“If only there were a message that could break through skepticism and persuade unvaccinated people to get their shots. What a world that would be. But over the past year, this really did happen,” reads a February 2022 Vox article1 that continues on to describe a Harvard Business School publication2 which offers new evidence on the most effective ways to convince the “anti-vax” population to get vaccinated.
The publication entitled “From Anti-Vax Intentions to Vaccination”2 involved surveying over 6,000 people in several countries including the United States, the United Kingdom, European Union, Australia and New Zealand.
The researchers first contacted the participants in December 2020 asking them to assess their likelihood of getting a COVID-19 shot on a scale from zero to ten. The researchers then experimented with four messages to respondents and followed up again six months later. The four messages included:
- protecting others
- Protecting public health
- Protecting the economy
Altruistic Messages of Protecting Others Most Effective in Convincing Skeptics to Vaccinate
The control group heard no messaging at all. Researchers found that the altruistic messages of protecting health, protecting others, and protecting the economy had a stronger impact on convincing respondents to get vaccinated than the self-protection message. One-third of individuals, who initially had rated their likelihood of getting a COVID shot as a zero before being subjected to altruistic messaging, went on to receive the vaccine by the time of the follow up.
A Vox article outlining the research states:
It is tempting to think of vaccination intentions as static… But people can be moved, too, according to these findings—not necessarily by emphasizing their personal health, but by persuading them that they will do good for the people around them and the country at large.1
Guilt, Embarrassment Used as Part of Vaccine Promotion Messaging
This was not the first time persuasive messaging has been studied regarding COVID shot acceptance. In July of 2020, Yale published a randomized controlled trial study entitled “Persuasive Messages for COVID-19 Vaccine Uptake.”3
The study’s primary outcome measure was to find out participants’ intentions of getting a COVID shot, while secondary outcome measures included a vaccine confidence scale; a measure of willingness to persuade others to get the vaccine; a measure of fear of those not vaccinated, and social judgement of those who do not get the vaccine. The latter category is described as being a “scale composed of four items measuring the trustworthiness, selfishness, likeableness, and competence of those who choose not to get vaccinated after a COVID shot becomes available.”3
The trial used one of several intervention messages to better understand which messages had the most impact on willingness to vaccinate. Some of these messages included:
- Personal Freedom Message: society members can preserve personal freedom when enough citizens are vaccinated.
- Economic Freedom Message: working together to stop COVID-19 by getting enough people vaccinated will help society preserve its economic freedom.
- Social Pressure—Guilt/Embarrassment Messages: the best way to protect family and community is to get vaccinated. The survey asks the participant to imagine the guilt or embarrassment they would feel if they don’t get vaccinated and spread the disease.
- Trust in Science Message: refusal to get vaccinated is not understanding how infections are spread and ignoring science
- Not Bravery Message: vaccinated firefighters, doctors, and front line medical workers are brave. Those who not to get vaccinated are not brave.
Yale, UNICEF and Facebook Advise Highlighting Societal Norms and Expectations to Promote Vaccination
In December 2020, Yale Institute of Global Health, along with UNICEF and Facebook, put out a “Vaccine Messaging Guide”4 intended for use by public health professionals, communicators and other vaccine advocates.
Part of this guide discusses how a messaging campaign aimed at reinforcing social norms may be effective and gives examples such as Ireland producing an “I got the HPV vaccine” video which reinforces the vaccine as a social norm. The guide reads:
We do what other people do. Social norms offer implicit guides for our behavior by telling us what others are doing or what they expect us to do. There is evidence that social norms are associated with vaccination decisions, and one study found that perceiving greater support for HPV vaccination from friends, parents, or doctor was associated with increased vaccine intentions.4
Authors of the Yale/UNICEF/Facebook “Vaccine Messaging Guide” also outline their definition of “vocal vaccine deniers” and maintain that vaccine deniers use four basic techniques when justifying refusal to conform to the social norm of complying with federal vaccine policies and law, including misrepresenting scientific evidence, shifting the hypotheses when their argument is not winning, censoring opposing viewpoints, and personally attacking the opposition.4
Psychologists, Social Scientists ‘At the Forefront’ of Combating Vaccine Hesitancy
According to the American Psychological Association (APA), psychologists are at the forefront of combating vaccine hesitancy and will be important leaders in ensuring that everyone believes COVID shots are safe and effective and “actually rolls up their sleeve to get it.”5 Psychologists and other social scientists have been tracking vaccine attitudes since 2020 to better understand who is hesitant to receive a COVID shot and why.
Steven Taylor, a clinical psychologist at the University of British Columbia in Canada says that those with strong anti-vax and anti-mask attitudes are driven by a phenomenon that psychologists have labeled “psychological reactance,” which is a “motivational state driven by the feeling that someone is trying to curtail one’s freedom.”5 To convince people with “psychological reactance” to vaccinate, Dr. Taylor says it’s best not to frame vaccination as an obligation but to use the message that “getting vaccinated is a right you have, don’t let people take that away from you.”5
Percentage Vaccinated to Reach Herd Immunity Remains Unknown
While the push to persuade those who refuse to get a COVID shot to change their minds continues, scientists still do not know how many people in a population have to get vaccinated to achieve the theorized “herd immunity.” Early estimates from epidemiologists were roughly 60 to 70 percent of the population having either natural immunity or vaccine acquired immunity but the situation is complicated by the fact that the COVID shots were not specifically designed to prevent infection and transmission of SARS-CoV-2, only to prevent severe COVID disease.6
Anthony Fauci, MD has slowly increased his estimate for COVID-shot induced herd immunity to 90 percent or more of the U.S. population.6 In a telephone interview, Dr. Fauci acknowledged that “he had slowly but deliberately been moving the goal posts,” partly based on science and partly on a “gut feeling” that the country is finally ready to hear what he truly thinks.7
Despite several studies demonstrating that natural immunity is broad and longer lasting,8 the focus of COVID disease control continues to be on increasing vaccination rates. Recently, Pfizer CEO Albert Bourla submitted data to the FDA for a fourth dose of the mRNA BNT162b2 (also known as “Comirnaty”) biologic.9 Bourla stated that while the third dose was protecting against hospitalizations and deaths, “it’s not that good against infections”9 and so a fourth booster is necessary.
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Click here to view References:
1 Scott D. What can actually convince vaccine skeptics to get their shots. Vox Feb. 17, 2022.
2 Galasso V et al. From anti vax intentions to vaccination: panel and experimental evidence from nine countries. National Bureau of Economic Research Feb. 2022.
3 Yale University. Covid-19 Vaccine Messaging, Part 1. NIH U.S. National Library of Medicine July 7, 2020.
4 Vaccine Messaging Guide. Yale Institute for Global Health, and Unicef, and Facebook December 2020.
5 Pappas S. Social science and the COVID-19 vaccines. American Psychological Association Mar. 1, 2021.
6 FDA. Development and Licensure of Vaccines to Prevent COVID-19: Guidance for Industry. Efficacy Considerations Pages 13-24. Revised June 2020.
7 McNiel D. How much herd immunity is enough? The New York Times Sep. 22, 2021.
8 Makary M. Natural immunity to COVID is powerful. Policymakers seem afraid to say so. The Washington Post Sept. 15, 2021.
9 Tin A. Pfizer CEO says fourth dose of COVID vaccine is “necessary,” submits data to FDA. CBS News Mar. 14, 2022.