# Economic and health consequence frames affect COVID-19 vaccine incentive attitudes in Germany– a survey based framing experiment

## TL;DR

This study shows that framing messages about vaccine incentives in Germany can increase support for financial rewards, regardless of the specific message used.

## Contribution

The study demonstrates that the mere presence of consequence frames, rather than specific narrative content, influences attitudes toward vaccine incentives.

## Key findings

- Over 75% of participants found incentives not meaningful, but all frames increased support for monetary and lottery incentives.
- All frames had similar effects across subgroups like age, gender, and vaccination status.
- The existence of frames, not their specific content, was key to boosting favorable views of incentives.

## Abstract

SARS-CoV-2 vaccines have significantly reduced human and economic losses. Nevertheless, vaccine hesitancy remains a major issue in many countries, including Germany. Recent studies have shown that public health framing and incentives can boost immunization rates. However, available evidence is fragmented and inconclusive regarding the effectiveness of different framing messages, types of incentives, and the size of financial incentives across different populations.

This randomized, controlled survey experiment elicited the attitudes of 6,685 Germans towards 4 financial/non-financial SARS-CoV-2 immunization incentives (food voucher, football tickets, participation in lottery, immediate monetary compensation), and tested whether framing (individual/collective, health/economic consequences) affected said attitudes. We assigned participants to five study arms (control: no frame; experiment: 1 of 4 frames) and measured attitudes towards immunization incentives, and the amount of monetary compensation deemed appropriate, should such an incentive be considered.

While > 75% of our sample considered all 4 incentives to be not meaningful, all frames increased favorable views towards the financial incentives lottery/money and the average amount deemed acceptable for immediate monetary compensation. Interaction models showed that all frames have similar effects across core subgroups, e.g. age-cohorts, gender, vaccine doses.

Across a sample of 6,685 Germans, we show that 4 different frames detailing the potential individual/collective consequences of COVID-19 have very similar effects on attitudes towards monetary incentives for SARS-CoV-2 immunization. Our results suggest that the existence of frames rather than specific narratives is key to increasing favorable views towards immunization incentives.

Not applicable.

The online version contains supplementary material available at 10.1186/s12889-025-23279-x.