Vaccination bubbles and the illusion of success

If you are one of those persons who have been vaccinated against Covid, there are probably many people around you who have also been vaccinated, even if only with one dose.

Behavioral science offers solutions

Tinatin Stambolishvili

If you are one of those persons who have been vaccinated against Covid, there are probably many people around you who have also been vaccinated, even if only with one dose. Your small social events now start with a question “Have you get a vaccine?” and then you go on about your vaccination experience. My arm hurt, I had a little fever, I had no side effects at all, had little allergic reaction, etc. You talk about how you convinced your parents or elderly aunts and uncles, registered them, drove them with your car and how relieved you are now that can visit them without any problems. Most likely, you meet your relatives in an open space – you will go for a walk on the Turtle Lake or Mziuri, you will take a blanket to Dedaena park and lay on the grass and talk about vaccination,  politics and review other socio-cultural events.

I hope you detect a profile of a person with a high or average income, living in a big city, who knows how to use the Internet, who has an opportunity to take care of his/her health, has the time and money to get a flu shot every year, and can more or less distinguish between false and true information in social or traditional media. Such a person is called a “vaccination enthusiast” according to a recent publication by a US research center. Let’s see how the rest of the population is grouped:

– The Enthusiast

– The watchful (I’ll wait for now)

– The cost-anxious (I don’t have time and opportunity to find out)

– The system distruster (everyone is a liar)

– The Covid skeptics (Covid does not exist)

The first stage in behavior design is research, but unlike the traditional method, we explore key insights to make so-called Behavior mapping. A behavior map allows us to discover clusters, personas not only by their demographic characteristics, but also by their behavior patterns. In the process of research, we look for psychological, social or physical barriers and high-potential motivational moments, which we then apply to our action plan.

The mentioned publication of the US research center is based on a national survey conducted in January and March 2021. Discovering patterns of behavior, or profiles, offers a solid strategy based on behavioral science for how to persuade different segments of the population and bring them to the vaccination center – this includes communication strategy as well as creating a social context.

The research tells us that the chance of convincing is only among those in the population who are watchful or cost anxious, and that the chance is zero in the last cluster—vaccine skeptics.

Let’s see what the last poll in Georgia. According to a recent IRI survey, only 20% are enthusiasts – that’s people from you babble. The number is twice less, compared to the USA, for example. And the most difficult to convince category – vaccine skeptics (“covid does not exist”) – is 39%, and this is also twice as much as in the USA.

Therefore, we have a much more difficult task in front of us than in other countries, and we must also take into account the absence of an intensive information campaign.

An information campaign is a basic tool, but this alone does not guarantee success. Lack of information is not the reason for vaccine skepticism. Behavioral approach tell us that often knowledge or even a positive attitude is not a guarantee that a person will necessarily follow it and take some action. This is proven by many studies, and I am convinced that your experience – often it seems that everything is said, repeated and the attitude is positive, a real action (click, purchase, signing a petition, etc.) – does not follow.

What is the reason?

Behavioral science tells us that with information (which obviously must be there), people often forget (limited attention), don’t have time or a process is too complex, and most importantly, observe how other people around them behave (social influence ).

In Covid vaccination, in addition to the problematic barriers listed above, our brain “generates” two types of reactions, which we should pay attention to when planning various events:


A person feels more “secure” if does not think about the danger and believes that it will not happen to him/her. The “it won’t happen to me” approach is problematic in health care, environmental protection programs, transportation or other safety programs. According to various studies, the acceptance of the covid vaccine depends more on the perception of covid risk than on the safety or confidence in the vaccine. In short, if a person thinks that the risk of infection and complications from Covid is low, they will be less likely to think about getting vaccinated. 

Confirmation Bias

When we believe in something, information that supports our belief catches our attention and vise-veras – alternative points of views are simply ignored by our brain. This tendency is successfully used by social networks (Facebook, YouTube, Twitter, etc.) that offer information tailored to your likes/dislikes. If you are a vaccine enthusiast, your newsfeed is more likely flooeded with pro-vaxxer information, and if you are a skeptic (covid does not exist), than anti-vaxxer or misleading information will predominate. Skeptics are more likely to listen to and actively share anti-vaccine programs or videos. If they are exposed to pro-vaxxer information, the latter reinforces their belief that “everyone is a liar” and “I told you, there is no such thing as Covid”.

There are also other mechanisms involved, but I would suggest only these two bias in this article, because the WHO has recognized the two reactions mentioned above as priorities for communication and health professionals.

To return to vaccination incentives, together with the information campaign, below listed actions can nudge undecided to get vaccinated: 

Simplify the vaccination process as much as possible

Turn vaccination centers as visible as possible, easy to find, salient. Only online registration is not a slution. If you can’t go to the vaccination center, the vaccine comes to you – mobile social workers and volunteers who will organize the process, if necessary mobile centers should also be created. The simplicity and high availability of the process and the visibility create a feeling of social norm on the one hand (everyone is getting vaccinated) and on the other hand, a person is gently nudged towards a desired behavior (vaccination). 

Automatic recording

For all those citizens who did not come to the vaccination center, the state will register it, and the citizen will be able to change the date by mobile phone or hotline. According to various studies, this approach increases the chance of participation by 20%.

GP’s or nurse’s recommendation

According to the available data, the medical worker is the most reliable source. Therefore, the training of doctors (if not already started) and their incentives, even monetary, may become crucial. Medical workers themselves can register citizens during a routine patient visits.

As for the category, which are so-called rejecters, skeptics (covid does not exist) we generally do not direct efforts towards them. In the vaccination campaign, the case is different. As I mentioned, the number of skeptics in Georgia is almost twice as high as in other countries, and without them we will not be able to reach the 60% benchmark.

The behavioral insights has some solutions:

o Automatic registration:

The mechanism mentioned above, when all citizens are registered by the state after a certain period of time, may work here as well. According to various studies, people easily follow the “pre-set options”.

o Covid-passport privileges:

If we want to encourage desirable behavior, we must create a barrier to undesirable behavior. The privileges of the Covid-passport are just such a barrier for the vulnerable population. Unvaccinated persons will not have the opportunity to go out during curfew, have dinner in a restaurant, enter a cinema, work in catering or tourist facilities, etc. This process has already started and should continue much more actively.

o Monetary incentive:

In several states of USA, a lottery has recently been announced, in which people can participate with a Covid-passport. The top prize is $1 million, and thousands of other prizes include college tuition and more. As you can see, the target is the young segment, where the covid risk perception is very low. Studies show that participation is much more likely if monetary incentives are in place, and this approach has been used successfully by private companies. In vaccination, this can become another quite strong stimulus.

As a conclusion, we can say that the seemingly active vaccination process is not active at all. The only people who are themselves advocates of the process are getting vaccinated, and almost nothing is done to convince and nudge the rest of the population. The latter will be the key to success in the vaccination campaign in the coming months.

*The article was published on the website of the ForbesHealth platform in 2021. June 1.


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