How Fear Drove Near-Total Vaccination in Low-Risk Group
The ability to evaluate danger, and act accordingly, is part of daily life. Yet as a striking new study from the Covid era demonstrates, even a small amount of fear can hijack this essential function
If you wanted to create a group of people with the least objective reason to fear COVID-19, you’d design them in a lab to look a lot like university students: young, healthy, and statistically at a minuscule risk of severe illness from the virus.
Yet a fascinating new study reveals that within this very group, the presence of just a little fear was almost perfectly predictive of one thing: getting vaccinated. Not just once, but again and again.
The research, published in the prestigious peer-reviewed journal PLOS One, digs into the psychological engine behind vaccination decisions. And its findings pose a stark, uncomfortable question about the ethics of public health communication.
Let’s break down what they found.
The Study in a Nutshell
Researchers Jonas Tögel and Christof Kuhbandner surveyed 419 German university students between December 2022 and January 2023, a time when the vaccination campaign was well-established (Tögel & Kuhbandner, 2025).
They measured:
- Fear of COVID-19: Using a simple scale from “no fear” to “high fear.”
- Perceived Risk: Asking students to estimate their chances of hospitalization or ICU admission from an infection.
- Vaccination Status: How many shots they had received.
The context is critical. As the authors note, “university students are a group of people who only very rarely become seriously ill in the event of a SARS-CoV-2 infection.” This wasn’t a study of the vulnerable elderly; it was a study of the demographic with the strongest biological shield against bad outcomes.
The Jaw-Dropping Findings
- The “No Fear” Group Was the Only Holdout. In the cohort of students who reported zero fear of COVID-19, the vaccination rate was still a remarkably high 83 percent. But this was the lowest rate. As soon as researchers looked at students with even a “low” level of fear, the vaccination rate skyrocketed to nearly 100 percent.
- Fear Drove the Booster Train. The pattern was even starker for third and fourth doses. Among the double-vaccinated, only 61 percent of the “no fear” group got a booster. But with just a “low” amount of fear, that booster rate jumped to 79 percent, climbing to 83 percent for “medium” fear and 100 percent for “high” fear.
- Risk Perception Took a Back Seat. While students’ estimated risk of severe illness showed a marginal correlation with the first shots, it had no significant link to whether they got boosters. Fear was the dominant driver, the psychological puppet master pulling the strings.
In other words, for this low-risk group, the decision to get a shot—and especially to get repeated shots—wasn’t primarily a cool-headed calculus of personal risk. It was an emotional response.
And the threshold for that response was astonishingly low.
The Uncomfortable Conclusion: Irrationality by Design?
The authors’ conclusion is unambiguous:
“A fear-based communication is irresponsible and can lead to irrational decisions.”
Why “irrational”? Because we’re talking about people making significant health decisions based on an emotion (fear) that is disproportionate to their actual, statistical level of threat.
A young student with a 0.1 percent risk of hospitalization but a “medium” fear level was as likely to be vaccinated as a 70-year-old with a far greater objective risk.
The study powerfully suggests that public health messaging that amplifies fear can bypass our rational faculties. It can lead low-risk individuals to make medical choices that are misaligned with their personal health needs, driven instead by a generalized anxiety.
The authors point to another likely factor: mandates. The incredibly high baseline vaccination rate (93.6 percent among students, compared to ~81 percent in the general German population of the same age) was probably heavily influenced by university policies that restricted campus access, library use, and in-person classes for the unvaccinated.
Fear of the disease and fear of social/educational exclusion became a potent, intertwined mix.
The Takeaway: A Lesson for the Next Crisis
This study is a crucial case study in the power of behavioral psychology. It demonstrates that fear is not just a powerful motivator; it is an overwhelmingly efficient one, capable of producing near-uniform compliance even in groups that have little objective reason to comply for their own health.
For public health officials and communicators, the lesson is profound. Leaning on fear might produce the desired short-term metric—high vaccination rates—but it does so at a cost.
It can infantilize the public, discourage informed personal risk assessment, and potentially erode trust when people later realize the gap between the perceived threat and the reality for their demographic.
The most effective and ethical public health strategy is not to make people afraid. It is to make them informed, to equip them with clear data about their personal risk, and to trust them to make rational decisions alongside their doctors.
Because as this study shows, you only need a tiny dose of fear to make a low-risk population do almost anything.
And in the long run, that might be a more dangerous prescription than the virus itself.
World Council for Health stands for a better way.
Reference
Tögel, J., & Kuhbandner, C. (2025). COVID-19 vaccinations among German university students: The role of fear of COVID-19 and risk assessment. PLOS ONE, 20(9), e0333082. https://doi.org/10.1371/journal.pone.0333082
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