Longitudinal changes of COVID-19 vaccine-related health beliefs and associations with psychopathology in Germany

Vaccination is among the most effective measures to prevent fatal disease outcomes of COVID-19. However, coverage has mostly fallen short of intended goals, and evidence on psychological determinants within certain high-risk groups (e.g., individuals with mental disorders) are inconclusive. This study aimed to examine the courses of COVID-19 vaccine-related health beliefs and their associations with psychopathology. We conducted a 16-wave longitudinal study from December 2020 to November 2022 assessing N = 1865 participants of the adult general population in Germany. Linear mixed-effects models were employed to examine courses of health beliefs (i.e., perceived risk and fear of SARS-CoV-2 infection, COVID-19 vaccine-specific beliefs) and associations with diagnostic status, depressive, anxiety, and somatic symptoms, as well as health anxiety. Pandemic-related threat appraisals showed significant changes over time, with perceived risk and fear of infection exhibiting notable fluctuations. In contrast, vaccine-specific beliefs remained relatively stable. We observed few practically meaningful between-person associations between specific psychopathological characteristics and health beliefs that diverged in terms of their favorability toward vaccination, but meaningful within-person associations were largely absent. Individuals with a mental disorder at study entry reported a significantly lower perceived risk of infection. The study revealed differential courses of COVID-19 vaccine-related health beliefs. Psychopathological characteristics play, at most, only a subordinate role in affecting vaccine-related health beliefs. Still, individuals with mental disorders should have been targeted more explicitly by public health interventions to foster awareness of their heightened risk.