To Vax or Not to Vax? Potential Behavioural Science-Based Influences on the COVID-19 Vaccination Choice

As I write this, Australia’s COVID-19 vaccination rates are continuing to rise. My state of NSW has exceptionally high numbers: 89.1% double dose and 93.8% single dose for those aged 16 and over.

However, the topic of vaccination continues to be a heated and often emotionally fuelled discussion. In recent months, these tensions have bubbled to the surface, making their way into public conversations and those with friends and family. There are articles about people breaking up with friends over their vaccination stance, debates over vaccine mandates, protests, and tensions increasing between pro and anti-vax groups.

As my social circle knows, I am ardently pro-vaccination. However, I have tried here to step back from my personal views to an extent and take an approach through the lens of behavioural science: What might influence our decision-making process when it comes to the COVID-19 vaccination?

What little nudges might we unknowingly experience that bump us towards one stance or the other?

Needless to say, whether or not to get a COVID-19 vaccination is ultimately a personal choice. Political, philosophical, economic, cultural, and other factors can all play into that choice, and could each be far stronger influences than the nudges I cover here.

Here are some ideas about potential influences from behavioural science:

 

Social Proof

At the beginning of the pandemic, I engaged in a few conversations that involved someone asking, ‘do you actually know anyone who has had COVID?’

As humans, we naturally look to the experiences and behaviours of others for reference. Social proof is based on this concept. It’s the reason why hotel sites often have pop-ups with notes like, ‘someone in Sydney just booked this room!’. We like to think our decisions are good ones, and if others are making the same choices, it adds credibility to those decisions.

In this context, I suggest social proof could play out in several ways:

1.     The focus on vaccine rates in the media creates social proof in favour of vaccination. Seeing that many others have had the vaccine can make us feel more inclined to get it ourselves.

2.     The anecdotes of trusted family and friends also serve as social proof. If your family members have all been vaccinated, there’s more credibility to vaccination. On the other hand, if you have an unvaccinated friend who contracted COVID and had only a mild case, this might cement an idea that vaccination is not that important. I also know of some people who were vaccine-hesitant until relatives contracted the disease and had to be hospitalised.

3.     Remember all those ads with celebrities getting vaccinated? Social proof. The carefully curated videos of celebrities stating they won’t get vaccinated? Also social proof.

You’d think that data and science would be more important than the stories of people we know or the behaviour of an unqualified celebrity. Unfortunately, that may not always be the case. We may not always weigh the opinion of experts and the opinion of non-experts in logical proportions. I’d also argue here that those with an existing suspicion towards government and authority would potentially be more susceptible to emphasising social proof style evidence.

 

Confirmation Bias

This tricky little bias involves a person seeking out views that confirm their existing beliefs or attitudes and disregarding anything that challenges them. In this case, if you have decided that the vaccine is not a good idea, confirmation bias would involve seeking out only the views and evidence that reinforce this perspective.

An example here for the vaccine-hesitant might include focusing on the numbers of people who have been vaccinated and still required hospitalisation, rather than broader evidence indicating significantly reduced hospitalisation risks. Or, focusing on the fact that a very small percentage of COVID tests have seen a positive result, rather than an overarching exponential trend.

Social media is a powerful beast. By design, it gets to know you and then shows you the things you’re more likely to find interesting. This is one of the reasons it’s so appealing. But this same feature can also lead to a siloed virtual space that strengthens and perpetuates our existing beliefs, rarely challenging them or presenting alternative perspectives. Social media is a confirmation bias petri dish.

 

Groupthink

Groupthink, a term coined by psychologist Irving Janis, refers to the phenomenon where a desire for group cohesion compromises the rationality of a group’s judgement and decision-making. Members of the group hesitate to challenge each other for fear of disrupting group harmony. This pressure to conform can then lead the group to make irrational decisions. Janis considered groupthink to be like a disease that can infect highly cohesive groups.

If your social circle or virtual group has a strong stance, you may feel social pressure to conform. Social psychologist Donelson R. Forsyth has a great piece from 2020 which takes a groupthink approach to COVID health mandate resistance.

 

The backfire effect 

Perhaps the key solution to opening minds, then, is to expose people to more alternative views and different perspectives? Perhaps… not.

Those who are decidedly anti-vaccination have been targeted by many government campaigns across mainstream and social media. While well-intentioned, there may be an argument that these nudges could sometimes have a reverse effect.

One potential force behind this is known as the ‘backfire effect’, which is precisely what it sounds like: Sometimes, the act of challenging someone’s belief can prompt them to hold onto it more tightly. In one 2018 study, American Twitter users identifying as either Democrats or Republicans were exposed to bots retweeting views from the opposing party. Exposure to oppositional views exacerbated the existing positions of users. Democrats became a little more liberal. Republicans became significantly more conservative. Views became more polarised – not less.

 

Reactance

In a similar vein, a sense of freedom is also important. If one feels that their freedom about a choice has been stripped from them, they may push against it. This is known as reactance.

With the move towards mandates for some industries and the consequent risk that someone might lose their job if they don’t vaccinate, I’d argue that reactance has been a strong player in this context. When a nudge from authority is perceived to be more like a push, some may feel inclined to push back, with perceived threats to freedom overpowering other factors. The question may move from ‘is the vaccine right for me?’ to ‘how can I assert my freedom in this context?’

 

Bringing it all together

The human brain is a fascinating thing. Ultimately, we all make the best decisions we can with the information we have at the time. I think the most important questions then become: Where am I acquiring my information? How am I weighing up this information?

The biases above, of course, transcend the decision to get a vaccine or not. They can affect many of the choices we make. Perhaps being more aware of these biases can help us to make better decisions. Or, at the very least, help us to appreciate some of the layers involved in the perspectives around us.