Mental Contrasting of a Feared Future and Uptake of Initial COVID-19 Vaccines and Bivalent Booster Shots: Two Randomized Controlled Trials

Objective: Despite previous literature suggesting that merely fantasizing about a feared future does not lead to behavior change, COVID-19 vaccine campaigns often emphasized negative fantasies depicting the future scenarios of contracting the virus. In the current research, we propose a 5-min psychological intervention—mental contrasting of a feared future with a still positive reality—as a way to encourage individuals who expect severe COVID-19 symptoms to get vaccinated. Method: In two randomized controlled trials, we examined the uptake of initial COVID-19 vaccine shots among vaccine-reluctant unvaccinated individuals (Study 1) and the uptake of bivalent booster shot among fully vaccinated individuals who were unwilling to receive booster shots (Study 2). In both studies, we measured participants’ expected severity of symptoms if they fell ill with COVID-19 and manipulated modes of thought (mental contrasting vs. fantasizing about a feared future) via a short writing task. As outcome variables, we assessed vaccine-related behaviors (information seeking and actual vaccine uptake) over a period of 6 weeks (Study 1) and 4 weeks (Study 2). Results: We found that mental contrasting of the feared future of COVID-19 with a still positive reality guided people who expected severe COVID-19 symptoms toward vaccination via increased information-seeking, whereas negative fantasizing did not. Conclusion: The findings suggest that mental contrasting of a feared future can be employed as an effective intervention for promoting information seeking and eventually the uptake of COVID-19 vaccine shots, not only for vaccine-reluctant unvaccinated individuals but also for vaccine-unwilling fully vaccinated individuals.