Public preferences for vaccination campaigns in the COVID-19 endemic phase: insights from the VaxPref database

Objective: Despite widespread perceptions that SARS-CoV-2 (COVID-19) is no longer a significant threat, the virus continues to loom, and new variants may require renewed efforts to control its spread. Understanding how individual preferences and attitudes influence vaccination behaviour and policy compliance in light of the endemic phase is crucial in preparation for this scenario. Method: This paper presents descriptive data from a global stated choice survey conducted in 22 countries across 6 different continents between July 2022 and August 2023, and reports the methodological work developed to address the need for comparable data. Results: This study included 50,242 respondents. Findings indicated significant heterogeneity across countries in terms of vaccination status and willingness to accept boosters. Vaccine hesitancy and refusal were driven by lower trust in public health bodies, younger age, and lower educational levels. Refusers and hesitant people reported lower willingness to take risks compared to those fully vaccinated (p<0.05). Lower mental health levels were found for the hesitant cohort (p<0.05). Conclusions: Insights from this database can help public health authorities to gain a new understanding of the vaccine hesitancy phenomenon, support them in managing the transition from the pandemic to the endemic phase, and favour a new stream of research to maximise behavioural response to vaccination programs in preparation of future pandemics.