Experts Suggest 12 Strategies to Encourage COVID-19 Vaccinations

As coronavirus disease 2019 (COVID-19) vaccines begin rolling out around the country, experts are turning to the issue of vaccination rates. Effective communication with patients will be essential to promoting the vaccines, and experts are turning to behavioral economics and consumer behavior therapy to examine communication techniques.

Hesitation about the vaccines has been a major concern for public health experts. Recent surveys show the proportion of the US population willing to be vaccinated fluctuated from 72% in May to 51% in September 2020, before increasing slightly in November to 60%.¹ Among the respondents who said they probably or definitely would not get the vaccine less than half said they would be more willing once others start getting it and more information is available.¹

“The country has made an incredible investment in fast-tracking [severe acute respiratory coronavirus 2] vaccines from conception to market, which would make it even more tragic if we fail to curtail the virus simply because Americans are hesitant to be vaccinated,” said Stacy Wood, MBA, first author of “Beyond Politics—Promoting COVID-19 Vaccination in the US.”²

According to the study authors, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and a leader in the federal response to COVID-19, has said that at least 80% of the population will need to be vaccinated in order to get the country back to normalcy. In a press release, Wood said this means it will be necessary to achieve 100% follow-through from individuals who are more likely to get the vaccine and 100% conversion of those who are currently unlikely but willing to keep an open mind.²

To address this challenge, Wood and her colleague Kevin Schulman, MD, MBA, utilized behavioral economics and consumer research to develop 12 strategies that could potentially create an effective vaccine-promotion effort.

One strategy could be using analogies, such as comparing the COVID-19 pandemic response with a war. According to the press release, saying “the war against COVID” evokes thoughts of coming together, making sacrifices, and emerging on the other side with new improvements and inventions. Another analogy could involve explaining that mRNA vaccines are not weak doses of the virus but are similar to instruction manuals teaching the immune system how to defend itself.¹

Increasing observability could also increase public trust in the vaccines, with studies showing that consumers’ ability to observe other individual’s choices can accelerate rates of adoption. Visible tokens of participation, such as Livestrong-style bracelets or stickers, or digital badges such as social media profile frames, may be effective in increasing consumer participation.¹

The paper authors also suggested compromise options, noting that coffee shops offering 3 serving sizes typically sell more of the medium size. This concept is based on choice preferences for compromise options, so the authors said that communicators should not make the vaccine seem like an either-or decision.

Rather, they suggested framing it as 3 options in which vaccination is in the middle. For example, options could include allowing people to get the injection now, signing up for a later date, or not getting it at all. The key, they said, is to avoid depicting vaccination as the most extreme option.¹

Other recommendations involve leveraging natural scarcity, segmenting the population according to identity barriers, identifying a common enemy, addressing negative attributions, prompting any anticipated regrets, avoiding piecemeal risk information, creating a fear of missing out, combating individuals who feel that they have unique reasons not to get vaccinated, and countering negative experience stories with positive experiences.¹

REFERENCES

• Wood S, and Schulman K. Beyond Politics—Promoting COVID-19 Vaccination in the United States. New England Journal of Medicine; January 6, 202 https://www.nejm.org/doi/full/10.1056/NEJMms2033790. Accessed January 12, 202
• Tapping into Behavioral Research to Promote COVID-19 Vaccination [news release]. NC State University; January 7, 2021. https://news.ncsu.edu/2021/01/behavioral-research-promoting-vaccination/. Accessed January 12, 2021.