the pandemic. Previous studies have explored predictors of hesitancy to be vaccinated against COVID-19, but evidence on these predictors was partly mixed, and the number of assessed predictors was often limited. This study aimed to explore a wide range of potential predictors of vaccine hesitancy in a population-based cross-sectional study. Methods We assessed associations of vaccine hesitancy with individuals' fears about the future, social media use, and sociodemographics in a hierarchical multiple regression analysis. Data were collected via online questionnaires in a population-based cross-sectional study with 4018 respondents representative of the Austrian adult population between October and December 2020. Results Vaccine hesitancy was predicted by freedom-related fears (i.e., fears regarding the political situation, particularly loss of personal freedoms), but were negatively associated with health-related fears (i.e., fears about physical or mental health) and society-related fears (i.e., fears regarding societal issues such as solidarity, distance learning, and isolation). Social media use as well as female gender, younger age, lower education, lower income, and living in rural regions were further predictors of vaccine hesitancy. Conclusion The study confirms that public health efforts targeting unvaccinated persons need to address freedom-related fears and social media discourse in order to improve vaccine uptake in the population. Particularly individuals in socially and economically disadvantaged groups and social media users need to be targeted to reduce vaccine hesitancy.