Social norms and free-riding in influenza vaccine decisions in the UK: an online experiment

Abstract

Background Nudge-based social norm messages conveying high influenza vaccination coverage levels signal a strong social norm, encouraging vaccination, but also a low risk of infection, discouraging vaccination and promoting free-riding. The complex interplay between these two signals can result in ambiguous vaccination decision-making at varying coverage levels. We aimed to measure different vaccination coverage levels' (VCLs) effect on influenza vaccination intention through an online experiment.Methods UK residents aged 18 years or older were eligible to participate in this online experiment and recruited via Prolific. They were stratified by gender and randomly assigned to a control group with no message (n=202) or one of seven treatment groups (n=1 163) with different messages of VCLs (ie, proportion of vaccinated people [10%, 25%, 50%, 65%, 75%, 85%, or 95%]) in the respondents' environment. Effect on respondents' vaccination intention was measured with self-reported intention and three elicited behaviour measures: opening an online map locating nearby private flu jab providers; time looking at this map; and downloading a calendar reminder to vaccinate. Linear regressions, probit, logistic, and double hurdle models were used, controlling for population behaviour perceptions, risk attitudes, and behavioural and socioeconomic characteristics collected through individual questionnaires.

Anticipation of COVID-19 vaccines reduces willingness to socially distance

“…By documenting the impact of vaccine anticipation on health behaviors and pandemic beliefs, we complement an interdisciplinary literature that aims to understand how behavioral factors contribute to the spread and prevention of COVID-19 infections ( Bavel et al, 2020 ; Betsch, 2020 ; Betsch et al, 2020 ; Briscese et al, 2020 ; Campos-Mercade et al, 2021 ; Cappelen et al, 2021 ; Charoenwong et al, 2020 ; Clinton et al, 2021 ; Galasso et al, 2020 ; Gollwitzer et al, 2020 ; Müller and Rau, 2021 ; Bartscher et al, 2021; Thunström et al, 2020 ). We also add to a large literature studying the role of psychological factors and economic preferences in shaping health behaviors ( Betsch et al, 2017 , 2010 ; Brewer et al, 2017 ; Galizzi et al, 2018 ; Harris et al, 2010 ; Korn et al, 2020 ; Lau et al, 2019 ; Maurer et al, 2009 ; Milkman et al, 2011 ; Schilbach, 2019 ). Last, we build on previous findings which document important effects of news and information on people's beliefs and behavior in general ( Akesson et al, 2020 ; Armona et al, 2019 ; Haaland and Roth, 2020 ; Marreiros et al, 2017 ; Roth and Wohlfart, 2020 ) and particularly during the COVID-19 pandemic ( Ajzenman et al, 2020 ; Bursztyn et al, 2020 ; Fetzer et al, 2020 ; Simonov et al, 2020 ).…”

Vaccinating against COVID-19: The Correlation between Pro-Vaccination Attitudes and the Belief That Our Peers Want to Get Vaccinated

“…We must also mention an experimental study published in 2019 in The Lancet [15] which describes the complex way in which social norms influence the intention of subjects to receive the influenza vaccination. The research does not study the link between the perceived group norm and vaccination, but only between the interest/intention of vaccination and exposure to pro-vaccination messages that suggest that a certain percentage of the population in that area has been vaccinated.…”

Toward controlling of a pandemic: How self-control ability influences willingness to take the COVID-19 vaccine

“…Social norms, the unwritten rules or standards that members of a particular social group or culture implicitly recognize, direct and guide individuals' cognition, emotion, and behavior ( Cialdini et al, 1991 ). An emerging line of research has explored how social norms influence public willingness to get vaccinated against COVID-19 ( Lau et al, 2019 ). In a recent study conducted by Sinclair and Agerström (2021) , it was found that conveying strong (compared to weak) norms can significantly increase young people's willingness to take the vaccine and reduce their vaccine hesitancy.…”