Why Psychologists need to be at the forefront of the COVID-19 Vaccination Effort
This may sound pessimistic, but developing the COVID-19 vaccine is only one part of the larger fight against the pandemic. Even if we have a 100% effective vaccine, we still have to get people to take it. Without people on board, the vaccine could very well be sparkling water in a vial for all practical purposes.
Until this point, natural sciences such as biology, immunology, pharmacokinetics, etc. have played an invaluable role. Moving forward, it is time for psychologists to lead the messaging effort around the vaccines. As with other decisions regarding COVID-19, human beings are not the best decision-makers and are unfortunately not perfectly rational.
Recently, I was reading a transcript of an American Psychological Association (APA) podcast — ‘Speaking of Psychology’ — where Dr. Chapman, a professor in the Department of Social and Decision Sciences at Carnegie Mellon University who studies psychological processes underlying how people make decisions around behaviors such as vaccination and blood donation, was offering her insights on this issue.
According to her, if we consider this issue under the broader umbrella of health behaviors, the fact that it is hard to get people to take the vaccine should not come as a surprise. The disadvantages of smoking are well known, but people still smoke. The advantages of daily physical exercise are well known, but people still don’t exercise. We all know what a balanced diet should look like, yet, many of us don’t follow one.
A Professor of Cognitive Psychology, Dr. Trueblood, specifically frames the decision to take the COVID-19 vaccine as a gamble. An individual must consider the potential benefits of the vaccine (immunity) against the cost, physical pain, and the possibility that the vaccine may not work or cause active harm (side effects).
The challenge is to get people to not see this decision as a gamble, but rather as something that is as ‘matter-of-fact’ as putting on a jacket before going out in the cold. Essentially, what we are trying to achieve, is a change in people’s attitudes that makes them engage in optimal public health behaviors.
According to Dr. Chapman, there is no one-size-fits-all solution to this problem. On the podcast, she talks about three specific interventions that, according to her research, may help increase the community buy-in to the COVID-19 vaccine program:
1. Information-Based Messaging
This type of intervention is centered around providing science-backed information to people to alleviate their apprehensions about the “harm” that the vaccine may cause. Dr. Chapman says that usually, these type of interventions are quite ineffective when it comes to changing health behaviors, either because they are not powerful enough (think about it — if you don’t like eating broccoli, would an Instagram post or a brochure at a doctor’s office about its benefits suddenly make you start eating it?) or because they are redundant — people already know the information but still choose not to partake in the desired behavior.
However, in the case of the COVID-19 vaccine, such interventions — if the information is communicated precisely and honestly — may work. This is because people don’t already know much about the vaccine, and information does have the potential to change their attitudes and beliefs.
“But, with COVID we don’t know anything about that vaccine yet. So, this is a situation where an information intervention might actually have an influence on people’s belief and then their behavior because we’re sort of starting from a starting point of no information.” ~ Dr. Chapman
But, not all of us are equally receptive to this sort of information. For certain communities, who have a history of distrust in science or medicine, this type of messaging is likely to fall on deaf ears as questions will be raised about its credibility. In such cases, the other two types of interventions may be worth exploring.
2. Social Norms
This sort of intervention would be centered around the use of social and psychological factors such as conformity, shared responsibility, compliance, etc. The messaging would involve informing people about what everyone else in their community is doing or about the social benefits of vaccination. This type of messaging, according to Dr. Chapman, can mobilize minorities to buy into the vaccine as well.
“…the idea of social norms. This effect that we like to do what other people like us are doing. We sort of trust in the wisdom of the crowds in that sense. If we see other people like us getting vaccinated, then we think, “Oh, that’s what people like me do.” And social psychology shows that proximal norms, or norms… what other people like me are doing in the very situation that I am in. Those are the norms that are most influential.”
3. Convenience based interventions
This intervention ‘intervenes directly on behavior’. That is to say, it makes taking the vaccine more convenient. Examples of such interventions include bundling the vaccine with flu-shots, making it available at 24/7 pharmacies, workplaces offering on-site vaccinations, etc. This intervention reduces the metaphorical distance between the decision to engage in a behavior and actually engaging in it. To put it simply, it is similar to feeling somewhat hungry while waiting in line at the grocery store, and having a snack available right in front of you, as opposed to having to go back to the snack aisle to grab one, thereby giving up your place in the line. You are more likely to decide to buy a snack in the former case and forego the purchase in the latter.
Of course, these are not the only possible solutions to help the vaccination effort, and are themselves are not without their challenges. Programs need to be tailored to the community they are intended for and keep in mind the framing effect, a cognitive bias that influences decision making based on how the information is presented.
“From a policy or marketing standpoint, messaging needs to be very carefully tested. When people start to think about what they want to say about this vaccine, it’s critical to realize that the information is not going to be received equally by everyone.” ~ Dr. Trueblood
Nevertheless, two things are clear — public health officials and other mass communicators have to be purposeful and targeted in their messaging, and psychologists need to play a central role in the effort.