Nudges for COVID-19 voluntary vaccination: How to explain peer information?
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ABSTRACT:
SUBMITTER: Sasaki S
PROVIDER: S-EPMC8577869 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Enhancing vaccine uptake is a critical public health challenge1. Overcoming vaccine hesitancy2,3 and failure to follow through on vaccination intentions3 requires effective communication strategies3,4. Here we present two sequential randomized controlled trials to test the effect of behavioural interventions on the uptake of COVID-19 vaccines. We designed text-based reminders that make vaccination salient and easy, and delivered them to participants drawn from a healthcare system one day (first randomized controlled trial) (n = 93,354 participants; clinicaltrials number NCT04800965) and eight days (second randomized controlled trial) (n = 67,092 individuals; clinicaltrials number NCT04801524) after they received a notification of vaccine eligibility. The first reminder boosted appointment and vaccination rates within the healthcare system by 6.07 (84%) and 3.57 (26%) percentage points, respectively; the second reminder increased those outcomes by 1.65 and 1.06 percentage points, respectively. The first reminder had a greater effect when it was designed to make participants feel ownership of the vaccine dose. However, we found no evidence that combining the first reminder with a video-based information intervention designed to address vaccine hesitancy heightened its effect. We performed online studies (n = 3,181 participants) to examine vaccination intentions, which revealed patterns that diverged from those of the first randomized controlled trial; this underscores the importance of pilot-testing interventions in the field. Our findings inform the design of behavioural nudges for promoting health decisions5, and highlight the value of making vaccination easy and inducing feelings of ownership over vaccines.
| S-EPMC8443442 | biostudies-literature
Project description:Behavioral nudges in Facebook ads reached nearly 15 million people across six diverse countries and, consequently, many thousands took the step of navigating to governments' vaccine signup sites. However, none of the treatment ads caused significantly more vaccine signup intent than placebo uniformly across all countries. Critically, reporting the descriptive norm that 87% of people worldwide had either been vaccinated or planned vaccination-social proof-did not meaningfully increase vaccine signup intent in any country and significantly backfired in Taiwan. This result contradicts prominent prior findings. A charge to "protect lives in your family" significantly outperformed placebo in Taiwan and Turkey but saw null effects elsewhere. A message noting that vaccination significantly reduces hospitalization risk decreased signup intent in Brazil and had no significant effects in any other country. Such heterogeneity was the hallmark of the study: some messages saw significant treatment effects in some countries but failed in others. No nudge outperformed the placebo in Russia, a location of high vaccine skepticism. In all, widely touted behavioral nudges often failed to promote vaccine signup intent and appear to be moderated by cultural context.
| S-EPMC11302845 | biostudies-literature
Project description:A novel statistical model based on a two-layer, contact and information, graph is suggested in order to study the influence of disease prevalence on voluntary general population vaccination during the COVID-19 outbreak. Details about the structure and number of susceptible, infectious, and recovered/vaccinated individuals from the contact layer are simultaneously transferred to the information layer. The ever-growing wealth of information that is becoming available about the COVID virus was modelled at each individual level by a simplified proxy predictor of the amount of disease spread. Each informed individual, a node in a heterogeneous graph, makes a decision about vaccination "motivated" by their benefit. The obtained results showed that disease information type, global or local, has a significant impact on an individual vaccination decision. A number of different scenarios were investigated. The scenarios showed that in the case of the stronger impact of globally broadcasted disease information, individuals tend to vaccinate in larger numbers at the same time when the infection has already spread within the population. If individuals make vaccination decisions based on locally available information, the vaccination rate is uniformly spread during infection outbreak duration. Prioritising elderly population vaccination leads to an increased number of infected cases and a higher reduction in mortality. The developed model accuracy allows the precise targeting of vaccination order depending on the individuals' number of social contacts. Precisely targeted vaccination, combined with pre-existing immunity, and public health measures can limit the infection to isolated hotspots inside the population, as well as significantly delay and lower the infection peak.
| S-EPMC8229990 | biostudies-literature
Project description:RNA was extracted from whole blood of subjects collected in Tempus tubes prior to COVID-19 mRNA booster vaccination. D01 and D21 correspond to samples collected at pre-dose 1 and pre-dose 2 respectively. RNA was also extracted from blood collected at indicated time points post-vaccination. DB1, DB2, DB4 and DB7 correspond to booster day 1 (pre-booster), booster day 2, booster day 4 and booster day 7 respectively. The case subject experienced cardiac complication following mRNA booster vaccination. We performed gene expression analysis of case versus controls over time.
