---
title: "Effect of pre-booked vs self-scheduled appointments on COVID-19 vaccination uptake and intentions"
id: "pubmed-42546637"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42546637"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42546637/"
doi: "10.1016/j.vaccine.2026.128967"
published_at: "2026-08-30T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Effect of pre-booked vs self-scheduled appointments on COVID-19 vaccination uptake and intentions
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42546637
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42546637/)
- **DOI:** [10.1016/j.vaccine.2026.128967](https://doi.org/10.1016%2Fj.vaccine.2026.128967)
- **Published At:** 2026-08-30T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This formative mixed-methods evaluation assessed how switching from self-scheduling to **pre-booked appointments** affected perceptions and **COVID-19 vaccination intentions** for three eligible groups in the Netherlands: individuals under 60 with an influenza indication, those aged 60–69, and those 70+. - Phase 1 comprised 15 qualitative interviews that found mixed attitudes: some participants considered **pre-booked appointments** presumptuous or inconvenient, while others viewed them as a helpful prompt to support vaccine uptake; some individuals expressed both positive and negative views. - Phase 2 was an experimental survey in a representative online panel (n = 1,886) comparing perceived burden and effects on intentions between **self-scheduling** and **pre-booked** appointment formats. - Participants rated self-scheduling as less burdensome (reported effect: Coefficient = -0.23), indicating a preference for self-scheduling on perceived ease/pleasantness of the process. - Despite differences in perceived burden, the change in appointment default did not produce statistically meaningful changes in actual **vaccination intentions** in the full sample (Adjusted OR = 1.11). - In the subgroup reporting hesitancy about this vaccination round, perceived burden differences persisted (Coefficient = -0.25) but there was likewise no increase in vaccination intention with pre-booked appointments (Adjusted OR = 0.88). - Overall, the intervention of assigning **pre-booked appointments** did not increase stated vaccination intentions in this study sample, though it elicited both negative and positive reactions. - Based on these results, the authors conservatively recommend implementing pre-booked appointments only for older adults who were vaccinated in the previous year, reflecting a cautious approach given mixed sentiments and no measurable increase in intentions. - The authors declared no competing financial interests or personal relationships that might have influenced the work.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 3. # Switching the default: a formative evaluation of pre-booked appointments on COVID-19 vaccination uptake and effects on intended uptake [Jet G Sanders](https://pubmed.ncbi.nlm.nih.gov/?term=Sanders+JG&cauthor_id=42546637)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-1 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; London School of Economics and Political Science, London, United Kingdom. Electronic address: jet.sanders@rivm.nl."), [Floor Kroese](https://pubmed.ncbi.nlm.nih.gov/?term=Kroese+F&cauthor_id=42546637)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-2 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands."), [Sumit Mehra](https://pubmed.ncbi.nlm.nih.gov/?term=Mehra+S&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Marijn Stok](https://pubmed.ncbi.nlm.nih.gov/?term=Stok+M&cauthor_id=42546637)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-2 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands."), [Aylin Munyasya](https://pubmed.ncbi.nlm.nih.gov/?term=Munyasya+A&cauthor_id=42546637)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-4 "Populytics, Research Agency, Leiden, the Netherlands."), [Manon R Haverkate](https://pubmed.ncbi.nlm.nih.gov/?term=Haverkate+MR&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Niek Mouter](https://pubmed.ncbi.nlm.nih.gov/?term=Mouter+N&cauthor_id=42546637)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-5 "Populytics, Research Agency, Leiden, the Netherlands; Technology, Policy and Management, Delft University of Technology, the Netherlands."), [Susan J M Hahné](https://pubmed.ncbi.nlm.nih.gov/?term=Hahn%C3%A9+SJM&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Susan van den Hof](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hof+S&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Marijn de Bruin](https://pubmed.ncbi.nlm.nih.gov/?term=de+Bruin+M&cauthor_id=42546637)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-6 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands."), [Mattijs S Lambooij](https://pubmed.ncbi.nlm.nih.gov/?term=Lambooij+MS&cauthor_id=42546637)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#full-view-affiliation-7 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands.") Affiliations Expand ### Affiliations * 1 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; London School of Economics and Political Science, London, United Kingdom. Electronic address: jet.sanders@rivm.nl. * 2 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands. * 3 National Institute for Public Health and the Environment, Bilthoven, the Netherlands. * 4 Populytics, Research Agency, Leiden, the Netherlands. * 5 Populytics, Research Agency, Leiden, the Netherlands; Technology, Policy and Management, Delft University of Technology, the Netherlands. * 6 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands. * 7 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands. * PMID: **42546637** * DOI: [ 10.1016/j.vaccine.2026.128967 ](https://doi.org/10.1016/j.vaccine.2026.128967) Free article Item in Clipboard # Switching the default: a formative evaluation of pre-booked appointments on COVID-19 vaccination uptake and effects on intended uptake Jet G Sanders et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42546637/) . 