As the COVID-19 pandemic continues to unfold, vaccine uptake has remained below the level needed to allow for a safe return to pre-pandemic life and thus is an immediate major public health concern. We might expect to see even greater disparities in vaccine choices if variants of concern are less responsive to available vaccines, when boosters become more widely available, and when previously established childhood vaccines regain attention. Research is showing that it is not enough to rely on predictive modeling of COVID-19 spread and vaccine uptake to induce behavioral change; identifying actual behavioral markers of vaccine hesitancy and unwillingness is a crucial next step to reduce the severity and spread of COVID-19 and other infectious diseases. A promising marker derived from behavioral economics is delay discounting, a tendency to prefer small immediate rewards over larger future rewards as the delay until receipt of the reward increases. It has been known since before the pandemic that short-sighted decision-making in the form of steep discounting is a reliable indicator of financial hardship (e.g., income inequality) and health issues (e.g., anxiety), which are heightened by the pandemic. I will present evidence from a multination experiment spanning 13 industrialized countries that short-sighted decision-making in the form of extreme discounting predicts vaccination status over and above demographic and mental health variables. Findings from this research can be used to better understand and predict choices to be vaccinated and to design targeted interventions to overcome suboptimal decision-making, particularly when the outcome of those decisions has the potential to harm oneself and other people.