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  • 11th Jan 2021

Holding up our (behavioural) guard long enough for the vaccine to take hold

In dealing with the unprecedented situation of a global pandemic, people all around the world have shown enormous resolve and remarkable abilities to adapt to sudden change. They have endured not just weeks but many months of restrictions, learning new behaviours and developing new habits that have become increasingly automatic, from keeping a mask in your pocket to avoiding shaking hands and embracing friends.

As we enter what we all hope will be the endgame of the pandemic, there is a final desperate race between the herculean effort to get the vaccine out, the resurgence of more transmittable strains, and the need to maintain behavioural bulwarks against the spread of the virus.

Who is willing to get vaccinated?

First, let’s turn our attention to how behavioural science can help in the race to vaccinate. A key challenge will be ensuring that a high percentage of those offered the vaccine take up the offer.

3 in 10 people in the UK are ‘vaccine hesitant’

In mid-December, we collected data on the coronavirus vaccination intentions of 3,538 UK adults. 

We found that 7 in 10 people in the UK said they will definitely or probably get the vaccine. In other words, almost a third of the population are ‘vaccine hesitant’.

As you might expect, there are some notable differences between those who say they will definitely get the vaccine and those who say they definitely won’t – the ‘strong no’ group has far fewer older people, and tends to be much less trusting of the government and less worried about coronavirus generally. 

There are also notable differences between those who ‘do not’ intend to get the vaccine and those who ‘don’t know’. The number one concern, reported by a majority of people in both these groups, was worry about possible side effects. But the ‘no vaccine’ group was also more likely to say they didn’t think the vaccine would work, and that coronavirus was not a serious risk anyway. 

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The ‘don’t know’ group did not have such strong objections to the vaccine – half were open to taking a ‘wait and see’ approach. Once this group sees the vaccine roll-out going smoothly and that the vaccine is not harming people, they might then be willing to get in line for their own vaccination. In this sense, we might think of them as the ‘after-you’s’. 

Levels of willingness in the US are actually quite similar. Across two experiments, featuring 13,000 people, we found that 65-67% of people intend to get the COVID-19 vaccine. Willingness varies by groups: black respondents were less willing, as were women, those under the age of 55, those in rural areas, or people who identified as Republican. Many of these differences between groups were very large (10-15 percentage points), and are in line with the major US national surveys. We saw similar levels of support when we asked people whether they think the COVID-19 vaccine is effective, and slightly less agreement when we asked people if it was safe (around 60-63%).

Lowering the barriers

Readers of BIT blogs will know our obsession with ‘make it easy’ when it comes to encouraging people towards certain behaviours. This principle has been applied to the coronavirus vaccine rollout – so far many vaccines are being administered directly in care homes and front-line healthcare settings. 

As the roll-out expands, it is important that this simple but important detail is maintained. In the UK and elsewhere, work is underway to create many local sites where people can get vaccinated. This should work well for the early target groups (e.g. older people and the clinically vulnerable), who will be highly motivated to get the vaccine. But, as we move into whole population vaccination, and as we need to start reaching the ‘probably nots’ and ‘don’t knows’, we may well need to flip the delivery model from ‘come to us’ to ‘we’ll come to you’. Communications encouraging people to get vaccinated will become less important, relative to focusing on the ‘how’ to make it as easy as possible for these people to get the vaccine.

Plasters not needles?

One quirky, but potentially important, detail is that a lot of people don’t like needles. In fact, there’s a particular group of people who don’t like needles – the young! Research has found needle fear decreases with age –  for every decade increase in age (years), there was an 8.7% decrease in the prevalence of needle fear.

Perhaps we could ask our friends in the media if they might dial down the images of needles, and add in a few ‘I had my covid vacc’ stickers instead. 

Relaxing too soon

Despite the rapid progress on vaccine administration – more than 2.4 million vaccinations have been given in the UK so far – many clinicians and global leaders worry that the availability of the vaccine will lead people to lower their guard at the last minute. It would be a tragedy for people to needlessly die just as we begin to finally beat back the virus. 

Our data supports this concern – people’s intended future compliance with the coronavirus guidance dropped off notably when asked to imagine that they had received the vaccine, or that many others had received it. That said, many things have changed since this data was collected in mid-December – coronavirus cases have risen dramatically, and the UK has entered a new national lockdown in response to the emergence of the new, more contagious coronavirus strain. So, it’s possible that compliance will remain high in response to this new, more threatening environment.

We don’t have all the answers about what to do about this. But we do know that the vaccine does not offer instant protection – and therefore it seems that there’s one last habit we all need to learn here: holding on just a bit longer than we think we need to.


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