COVID-19 vaccination rates slowed in many countries during the second half of 2021, along with the emergence of vocal opposition, particularly to mandated vaccinations. Who are those resisting vaccination? Under what conditions do they change their minds? Our 3-wave representative panel survey from Germany allows us to estimate the dynamics of vaccine opposition, providing the following answers. Without mandates it may be difficult to reach and to sustain the near universal level of repeated vaccinations apparently required to contain the Delta, Omicron and likely subsequent variants. But mandates substantially increase opposition to vaccination. We find that few were opposed to voluntary vaccination in all three waves of the survey. They are just 3.3 percent of our panel, a number that we demonstrate is unlikely to be the result of response error. In contrast, the fraction consistently opposed to enforced vaccinations is 16.5 percent. Under both policies, those consistently opposed and those switching from opposition to supporting vaccination are socio-demographically virtually indistinguishable from other Germans. Thus, the mechanisms accounting for the dynamics of vaccine attitudes may apply generally across societal groups. What differentiates them from others are their beliefs about vaccination effectiveness, trust in public institutions, and whether they perceive enforced vaccination as a restriction on their freedom. We find that changing these beliefs is both possible and necessary to increase vaccine willingness, even in the case of mandates. An inference is that well-designed policies of persuasion and enforcement will be complementary, not alternatives.

This data set provides the data and Stata code used for the article. A detailed description of the variables is available from the corresponding publication. Please cite our paper if you use the data.

A mock report for the Director-General of the World Health Organization. The analysis was done in Excel.

Achieving longer life expectancies can help a nation become economically stronger. The Director-General at the next U.N. meeting should recommend an increase in vaccination rates (including vaccination mandates for Diphtheria, Polio, and Measles), an increase in government spending on health, and an increase in public health courses in and out of schools as ways to increase life expectancy in individual countries. These recommendations are based on an analysis of immunization statistics, spending habits on health per country, schooling data, sickness data, and how they relate to life expectancy. These recommendations by the Director-General could end up improving the lives of millions, increasing the productivity of its citizens, and leading to higher economic growth.