# Impact of Dark Triad personality traits on COVID-19 vaccination uptake and prevention efforts: insights from the European Covid Survey (ECOS)

## TL;DR

This study shows how personality traits like psychopathy and narcissism affect vaccination and prevention behaviors during the pandemic.

## Contribution

The study identifies the impact of Dark Triad traits on vaccination uptake and preventive measures during the pandemic.

## Key findings

- High psychopathy scores correlate with lower primary vaccination rates.
- High narcissism scores correlate with higher refusal of booster shots.
- Personality traits influence adherence to preventive behaviors during the pandemic.

## Abstract

Even though the COVID-19 vaccination roll-out in general can be considered as one of the most successful public health campaigns in the history of medicine, general vaccination hesitancy has remained an issue of concern throughout the world. We add to a deeper understanding of vaccination hesitancy by identifying what drives primary vaccination and booster uptake, as well as adherence to simple preventive measures such as physical distancing by investigating the role of Dark Triad personality traits, i.e. Machiavellianism, narcissism, and psychopathy.

We investigate data from Germany and the United Kingdom from the European Covid Survey which was collected from 23 December 2021 to 10 January 2022. Logit regressions and random effects regressions were performed to study the effect of dark personality traits on COVID-19-related prevention.

We find a statistically significant association between Dark Triad personality traits and prevention efforts, primary vaccinations, and booster uptake against COVID-19. Specifically, individuals scoring high in psychopathy are associated with a lower likelihood of having received primary immunization. The marginal effect amounts to 3.31%-points. High narcissistic personality traits are correlated with a substantially higher likelihood (4.52%-points) to refuse booster shots after having received the primary vaccinations. Dark Triad personality traits may be relevant factors associated with vaccine-related decision-making. In addition, individuals with higher psychopathic tendencies report significantly lower engagement in other simple preventive behavior, while higher scores in narcissism are associated with higher reported adherence to simple preventive measures.

Our findings highlight the crucial role that personality plays in pandemic-related prevention. Policymakers, health professionals, and those in charge of health messaging may take these factors into account when devising communication strategies to improve the vaccination uptake and adherence to preventive behaviors. Future pandemics and public health crises would benefit from targeted, nuanced approaches to public health messaging to promote greater public adherence and public health.

The online version contains supplementary material available at 10.1186/s12889-025-22471-3.