Do disease prevalence and severity drive COVID-19 vaccine demand?

Large scale vaccination of population is widely accepted to be the key to recovery from the devastating economic and public health impacts of the COVID-19 pandemic. However, low uptake of vaccine has challenged vaccination efforts in many parts of the world. The paper explores the determinants of demand for COVID-19 vaccination – specifically, the prevalence dependence hypothesis – that identifies infection prevalence and mortality as the key drivers of individual preventive behavior against infectious diseases. Using daily disease tracking and vaccination data from 47 European countries the paper finds strong evidence that COVID-19 infection rate and mortality rate drive future vaccination uptake. Specifically, results from fixed effects models suggest that while lagged infection prevalence induce vaccination uptake by 0.18 to 0.24 percent, while the effect of lagged mortality is significantly larger, ranging between 1.10 to 1.53 percent. The results highlight the critical role of behavioral response to epidemiological outcomes and are of critical significance for COVID-19 mitigation policies, especially as they relate to achieving vaccine-induced herd immunity and economic reopening.