The COVID-19 Snapshot Monitoring COSMO is a serial cross-sectional study that aims at regularly supporting the German government and other regulatory bodies to gain insights into public opinion and acceptance of measures and policies during the COVID-19 pandemic. It started in March 202 and will run until April 2022.

The fortnightly data collections made it possible to constantly address current topics and thus to draw a psychological profile of the public during the dynamic pandemic situation in Germany. The monitoring is able to show trends in parameters which are relevant for protective behaviour (e.g., trust, risk perception, acceptance of measures). This allowed a quick "live" assessment of the psychological situation. Recommendations derived from the findings are regularly edited as policy briefs and sent to health authorities, ministries, and relevant stakeholders.  

In addition, the survey-based monitoring was supplemented by psychological survey-experiments that could also shed light on causal relationships (e.g., when asked about effective communication on safe behavior after rapid tests; or regarding the perception of mandatory mask policies). Qualitative data from open-ended responses also allowed us to quickly map unknown topics (e.g., which vaccination venues are preferred by the unvaccinated people, what motivates testing behaviors, or what rumors and misinformation are circulating, etc.). This innovative combination of methods-serial cross-section, experiments, and qualitative data-allowed for both exploratory and hypothesis-testing approaches, as well as maximum understanding of the situation within the population.

The COSMO Explorer allows users to interactively view and stratify data that are not explicitly evaluated on the website (e.g. vaccination rate by East and West Germany). The application also allows users to explore various aspects over time (e.g., vaccination readiness), distributions (e.g., proportion of vaccination opponents in the total sample), and correlations (e.g., between vaccination readiness and trust in government). The Explorer can be accessed here: projekte.uni-erfurt.de/cosmo2020/web/explorer/

COSMO is a joint project of the University of Erfurt, the Robert Koch Institute, the Federal Center for Health Education, the Leibniz Institute of Psychology, the Science Media Center, the Bernhard Nocht Institute for Tropical Medicine, and the Yale Institute for Global Health.

Website (in German): www.corona-monitor.de

Publications from the project: https://projekte.uni-erfurt.de/cosmo2020/web/publications/

Overcoming the social dilemma in vaccination decisions and the consumption of antibiotics

Scientific approaches often describe preventive and curative health decisions as individual decision-making tasks, where individuals weigh their own costs and benefits. However, some health decisions do not only affect the individual decision-maker, but also have direct or indirect effects on others.

The classical perspective ignores potential positive or negative effects on others (externalities) as mechanisms and potential incentives in health decisions. Vaccinations, for instance, often have positive externalities because every vaccination reduces the transmission of a disease and thus indirectly protects unvaccinated individuals. Antibiotic use, in contrast, is an example for negative externalities, because excessive and inappropriate use leads to drug resistance and can harm uninvolved others if antibiotics are no longer effective. As a result, health decisions become social interactions when the decisions of several individuals and their health consequences influence each other, and individual interests have to be weighed up against collective interests.

In a preceding project we systematically analyzed vaccination decisions as social interactions at the behavioral level. The three work packages of this follow-up project directly build upon the established research method of analyzing social-interactive health decisions through interactive decision tasks (Health Games). It has been repeatedly shown that interventions stressing prosocial aspects of vaccinations are helpful in increasing the willingness to vaccinate. Work package WP1 therefore critically examines this finding with regard to mediators as well as facilitating and attenuating moderators.

Furthermore, previous studies showed that integrating vaccine effectiveness into the vaccination decision leads to a cognitive bias ("Vaccine Effectiveness Fallacy"). When vaccines are less effective, individuals are less willing to vaccinate. Theoretical models, however, suggest that this is incorrect from a normative perspective since with decreasing effectiveness the indirect protection also decreases. Therefore, WP2 identifies and evaluates different debiasing strategies.

WP3 applies our research approach to antibiotic use in order to examine its determinants. These insights will facilitate the future development of strategies to reduce excessive and inappropriate antibiotic use. For this purpose, we developed a novel interactive decision task that models the social-interactive mechanisms in the development of antibiotic resistance.

Based on these interdisciplinary research methods, this project extends theoretical models of health decision dilemmas, taking into account that behavioral predictions can vary depending on whether externalities of the individual decision are considered or not. The results of this project will increase our understanding and the development of evidence-based interventions to overcome vaccine hesitancy and antibiotic overuse.

This is a collaboration with Prof. Dr. Robert Böhm, University of Vienna.

See also website DFG Gepris Database