2026 Aug 30:89:128967. doi: 10.1016/j.vaccine.2026.128967. Epub 2026 Aug 3. ### Authors [Jet G Sanders](https://pubmed.ncbi.nlm.nih.gov/?term=Sanders+JG&cauthor_id=42546637)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-1 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; London School of Economics and Political Science, London, United Kingdom. Electronic address: jet.sanders@rivm.nl."), [Floor Kroese](https://pubmed.ncbi.nlm.nih.gov/?term=Kroese+F&cauthor_id=42546637)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-2 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands."), [Sumit Mehra](https://pubmed.ncbi.nlm.nih.gov/?term=Mehra+S&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Marijn Stok](https://pubmed.ncbi.nlm.nih.gov/?term=Stok+M&cauthor_id=42546637)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-2 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands."), [Aylin Munyasya](https://pubmed.ncbi.nlm.nih.gov/?term=Munyasya+A&cauthor_id=42546637)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-4 "Populytics, Research Agency, Leiden, the Netherlands."), [Manon R Haverkate](https://pubmed.ncbi.nlm.nih.gov/?term=Haverkate+MR&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Niek Mouter](https://pubmed.ncbi.nlm.nih.gov/?term=Mouter+N&cauthor_id=42546637)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-5 "Populytics, Research Agency, Leiden, the Netherlands; Technology, Policy and Management, Delft University of Technology, the Netherlands."), [Susan J M Hahné](https://pubmed.ncbi.nlm.nih.gov/?term=Hahn%C3%A9+SJM&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Susan van den Hof](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hof+S&cauthor_id=42546637)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-3 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands."), [Marijn de Bruin](https://pubmed.ncbi.nlm.nih.gov/?term=de+Bruin+M&cauthor_id=42546637)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-6 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands."), [Mattijs S Lambooij](https://pubmed.ncbi.nlm.nih.gov/?term=Lambooij+MS&cauthor_id=42546637)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42546637/#short-view-affiliation-7 "National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands.") ### Affiliations * 1 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; London School of Economics and Political Science, London, United Kingdom. Electronic address: jet.sanders@rivm.nl. * 2 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Utrecht University, Utrecht, the Netherlands. * 3 National Institute for Public Health and the Environment, Bilthoven, the Netherlands. * 4 Populytics, Research Agency, Leiden, the Netherlands. * 5 Populytics, Research Agency, Leiden, the Netherlands; Technology, Policy and Management, Delft University of Technology, the Netherlands. * 6 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands. * 7 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands. * PMID: **42546637** * DOI: [ 10.1016/j.vaccine.2026.128967 ](https://doi.org/10.1016/j.vaccine.2026.128967) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** In autumn 2023, COVID-19 vaccination invitations in the Netherlands shifted from self-scheduling to pre-booked appointments for selected groups. While defaulting to pre-booked slots may increase uptake, potential rebound effects remain unclear. We examine preferences between appointment types, their effect on vaccination intentions, and whether effects are different for individuals hesitant about this vaccination round. **Methods:** A mixed-methods approach was used to assess vaccination intentions for three groups (<60 with influenza vaccination indication, 60-69 and 70+ years) eligible for pre-booked appointments. In a two-phase formative evaluation study, we examined attitudes around pre-booked appointments in 15 interviews (phase 1) and experimentally tested (phase 2) perceived burden of pre-booked appointments vs self-scheduled appointments and their effect on vaccination intentions in a representative online panel (n = 1.886) and those who experience hesitancy about this vaccination. **Findings:** Interviews (phase 1) showed that pre-booked appointments are seen as presumptuous or inconvenient by some, but also as a useful aid in support of vaccination uptake, sometimes by the same people. Participants in the experiment (phase 2) indicated to perceive self-scheduling as less burdensome (Coefficient = -0.23) but this perception did not translate to differences in vaccination intentions (Adjusted OR = 1.11) Similar results were observed in the hesitant subgroup (Coefficient = -0.25; Adjusted OR = 0.88). **Discussion:** In our study pre-booked appointments do not change COVID-19 vaccination intentions. As pre-booked appointments evoked negative and positive sentiments and self-scheduling was found easier and more pleasant, we conservatively recommend its implementation for older adults who received their COVID-19 vaccination the previous year. **Keywords:** Attitudes; COVID-19; Defaults; Mixed methods; Opt-out; Pre-booked appointments; Preferences; Vaccination coverage; Vaccination intention; Vaccination uptake; Vaccines. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Predictors of COVID-19 Vaccination Intention and Behavior Among Young People in a European Union Country With Low COVID-19 Vaccination Rates: Cross-Sectional Study. ](https://pubmed.ncbi.nlm.nih.gov/39983109/) Atanasova S, Kamin T, Perger N.Atanasova S, et al.JMIR Public Health Surveill. 2025 Feb 21;11:e64653. doi: 10.2196/64653.JMIR Public Health Surveill. 2025.PMID: 39983109Free PMC article. * [ Effect of COVID-19 vaccination appointment letters on uptake by sociodemographic characteristics: a regression discontinuity analysis in Sweden, December 2020 to September 2021. ](https://pubmed.ncbi.nlm.nih.gov/40581614/) Varotsis G, Hammar U, Bonander C, Lundmark P, Kennedy B, Gomez MF, Martinell M, Dyar OJ, Sarkadi A, Kristiansson R, Svaleryd H, Fall T.Varotsis G, et al.Eur J Public Health. 2025 Aug 1;35(4):795-802. doi: 10.1093/eurpub/ckaf097.Eur J Public Health. 2025.PMID: 40581614Free PMC article. * [ Knowledge, attitudes, and intentions regarding COVID-19 vaccination in the general population and the effect of different framing messages for a brief video on intentions to get vaccinated among unvaccinated individuals in the United States during July 2021. ](https://pubmed.ncbi.nlm.nih.gov/38608538/) Zapf AJ, Schuh HB, Dudley MZ, Rimal RN, Harvey SA, Shaw J, Balgobin K, Salmon DA.Zapf AJ, et al.Patient Educ Couns. 2024 Jul;124:108258. d
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