Using protection motivation theory to explain intentions to vaccinate against tick-borne encephalitis

Background In central Europe, tick-borne encephalitis (TBE) virus poses a growing health risk, amplified by climate-related changes in tick distribution. However, the TBE vaccination rate in Germany remains low. This study uses the Protection Motivation Theory (PMT) to investigate factors influencing TBE vaccination intention in Germany and the effect of tailored information on TBE risk areas. Methods Participants ( N  = 309) aged between 18 and 61 living in Germany were included in an online survey with an additional experimental variation of tailored TBE risk messages. Three experimental groups were provided with (a) no tailored risk information, (b) semi-tailored information about risk areas on federal level or (c) full-tailored information on risk areas on county levels. Results The PMT concepts showed that perceived susceptibility, severity, and response efficacy were positively related to the intention to be vaccinated against TBE. In exploratory analyses, perceived self-efficacy was a positive predictor of vaccination status. Permanent residence in risk areas was also associated with vaccination status, whereas planned or previous vacations in such areas were not. The effect of tailored information on vaccination intentions could not be confirmed. Conclusions TBE vaccination intentions and uptake appear to be shaped by PMT factors and residence in risk areas. Public health interventions should therefore focus on communicating TBE risk, enhancing self-efficacy, and presenting clear evidence of vaccine efficacy to strengthen preventive measures against tick-borne diseases. Factors such as travel planning should also be considered in evidence-based health campaigns.