Wielding the psychology of COVID-19 vaccine acceptance

Convincing Americans to vaccinate will require a ‘cause-and-effect’ conversation

DALLAS (SMU) – Understanding the psychology of vaccine acceptance is key to convincing the majority of Americans to take the COVID-19 vaccine when it becomes available, says SMU health behavior researcher Austin Baldwin.


Pfizer and BioNTech’s Nov. 9 announcement of a promising COVID vaccine candidate, followed by Moderna’s Nov. 16 vaccine announcement, sent stocks soaring and kindled hope across the globe. But a STAT/Harris Poll conducted just days before these announcements found just 58 percent of the American public said they would likely get a COVID vaccine if it lowered their risk by at least half, and those between the ages of 18 and 34 were less likely.


Health experts say 70 percent of Americans need to be vaccinated to reach the level of “herd immunity” that stops or slows the spread of the disease.  What will it take to close the vaccine acceptance gap?


Baldwin, who studies the factors that influence individuals’ health behavior decisions, says communication based on psychology research is key to Americans’ acceptance of a COVID-19 vaccine.


Understanding how health decisions are made

Research shows that individuals make health decisions based on their perceptions – the process of interpreting information and turning it into meaningful knowledge – and their beliefs – the process of acceptance of the truth or validity of something. To choose to take a COVID-19 vaccine, individuals must have a perception of the severity of the virus and that a vaccine will be effective as well as a belief that they are at risk of contracting the disease, Baldwin says. Anticipated regret is also a robust predictor of how health decisions are made, he says. Humans can imagine how they would feel if they chose not to be vaccinated, then became infected with COVID-19 or infected someone dear to them.


Creating the successful appeal

The most successful appeals for health decisions are transparent, engage the individual and help individuals to learn and remember information. Forget old-school propaganda and “you should” instructions. Instead, people are more likely to react positively to an appeal that is also paired with questions, Baldwin says, such as:

·      What will happen if I get COVID?

·      How will I benefit from a COVID-19 vaccine?

·      How will my family benefit if I get the vaccine?

·      How will the public benefit if I get the vaccine?


“Asking questions makes it more likely people will actively engage with the information instead of being passive participants,” Baldwin says.


Influencing behavior without a mandate

Vaccines were a key medical intervention in the last century, virtually eliminating smallpox, polio, diphtheria, mumps, measles and rubella in the United States.  According to the CDC, state and local vaccination mandates for daycare centers, schools and universities can be credited for high vaccination rates in the U.S.


But no mandate exists for a COVID-19 vaccine, at least not yet. In fact, there is no precedent for creating and distributing vaccinations for a virus that has caused a worldwide pandemic affecting all ages.  Research tells us that the newness of the vaccine, concern for long-term side effects and the growing anti-vaccine movement could contribute to hesitation to take the vaccine, Baldwin says.


“Communication about the COVID-19 vaccine will have to circumvent some individual’s natural defensiveness to help them come to their own decision about taking a vaccine to prevent a virus that is affecting society in a widespread way,” Baldwin says. “We might see a quicker and more widespread acceptance of the COVID-19 vaccine if people perceive the outcome of getting the vaccine for themselves as a return to life close to what it was before the pandemic.”


Austin Baldwin, SMU associate professor of psychology, joined SMU in 2008. His research includes studies on parental motivation for HPV vaccination of their adolescents, as well as affective and cognitive experiences of exercise, self-persuasion, health behavior theory and health behavior development.


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