2023-03-20 | E-MTAB-12829 | biostudies-arrayexpress
Project description:As of December 2021, all former Communist countries from Central and Eastern Europe were still lagging behind in terms of COVID-19 vaccination rates in Europe. Can institutional legacy explain, at least in part, this heterogeneity in vaccination decisions across Europe? To study this question we exploit novel data from the second wave of the SHARE (Survey of Health, Ageing and Retirement in Europe) COVID-19 Survey fielded in Summer (2021) that covers older individuals in 27 European countries. First, we document lower COVID-19 vaccine take-up amongst those who were born under Communism in Europe. Next, we turn to reunified Germany to get closer to a causal effect of having lived behind the Iron Curtain. We find that exposure to the Communist regime in East Germany decreased one's probability to get vaccinated against COVID-19 by 8 percentage points and increased that of refusing the vaccine by 4 percentage points. Both effects are large and statistically significant, and they hold when controlling for individual socio-economic and demographic characteristics. We explore several possible mechanisms. The East-West Germany gap does not seem to be explained by differences in the impact of the first wave of the pandemic or in general exposure to vaccines. We find that East Germans have lower social capital than West Germans and that social capital correlates negatively with Covid-10 vaccine uptake, but only a small fraction of the East-West Germany Covid-19 vaccination gap can be explained by our measures of social capital.
| S-EPMC9901226 | biostudies-literature
Project description:BackgroundVaccination is the most effective means of preventing the spread of infectious diseases. Despite the proven benefits of vaccination, vaccine hesitancy keeps many people from getting vaccinated.Methods and findingsWe conducted a large-scale cluster randomized controlled trial in Finland to test the effectiveness of centralized written reminders (distributed via mail) on influenza vaccination coverage. The study included the entire older adult population (aged 65 years and above) in 2 culturally and geographically distinct regions with historically low (31.8%, n = 7,398, mean age 75.5 years) and high (57.7%, n = 40,727, mean age 74.0 years) influenza vaccination coverage. The study population was randomized into 3 treatments: (i) no reminder (only in the region with low vaccination coverage); (ii) an individual-benefits reminder, informing recipients about the individual benefits of vaccination; and (iii) an individual- and social-benefits reminder, informing recipients about the additional social benefits of vaccination in the form of herd immunity. There was no control treatment group in the region with high vaccination coverage as general reminders had been sent in previous years. The primary endpoint was a record of influenza vaccination in the Finnish National Vaccination Register during a 5-month follow-up period (from October 18, 2018 to March 18, 2019). Vaccination coverage after the intervention in the region with historically low coverage was 41.8% in the individual-benefits treatment, 38.9% in the individual- and social-benefits treatment and 34.0% in the control treatment group. Vaccination coverage after the intervention in the region with historically high coverage was 59.0% in the individual-benefits treatment and 59.2% in the individual- and social-benefits treatment. The effect of receiving any type of reminder letter in comparison to control treatment group (no reminder) was 6.4 percentage points (95% CI: 3.6 to 9.1, p < 0.001). The effect of reminders was particularly large among individuals with no prior influenza vaccination (8.8 pp, 95% CI: 6.5 to 11.1, p < 0.001). There was a substantial positive effect (5.3 pp, 95% CI: 2.8 to 7.8, p < 0.001) among the most consistently unvaccinated individuals who had not received any type of vaccine during the 9 years prior to the study. There was no difference in influenza vaccination coverage between the individual-benefit reminder and the individual- and social-benefit reminder (region with low vaccination coverage: 2.9 pp, 95% CI: -0.4 to 6.1, p = 0.087, region with high vaccination coverage: 0.2 pp, 95% CI: -1.0 to 1.3, p = 0.724). Study limitations included potential contamination between the treatments due to information spillovers and the lack of control treatment group in the region with high vaccination coverage.ConclusionsIn this study, we found that sending reminders was an effective and scalable intervention strategy to increase vaccination coverage in an older adult population with low vaccination coverage. Communicating the social benefits of vaccinations, in addition to individual benefits, did not enhance vaccination coverage. The effectiveness of letter reminders about the benefits of vaccination to improve influenza vaccination coverage may depend on the prior vaccination history of the population.Trial registrationAEA RCT registry AEARCTR-0003520 and ClinicalTrials.gov NCT03748160.
| S-EPMC8870595 | biostudies-literature
Project description:Established vaccine hesitancy measurement instruments, such as the Vaccine Hesitancy Determinants Matrix, are not sufficiently equipped to adequately and consistently measure political and ideological attitudes. Focusing on Germany, which is a particularly interesting case since it witnessed the establishment of the by far most well-organized and sustained 'anti-Covid' movement in Europe, this quantitative study explores the impact of political ideology and partisanship on the degree of vaccine hesitancy based on four surveys (February-October 2021) among more than 30,000 individuals. We demonstrate that party affiliation, political ideology and region of residence all impact vaccine hesitancy. In fact, they turn out to have a greater impact than two factors often analysed with respect to vaccine hesitancy: gender and educational background. Further interaction models show that the effect of political ideology on vaccine hesitancy is moderated by age, gender and region of residency. For instance, while the more rightwing a young individual is, the more hesitant they are towards SARS-CoV-2 vaccination-for older individuals, this is not the case. Our findings are relevant for future investigators measuring vaccine hesitancy and policy makers contemplating the differential impact of complex public health interventions: as the impact of political and ideological attitudes on vaccine hesitancy are not adequately captured by established vaccine hesitancy measurement instruments, we recommend its modification to include a clear and harmonised definition of the political-ideological dimension of vaccine hesitancy together with pre-validated measurement items that improve future studies. In addition, we reason that vaccine hesitancy, while being an outcome of complex socio-political factors, is in itself an indicator for societal cohesion and anomie, the degree of which is associated with trust in (health) policy makers, (public) health authorities, health service providers, etc. Therefore, we further recommend that vaccine hesitancy questions should be integrated in pertinent national surveys.
