Malaysian Public Preferences and Decision Making for Covid-19 Vaccination: A Discrete Choice Experiment

Teh, Hoon Shien; Woon, Yuan Liang; Leong, Chin Tho; Hing, Nicholas Yee Liang; Yong, Teresa Sui Mien; Roope, Laurence; Clarke, Philip; Lim, Lee‐Ling; Buckell, John

doi:10.2139/ssrn.4057234

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Participants were also asked in the remaining sociodemographic section whether they had refused to vaccinate their child in the past. These questions were adapted from locally conducted studies 48 49. Participants were categorised as having a potential negative attitude if they provided responses indicating disagreement, uncertainty, or refusal to any of those questions.…”

Section: Methodsmentioning

confidence: 99%

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

Hing¹,

Woon²,

Lee

et al. 2022

BMJ Glob Health

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IntroductionVaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; that is, healthy adults, the elderly, and people with pre-existing health conditions.MethodsA randomised controlled experiment was conducted from 29 April to 7 June 2021, which coincided with the early phases of the national vaccination programme when vaccine uptake data were largely unavailable. 5784 Malaysians were randomly allocated into 14 experimental arms and exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, the elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent were modelled and we estimated the average marginal effects based on changes in the predicted probability of responding with a positive intent for each of the four outcomes.ResultsWe found that persuasive communication via several of the experimented messages improved recommendation intentions to people with pre-existing health conditions, with improvements ranging from 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among certain outcomes with messages using negative attribute frames, risky choice frames, and priming descriptive norms.ConclusionMessage frames that briefly communicate verbatim facts and stimulate rational thinking regarding vaccine safety may be ineffective at positively influencing vaccine-hesitant individuals. Messages intended to promote recommendations of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions.Trial registration numberNCT05244356.

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Section: Methodsmentioning

confidence: 99%

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

Hing¹,

Woon²,

Lee

et al. 2022

BMJ Glob Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…These questions were adapted from locally conducted studies. [32,33] Participants were categorised as having potential negative attitudes if they provided responses indicating disagreement, uncertainty or refusal to any of those questions.…”

Section: Data Collection and Interventionmentioning

confidence: 99%

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioral insights from a randomised controlled experiment in Malaysia

Hing

Woon

Lee

et al. 2022

Preprint

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IntroductionVaccine safety is a primary concern among vaccine hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; i.e. healthy adults, elderly, and people with pre-existing health conditions.MethodsA randomized controlled experiment was conducted among 5,784 Malaysians who were randomly allocated into 14 experimental arms. They were exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent after message exposure were modeled and we estimate the average marginal effects with respect to changes in the predicted probability of selecting a positive intent for all four outcomes.ResultsThe average baseline proportion of participants with positive intents in each arm to take, and recommend the vaccine to healthy adults, elderly, and people with pre-existing health conditions was 61.6%, 84.9%, 72.7% and 51.4% respectively. We found that persuasive communication via several of the experimented messages improved recommendation intent to people with pre-existing health conditions, with improvements ranging between 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among this group with messages using negative frames, risky choice frames, and priming descriptive norms.ConclusionPersuasive messages aimed at influencing vaccination decisions should incorporate a combination of factors linked to hesitancy. Messages intended to promote recommendation of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions.Clinical Trials registration numberNCT05244356Key Messages1.What is already known?Persuasive messages have been shown to influence COVID-19 vaccination intentions, but evidence from Low- and Middle-income countries are limited.There are limited studies investigating the effect of persuasive messages in influencing decisions to recommend the COVID-19 vaccine, with only a single study to date which investigated effects directed at recommending the COVID-19 vaccine to a friend, but without considering the individual’s health and age profile.2.What are the new findings?Persuasive messages that focused on vaccine safety did not positively influence Malaysian adults to take the COVID-19 vaccine or recommend it to healthy adults and the elderly, while messages framed as descriptive norms, negative attribute, and risky choices, significantly backfired for some of these outcomes.Several persuasive messages focusing on vaccine safety significantly improved intent to recommend the COVID-19 vaccine to people with pre-existing health conditions.3.What do the new findings imply?Instead of only addressing safety, persuasive messages aimed at nudging vaccination should incorporate multiple behavioral determinants linked to vaccine acceptance.Persuasive messages that are intended to promote uptake of novel health interventions should incorporate safety dimensions as a form of assurance for others to recommend it to people with pre-existing health conditions, given that they may be perceived as more susceptible to hazards from adverse events.

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Factors Affecting the Intention to Receive Future COVID-19 Booster Vaccines in East Coast States in Malaysia

Mohd Nawi,

Hussein

2024

IMBR

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This conceptual paper is presented to study the factors affecting the intention to receive future COVID-19 booster vaccines in three East Coast states in Malaysia, which has become a concern to the government and health system in the country. It begins by reviewing the literature on associated factors and intentions against the booster vaccination. The Theory of Planned Behavior is used as the basis of the study. This study is driven by the low vaccination rates in Kelantan, Terengganu, and Pahang. Past studies have discussed the acceptance of COVID-19 vaccination in the country, but very few focus on these states. Due to the limited findings on the issues, this study, therefore, attempts to explore the factors influencing vaccination intention using a quantitative method. The survey distribution and data collection focus on the three states' residents. The findings are believed to be able to provide new insight and knowledge, especially to the healthcare providers and government to increase the vaccination rates in these states and prevent the severity of COVID-19 comeback.

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Malaysian Public Preferences and Decision Making for Covid-19 Vaccination: A Discrete Choice Experiment

Cited by 3 publications

References 27 publications

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioral insights from a randomised controlled experiment in Malaysia

Factors Affecting the Intention to Receive Future COVID-19 Booster Vaccines in East Coast States in Malaysia

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