Overcoming COVID-19 vaccination resistance when alternative policies affect the dynamics of conformism, social norms, and crowding out

Schmelz, Katrin; Bowles, Samuel

doi:10.1073/pnas.2104912118

Cited by 79 publications

(79 citation statements)

References 45 publications

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“…Our exploration of preferences for COVID-19 vaccination enforcement strategies including restrictions to air travel, work or school and attendance of recreational gatherings indicated increasing aversion to enforcement with increasing vaccine hesitancy. Such control aversion may operate through several mechanisms, including the impact of the policy message of distrust of the population to be socially responsible, the removal the need to deliberate over vaccination driving out moral convictions to be "prosocial", inherent mistrust of the government and health systems leading to reduced compliance, and "psychological reactance" [3,29,30]. Resistance to vaccination enforcement is not surprising in North American culture which endorses individualism, independence and personal freedom [1,29,31].…”

Section: Plos Onementioning

confidence: 99%

Preferences for COVID-19 vaccine distribution strategies in the US: A discrete choice survey

et al. 2021

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Background The COVID-19 vaccination campaign in the US has been immensely successful in vaccinating those who are receptive, further increases in vaccination rates however will require more innovative approaches to reach those who remain hesitant. Developing vaccination strategies that are modelled on what people want could further increase uptake. Methods and findings To inform COVID-19 vaccine distribution strategies that are aligned with public preferences we conducted a discrete choice experiment among the US public (N = 2,895) between March 15 to March 22, 2021. We applied sampling weights, evaluated mean preferences using mixed logit models, and identified latent class preference subgroups. On average, the public prioritized ease, preferring single to two dose vaccinations (mean preference: -0.29; 95%CI: -0.37 to -0.20), vaccinating once rather than annually (mean preference: -0.79; 95%CI: -0.89 to -0.70) and reducing waiting times at vaccination sites. Vaccine enforcement reduced overall vaccine acceptance (mean preference -0.20; 95%CI: -0.30 to -0.10), with a trend of increasing resistance to enforcement with increasing vaccine hesitancy. Latent class analysis identified four distinct preference phenotypes: the first prioritized inherent “vaccine features” (46.1%), the second were concerned about vaccine “service delivery” (8.8%), a third group desired “social proof” of vaccine safety and were susceptible to enforcement (13.2%), and the fourth group were “indifferent” to vaccine and service delivery features and resisted enforcement (31.9%). Conclusions This study identifies several critical insights for the COVID-19 public health response. First, identifying preference segments is essential to ensure that vaccination services meet the needs of diverse population subgroups. Second, making vaccination easy and promoting autonomy by simplifying services and offering the public choices (where feasible) may increase uptake in those who remain deliberative. And, third vaccine mandates have the potential to increase vaccination rates in susceptible groups but may simultaneously promote control aversion and resistance in those who are most hesitant.

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Section: Plos Onementioning

confidence: 99%

Preferences for COVID-19 vaccine distribution strategies in the US: A discrete choice survey

et al. 2021

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“…This study involved a 2 (policy: mandatory vs. voluntary) × 2 (person: self vs. others) between-participants design (see Table 2). According to prior research [62,63], we designed the following hypothetical scenarios. In the mandatory condition, the participant imagined that waste separation is made mandatory and intervened in (e.g., supervision, feedback and punishment) by the government.…”

Section: Methodsmentioning

confidence: 99%

“…For instance, a mandatory policy may be ineffective for those with a less pro-environmental worldview [20,76]. Enforcement may also crowd out intrinsic motivation [62] and reduce the positive effects of voluntary participation, which needs further investigation. Second, self-reported results might contain elements of desirability bias or overestimation, which need to be treated with caution [77].…”

Section: Limitations and Future Researchmentioning

confidence: 99%

I Am Better Than Others: Waste Management Policies and Self-Enhancement Bias

et al. 2021

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Waste source separation has been a social dilemma globally with a low participation rate. This research attempted to solve this dilemma by exploring the effect of mandatory (versus voluntary) policies on waste separation from the perspective of the self-versus based on deterrence theory and self-enhancement motivation. Hypothetical scenarios were used to demonstrate the effectiveness of mandatory policies and self-enhancement bias for residents (n = 589) and adolescents (n = 121). Study 2 was performed to replicate the findings of Study 1 with a no-implementation policy condition, and Study 3 extended the findings to adolescents. We found robust self-enhancement bias, where participants perceived themselves to be better than others in both willingness to perform and attitudes toward waste separation behavior. Specifically, participants tended to perceive themselves to perform waste separation well when policy compliance was voluntary, but they tended to perceive others to perform well when policy compliance was mandatory with supervision. These findings highlight the impact of mandatory policy with supervision and self-enhancement bias in waste management. The present studies provide substantial evidence and implications for the necessity of supervision in mandatory policy implementation.

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“…In addition, vaccination acceptance is highly variable from one country to another and largely depends on the public trust on state policy for the management of the pandemic and the impact of misinformation spreading on large social media. 19 20 21 …”

Section: Limitations Of the “Stop And Go” Strategymentioning

confidence: 99%

The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper

et al. 2021

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One year after the declaration of the COVID-19 pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis. Non-pharmacological interventions (NPI) are efficient mitigation strategies. The success of these intense NPI is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic. Current issues: The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against SARS-CoV-2 and its variants. The need of a second and even third generation of vaccines and the possibility of potentially harmful side-effects of the vaccines (i.e. venous thromboembolism ) have already been acknowledged. Perspectives: There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA). Conclusion: The “PDA strategy” integrated into state policy for the support and expansion of health systems and introduction of digital organization (i.e. telemedicine, artificial intelligence and machine learning technology) is of major importance for the preservation of citizens’ health and life world-wide.

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Overcoming COVID-19 vaccination resistance when alternative policies affect the dynamics of conformism, social norms, and crowding out

Cited by 79 publications

References 45 publications

Preferences for COVID-19 vaccine distribution strategies in the US: A discrete choice survey

Preferences for COVID-19 vaccine distribution strategies in the US: A discrete choice survey

I Am Better Than Others: Waste Management Policies and Self-Enhancement Bias

The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper

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