Study reveals why public health messaging should focus on self-interest to tackle vaccine hesitancy

Public health messaging should focus on the benefits to the individual of a COVID vaccine rather than broader societal gains when attempting to overcome vaccine hesitancy, new research from academics at the University of Sussex Business School, the National University of Singapore Business School and the Indian Institute of Management Ahmedabad indicates.

Promoting the benefits of vaccine to an individual is a more effective means of overcoming vaccine hesitancy than extolling the broader societal benefits from mass immunization, a randomized survey-based experiment of more than 1,300 people reveals.

The promotion of individual gains instead of broader societal benefits was particularly effective among study participants who had never received any form of vaccination, the study newly published in Health Management, Policy and Innovation (HMPI) journal found.

Professor Chirantan Chatterjee, Reader in Economics of Innovation in the Science Policy Research Unit (SPRU) at the University of Sussex Business School, said: "Our findings reveal that certain approaches to public health messaging are much more effective than others in stimulating greater preference and willingness to receive the COVID-19 vaccine. Results from our experiment highlight the relative importance of benefits to self as an important driver of vaccine intake intention, which is consistent with the conceptual view that people make their vaccination decision based more on their self-interests rather than societal benefits.

"Although several factors influence the adoption of vaccines, the evidence-based insights of this study may help healthcare policymakers and firms design strategies to reduce vaccine hesitancy, steer clear of legal issues in global vaccine mandate decisions, increase vaccine adoption and save lives in developing and developed countries alike going forward in the third year of the pandemic."

In the study, visitors to Tata 1mg, the leading online pharmacy and healthcare platform in India, were offered the opportunity to participate in a healthcare-related survey.

Willing participants were randomly assigned different messaging that either highlighted the benefits of receiving the vaccine or highlighted the risks of not getting the vaccine; or which highlighted the individual or societal benefits of receiving a vaccine; or which highlighted either India or the US as the country of origin for the vaccine manufacturing firm; or which highlighted a significant or more moderate discount on the cost of the vaccine. They were then asked if they would be willing to receive the COVID-19 vaccine.

Participants who received the text promoting the individual benefits were 6.7% more likely to want the vaccine than study participants who read text promoting the wider societal benefits.

Being told about individual as opposed to societal benefits not only increased the likelihood that a patient would choose to have the vaccine rather than not have the vaccine, but also increased to a statistically significant degree how strongly they felt about getting the vaccine.

And specifically for individuals who had never received a vaccine, the impact of a call to the individual benefits of having a vaccine compared to the societal benefits was even more prominent (an 11.2% increase) than the impact the different messaging had on the population at large.

Participants who received text highlighting the risks of not having the vaccine were marginally more likely to want the vaccine than those who received text extolling the benefits but not to a statistically significant degree.

Messaging around the country of origin of the vaccine had no impact on an individual's willingness to receive the vaccine.

Dr. Arzi Adbi, assistant professor in the Department of Strategy & Policy at the National University of Singapore Business School, said: "Our research helps extend a growing body of research indicating that making subtle yet important variations in public health messaging may lead to greater willingness to consume the COVID-19 vaccine.

"The irony is that the developing countries, which may arguably benefit most from the effects of low-cost nudging interventions on a large scale given their huge population, are lagging behind developed countries such as the US and the UK in supplementing traditional policies with behaviourally informed policies.

"At the same time, it is important to understand not only the promises but also the limitations of such nudging interventions. Who gets impacted from nudges? Who does not? Our study reveals that the positive effect of individual benefit framing can be much stronger on those who have not received any adult vaccine in the past. Those who have already had adult vaccines in the past do not show any differential effect of individual versus societal benefit framing."