| S-EPMC9948222 | biostudies-literature
Project description:ObjectivesThis Registered Report attempted to conceptually replicate the finding that communicating herd immunity increases vaccination intentions (Betsch, et al., 2017, Nat. Hum. Behav., 0056). An additional objective was to explore the roles of descriptive social norms (vaccination behaviour of others) and the herd-immunity threshold (coverage needed to stop disease transmission).DesignAn online experiment with a 2 (herd-immunity explanation: present vs. absent) × 3 (descriptive norm: high vs. low vs. absent) × 2 (herd-immunity threshold: present vs. absent) between-subjects fractional design.MethodsSample consisted of 543 people (aged 18-64) residing in the United Kingdom. Participants first received an explanation of herd immunity emphasising social benefits (protecting others) in both textual and animated-infographic form. Next, they were faced with fictitious information about the disease, the vaccine, their country's vaccination coverage (80% or 20%), and the herd-immunity threshold (90%). Vaccination intention was self-rated.ResultsCompared to the control, communicating social benefits of herd immunity was effective in increasing vaccination intentions (F(1,541) = 6.97, p = .009, Partial Eta-Squared = 0.013). Communicating the descriptive norm or the herd-immunity threshold alongside the herd-immunity explanation demonstrated no observable effect.ConclusionCommunicating social benefits of herd immunity increased self-reported vaccination intentions against a fictitious disease, replicating previous findings. Although this result is positive, the practical relevance may be limited. Further research into the effect of social nudges to motivate vaccination is required, particularly with respect to the recent pandemic context and varying levels of vaccine hesitancy.
| S-EPMC8646271 | biostudies-literature
Project description:BackgroundMany countries, such as Germany, struggle to vaccinate enough people against COVID-19 despite the availability of safe and efficient vaccines. With new variants emerging and the need for booster vaccinations, overcoming vaccination hesitancy gains importance. The research to date has revealed some promising, albeit contentious, interventions to increase vaccination intention. However, these have yet to be tested for their effectiveness in increasing vaccination rates.Methods & resultsWe conducted a preregistered survey experiment with N = 1,324 participants in Germany in May/June 2021. This was followed by a series of emails reminding participants to get vaccinated in August and concluded with a follow-up survey in September. We experimentally assess whether debunking vaccination myths, highlighting the benefits of being vaccinated, or sending vaccination reminders decreases hesitancy. In the survey experiment, we find no increase in the intention to vaccinate regardless of the information provided. However, communicating vaccination benefits over several weeks reduced the likelihood of not being vaccinated by 9 percentage points, which translates into a 27% reduction compared to the control group. Debunking vaccination myths and reminders alone also decreased the likelihood, yet not significantly.DiscussionOur findings suggest that if soft governmental interventions such as information campaigns are employed, highlighting benefits should be given preference over debunking vaccination myths. Furthermore, it seems that repeated messages affect vaccination action while one-time messages might be insufficient, even for increasing vaccination intentions. Our study highlights the importance of testing interventions outside of survey experiments that are limited to measuring vaccination intentions-not actions-and immediate changes in attitudes and intentions-not long-term changes.
| S-EPMC9239477 | biostudies-literature
Project description:During a global health crisis, people are exposed to vast amounts of information from a variety of sources. Here, we assessed which information source could increase knowledge about COVID-19 (Study 1) and COVID-19 vaccines (Study 2). In Study 1, a US census matched sample of 1060 participants rated the accuracy of a set of statements and then were randomly assigned to one of 10 between-subjects conditions of varying sources providing belief-relevant information: a political leader (Trump/Biden), a health authority (Fauci/CDC), an anecdote (Democrat/Republican), a large group of prior participants (Democrats/Republicans/Generic), or no source (Control). Finally, they rated the accuracy of the initial set of statements again. Study 2 involved a replication with a sample of 1876 participants and focused on the COVID-19 vaccine. We found that knowledge increased most when the source of information was a generic group of people, irrespective of participants' political affiliation. We also found that while expert communications were most successful at increasing Democrats' vaccination intentions, no source was successful at increasing Republicans' vaccination intention. We discuss these findings in the context of the current misinformation epidemic.Supplementary informationThe online version contains supplementary material available at 10.1007/s41060-021-00307-8.
| S-EPMC8751473 | biostudies-literature