Stringent policies were associated with greater Covid-19 vaccine uptake including among those who did not trust the vaccine

Are stringent vaccine promotion policies associated with higher vaccine uptake? We argue policy stringency, which changes the costs and benefits of immunisation choices, can affect individual vaccination decisions. In a survey of G-7 countries, 22% of respondents ( n  = 42,417) said they did not trust the Covid-19 vaccine, but half of them reported having at least one vaccination. We investigate factors associated with take-up. Our data indicate a high-stringency policy environment (with vaccine mandates and travel restrictions) is associated with increased uptake of the initial vaccination protocol (7 percentage points) compared to a low-stringency policy environment. Among those who did not trust the Covid-19 vaccine, a high-stringency policy environment is associated with increased uptake of the initial vaccine (16 percentage points) and the booster vaccine (20 percentage points). Our findings suggest high-stringency policies can promote vaccine uptake but raise questions about how to strike the right balance between persuasive and coercive policies.