Vaccination Intention Following Receipt of Vaccine Information Through Interactive Simulation vs Text among COVID-19 Vaccine-Hesitant Adults during the Omicron Wave in Germany

Abstract

Importance: Hesitancy toward COVID-19 vaccination is a major factor in stagnating uptake rates and in the risk of health care systems becoming overwhelmed. Objective: To compare an interactive risk ratio simulation (intervention) with a conventional text-based risk information format (control) and analyze change in participants' COVID-19 vaccination intention and benefit-to-harm assessment. Design, Setting, and Participants: Cross-sectional study conducted online with 1255 COVID-19 vaccine-hesitant adult residents of Germany in April and May 2022, surveyed using a probability-based internet panel maintained by respondi, a research and analytics firm. Participants were randomized to 1 of 2 presentations on the benefits and adverse events associated with vaccination. Exposure: Participants were randomized to a text-based description vs an interactive simulation presenting age-adjusted absolute risks of infection, hospitalization, ICU admission, and death after exposure to coronavirus in vaccinated vs unvaccinated individuals relative to the possible adverse effects as well as additional (population-level) benefits of COVID-19 vaccination. Main Outcomes and Measures: Absolute change in respondents' COVID-19 vaccination intention category and benefit-to-harm assessment category. Results: Participants were 1255 COVID-19 vaccine-hesitant residents of Germany (660 women [52.6%]; mean [SD] age, 43.6 [13.5] years). A total of 651 participants received a text-based description, and 604 participants received an interactive simulation. Relative to the text-based format, the simulation was associated with greater likelihood of positive change in vaccination intentions (19.5% vs 15.3%, respectively; absolute difference, 4.2%; adjusted odds ratio [aOR], 1.45; 95% CI, 1.07-1.96; P =.01) and benefit-to-harm assessments (32.6% vs 18.0%; absolute difference, 14.6%; aOR, 2.14; 95% CI, 1.64-2.80; P