Leslie Massey
During the COVID-19 pandemic, Austria, along with Greece and Italy, announced and/or implemented mandatory vaccination for high-risk groups in the general population. This move was intended to increase vaccination rates and curb infections. While mandatory vaccination announcements substantially increased vaccination rates in Greece and Italy, no discernible increase in vaccination rates was observed in Austria after the announcement. Studies have shown a moderate negative correlation between vaccination rates and COVID-19 incidence rates in Austria, indicating that higher vaccination rates are associated with lower COVID-19 infection rates.
| Characteristics | Values |
|---|---|
| Date | 25 March 2022 |
| Median COVID-19 incidence rate | 194.5 cases/100,000 inhabitants |
| Median vaccination rate | 59.5% |
| Range of vaccination rate | 49.1%–71.6% |
| Median increase in incidence rates | 262.3 |
| Negative correlation between vaccination rate and COVID-19 incidence rate | r = -0.60, p < 0.001 |
| Negative correlation between vaccination rates and the observed increase in COVID-19 incidence rates | r = -0.51, p < 0.001 |
| Median incidence rate (stable infection rates) | 106.4 cases/100,000 inhabitants |
| Median vaccination rate (stable infection rates) | 57.3% |
| Range of median vaccination rate (stable infection rates) | 46.9%–69.6% |
| Median increase in incidence rates (stable infection rates) | 9.4 |
| Negative relationship between vaccination rates and COVID-19 incidence rates | r = -0.45, p<.001 |
| No correlation between vaccination rates and the change in incidence rates | r = -0.14, p = 0.186 |
| Total number of inhabitants | 8.9 million |
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What You'll Learn
COVID-19 vaccination rates in Austria
As of December 2021, Austria's COVID-19 vaccination rate was approximately two-thirds of the country's population, fully vaccinated. This rate was described as "shamefully low" by Austrian Chancellor Alexander Schallenberg, and the country had been experiencing a surge in infections, with a record daily high of 15,145 new cases reported on November 14, 2021.
In response, Austria implemented restrictions specifically for unvaccinated individuals, prohibiting them from leaving their homes for non-essential reasons. Those who violated these measures faced substantial fines. The Austrian government also announced its intention to mandate COVID-19 vaccination for the entire population, becoming the first European country to do so. This decision reflected a recognition that previous measures had not been sufficient in encouraging vaccination among the hesitant portion of the population.
Studies have examined the relationship between vaccination rates and COVID-19 incidence rates across Austria's 94 districts. These studies found a moderate negative correlation between vaccination rates and COVID-19 incidence, suggesting that higher vaccination coverage is associated with lower infection rates. However, the relationship between vaccination rates and the change in incidence rates during periods of stable or rising infections is less clear, with some studies finding no significant association.
Additionally, a small study focusing on patients with hemophilia in Austria found a higher vaccination coverage compared to the general population. The study reported that 75% of the patients were fully vaccinated, and 87.5% had received at least one dose. This higher coverage may be attributed to these patients' increased perception of vulnerability to COVID-19 and their receptiveness to scientific advancements.
Overall, Austria has faced challenges in increasing its COVID-19 vaccination rates, but the combination of incentives, restrictions, and mandates has led to a gradual rise in coverage.
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The impact of mandatory COVID-19 vaccination on rates
Austria has recorded almost three million coronavirus cases and over 15,000 deaths since the pandemic began in 2020. The country has one of the lowest vaccination rates in Western Europe, with only about 65.7% of the population fully vaccinated as of November 2021. In December 2021, 74.8% of people had received two doses, and 28.2% had received three doses. The low vaccination rate has been attributed to various factors, including complacency and vaccine hesitancy.
In response to the low vaccination rate, Austria became one of the few countries in the world to introduce mandatory COVID-19 vaccinations for all adults in February 2022. The law, which took effect on February 5, applied to all residents above 18 years old, except pregnant women, those with medical exemptions, and those who had recently recovered from COVID-19. The Austrian government expected a significant increase in vaccination rates due to the mandate, reducing the need for other protective measures and minimising the burden on the healthcare system.
However, the announcement of mandatory vaccination did not substantially increase vaccination rates in Austria, unlike in Greece and Italy, where a rapid increase in vaccination rates was observed after similar announcements. Despite the mandate, 13.8% of Austrians above 18 remained unvaccinated at the end of the study period. This suggests that while mandatory vaccination can address complacency, it may not effectively address vaccine hesitancy.
In March 2022, just weeks after the law took effect, Austria suspended mandatory COVID-19 vaccinations, citing the reduced danger posed by the pandemic and the "encroachment of fundamental rights". The suspension was also influenced by the predominance of the Omicron variant, which was widely believed to be less severe. At the time of the suspension, about 70% of the population was considered fully protected against the virus, indicating that the rate of fully vaccinated individuals had only slightly improved since the mandate's announcement.
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The relationship between vaccination rates and COVID-19 incidence
While COVID-19 vaccination rates have increased worldwide, some regions continue to experience rapid outbreaks. The relationship between vaccination rates and COVID-19 incidence has been studied extensively, particularly in the United States. These studies have revealed a strong negative correlation between vaccination rates and COVID-19 case incidence and mortality rates. In other words, as vaccination rates increase, COVID-19 infection rates decrease. This relationship was observed across various subgroups of counties, including those categorized by land use, median household income, and voting patterns.
