Quantifying the Impact of Public Perceptions on Vaccine Acceptance Using Behavioral Economics

Abstract

This study was conducted to evaluate the impact of public perceptions of vaccine safety and efficacy on intent to seek COVID-19 vaccination using hypothetical vaccine acceptance scenarios. The behavioral economic methodology could be used to inform future public health vaccination campaigns designed to influence public perceptions and improve public acceptance of the vaccine. In June 2020, 534 respondents completed online validated behavioral economic procedures adapted to evaluate COVID-19 vaccine demand in relation to a hypothetical development process and efficacy. An exponential demand function was used to describe the proportion of participants accepting the vaccine at each efficacy. Linear mixed effect models evaluated development process and individual characteristic effects on minimum required vaccine efficacy required for vaccine acceptance. The rapid development process scenario increased the rate of decline in acceptance with reductions in efficacy. At 50% efficacy, 68.8% of respondents would seek the standard vaccine, and 58.8% would seek the rapid developed vaccine. Rapid vaccine development increased the minimum required efficacy for vaccine acceptance by over 9 percentage points, γ = 9.36, p < 0.001. Past-3-year flu vaccination, γ = −23.00, p < 0.001, and male respondents, γ = −4.98, p = 0.037, accepted lower efficacy. Respondents reporting greater conspiracy beliefs, γ = 0.39, p < 0.001, and political conservatism, γ = 0.32, p < 0.001, required higher efficacy. Male, γ = −4.43, p = 0.013, and more conservative, γ = −0.09, p = 0.039, respondents showed smaller changes in minimum required efficacy by development process. Information on the vaccine development process, vaccine efficacy, and individual differences impact the proportion of respondents reporting COVID-19 vaccination intentions. Behavioral economics provides an empirical method to estimate vaccine demand to target subpopulations resistant to vaccination.

Factors Influencing Public Attitudes towards COVID-19 Vaccination: A Scoping Review Informed by the Socio-Ecological Model

“…In this review, 28 studies depicted the sociodemographic factors associated with public attitudes toward the COVID-19 vaccination. Coherent to findings from the literature [78], the most common factors found to influence vaccine acceptance at the microlevel were age, educational level, gender, race, and income status [23][24][25][26][27][28][29][30][31][32][33][34][35][36][44][45][46][47][48][49][50][51][52][53]63,65,68,[71][72][73]. More willingness to receive a vaccine was reported in the older age group [23,25,27,31,34,35,38,53,65], while resistance, hesitancy, and lack of intention to be vaccinated emerged in the younger age group [29,35,51].…”

“…The majority of the reviewed studies reported that men were more willing to accept a vaccine than women [28][29][30]38,48,49]. Only one study in the USA reported higher willingness among men [32]. Moreover, other factors were included, such as health condition, people with chronic diseases [29,31,49,65,73], occupation status [27,30,46,50,53,73], marital status [27,28,52], place of residence [29,51,68,73], women being pregnant [29] or having children [30], and those who have health insurance or not [30,31,36,51].…”

Acceptance of COVID-19 Vaccination Among Health System Personnel

“…Our prespecified hypotheses were that (1) most health care personnel would accept vaccination, (2) safety concerns would be the predominant barrier to vaccination uptake among those delaying vaccination, (3) job responsibilities involving direct patient interaction would facilitate vaccine acceptance, and (4) that educational attainment would be associated with vaccine acceptance. Survey content was developed by the principal investigator and research team, based on a review of the literature of similar published studies, [11][12][13][14][15][16][17] to interrogate these hypotheses and control for relevant covariables. A draft of the surveys was discussed with stakeholders within the health system, university, and local county health department for comment.…”

“…[10][11][12] COVID-19 vaccine acceptance among the general population has been associated with age, sex, race, marital status, educational attainment, political ideology, trust in media/health agencies/scientists, fear of COVID-19, perceived severity of the COVID-19 pandemic, level of vaccine efficacy, duration of vaccine protection, frequency of reported adverse effects, attitudes toward vaccination in general and prior influenza vaccination. [11][12][13][14][15][16][17] An analysis using a behavioral economics approach also showed that rapid vaccine development suppressed vaccine uptake at the same level of effectiveness. 13 FDA emergency use authorization, as compared with full FDA approval, was also associated with decreased vaccine acceptance.…”

“…[11][12][13][14][15][16][17] An analysis using a behavioral economics approach also showed that rapid vaccine development suppressed vaccine uptake at the same level of effectiveness. 13 FDA emergency use authorization, as compared with full FDA approval, was also associated with decreased vaccine acceptance. 16 Moreover, health care worker acceptance of influenza vaccination during an influenza pandemic the most analogous vaccine-preventable disease for which there is significant dataindicates that vaccination uptake is greater in males, physicians, nurses, full-time employees, and persons who perceive greater disease risk.…”