For instance, a study in Missouri found that while the average weekly number of COVID-19 cases reported was 66.1, the average cumulative proportion of vaccinated individuals at the end of the 25-week period was only 25.8%. Additionally, the study highlighted the impact of vaccine mandates in increasing vaccination rates, particularly in targeted age groups. However, it is important to note that vaccine mandates did not close the vaccination gap, as many people remained unvaccinated despite the mandates.
In Europe, countries such as Austria, Greece, and Italy announced and/or implemented mandatory COVID-19 vaccination for high-risk groups or all adults. While the simple announcement of a vaccine mandate rapidly increased vaccination rates in Greece and Italy, no discernible increase was observed in Austria after the announcement. This discrepancy may be due to various factors, including cultural norms, vaccine hesitancy, and the availability of vaccines.
Furthermore, the relationship between vaccination rates and COVID-19 incidence is influenced by other factors such as population density, the presence of frontline workers, and social vulnerability. For example, counties that voted Republican in the 2020 US Presidential election tended to have lower vaccination coverage rates and higher COVID-19 incidence and mortality rates. Additionally, the impact of vaccination rates on COVID-19 outcomes may vary across different variants, as seen during the Omicron wave, where the association between vaccination rates and case incidence was less pronounced.
Overall, the body of research suggests that increasing vaccination rates is crucial in reducing COVID-19 infection rates. However, it is important to consider the complex interplay of various factors, including vaccine hesitancy, social dynamics, and virus mutations, to fully understand the relationship between vaccination rates and COVID-19 incidence.
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Measles and Polio vaccination rates
Austria has experienced regular measles outbreaks, despite polio being eradicated in the country for several years. Measles is a highly contagious disease that spreads quickly in communities with low vaccination rates. To prevent outbreaks, it is necessary to maintain a high level of vaccination coverage.
The overall vaccination coverage for measles in Austrian school children aged 10-14 was reported to be 86.4%. However, studies suggest that there is a significant level of vaccine hesitancy in Austria, with around 1-11% of parents refusing vaccination and many more expressing hesitancy towards some recommended vaccinations. This has resulted in low vaccination coverage for vaccine-preventable diseases, not just measles but also mumps, rubella, and pertussis.
The official national vaccination coverage for measles in Austrian children and young adults is estimated using a computer-simulated model that takes into account administered vaccines, orders by paediatricians, and sales numbers. For the 2-5-year-old age group, coverage for the recommended two doses of the measles-mumps-rubella (MMR) vaccine is estimated at 82%, while for the 6-9-year-old group, it is estimated at 89%. The biggest deficit is in the 19-30-year-old age group, with a two-dose coverage of just over 70%.
Oral poliomyelitis vaccination coverage in Austrian school children was found to be 98.6% for the first dose, 96.5% for the second, 95.3% for the third, and 78.7% for the fourth dose. While polio has been eradicated in Austria, the model suggests a significant delay in the third dose of the hexavalent vaccine in 30% of eligible children and 6.5% of completely unvaccinated individuals in the 5-9-year-old age group.
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The impact of age on vaccination rates
While there is limited information on the impact of age on vaccination rates in Austria, some studies have shown that age may be a factor influencing vaccination rates.
During the COVID-19 pandemic, Austria, along with Greece and Italy, announced mandatory COVID-19 vaccination for all adults aged 18 and above. In Greece and Italy, this announcement led to a rapid increase in vaccination rates among the targeted age groups. However, in Austria, there was no discernible increase in vaccination rates after the announcement, and 13.8% of those aged 18 and above remained unvaccinated at the end of the study period. This suggests that age may have played a role in the varying responses to the vaccine mandate across these countries.
In terms of COVID-19 vaccination rates across Austria's 94 districts, there was a median vaccination rate of 59.5% (ranging from 49.1% to 71.6%). The negative correlation between vaccination rates and COVID-19 incidence rates was observed, indicating that higher vaccination rates were associated with lower infection rates. However, the study did not find an association between vaccination rates and the change in incidence during a period of stable infection rates. This suggests that other factors, such as the infectivity of virus variants and the time until vaccine immunity wanes, may also influence infection rates.
Apart from COVID-19, Austria has also dealt with measles outbreaks, which is a typical childhood disease. Polio, another childhood disease, has been eradicated in Austria for several years. The country aims for permanent eradication of measles through high vaccination coverage. An agent-based simulation of the Austrian population over 18 years considered births, deaths, emigration, and immigration to calculate vaccination coverage per year. While this provides insights into vaccination goals and improvements, the uncertainty about the vaccination status of immigrants is a limitation.
Overall, while age may play a role in vaccination rates, as seen in the varying responses to vaccine mandates across Europe, other factors, such as complacency, vaccine hesitancy, and the evolution of virus variants, also influence vaccination rates and infection dynamics in Austria.
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Frequently asked questions
As of March 2022, the median vaccination rate in Austria was 57.3% (range 46.9–69.6%).
There is variation in the vaccination rate across Austria's 94 districts. For example, during a period of rising infection rates, the median vaccination rate was 59.5% (range 49.1–71.6%).
A study in the US suggests that the spread of COVID-19 is unrelated to vaccination coverage, whereas a German study claims that the spread is driven by the unvaccinated.
