Boosting vaccination rates: lessons from behavioral economics

One domain that has the potential to revolutionize policy in behavioral economics is the global COVID-19 vaccination campaign. There is a remarkable diversity in the responses of citizens around the world, both within and between countries. In the UK, a hugely successful vaccination campaign saw about 60% of citizens get their first dose of vaccine by June 2021. It displayed a remarkable pace compared to neighboring countries such as France (39%) and Germany (45%) at the time. ,

While factors such as vaccine availability have played a large role in this success, we have observed that vaccination rates are often constrained by sluggishness among populations rather than by lack of vaccines. The UK overcomes this by incorporating two key insights from behavioral economics: the default effect is powerful and the choice architecture matters.

The default effect captures how people choose to stick with the default option. The major reason for this is the cost of decision-making: Even if someone wants to get vaccinated, it’s expensive to think they’ll be free to make an appointment, for example. Instead, they remain with the default: no appointments. It is important to acknowledge that this cost matters. To get vaccinated in India, you need to log in to an online portal, fill out a form, and provide details of your identity documents or wait in line for hours.

In the UK, however, the National Health Service contacted each citizen individually, inviting them to book their appointment via a link or phone number. Those who did not respond received assistance offering a follow-up phone call. The UK attempted to disable the default effect by proactively contacting citizens and by changing the structure of choice, simplifying the decision by giving immediate support.

The change in choice structure has proved to be extremely helpful with the organ donation drive, which is very similar to the vaccine drive. An Ipsos survey tells us that in India, 74% of people are willing to donate their organs; However, according to the WHO, less than 0.1% actually do. Once again, we can point to the default effect to explain this.

India, like many other countries, operates an opt-in system where people must explicitly agree to donate their organs, usually when applying for a driving licence. The tick-box to confirm your consent is blank at first, setting the default option – no – for those who are in a hurry or simply don’t want to think about it too much. Even if everyone wants to donate their organs, many people are unable to tick the box for one reason or the other. Realizing the power of choice architecture, countries such as Colombia and Wales have switched from a system where citizens choose to donate organs after death, to one where people can opt-out. After Wells opted out of opt-in in 2015, consent rates increased from 58% to 77% in four years.

By modifying the way an alternative is presented, we can maintain autonomy while pushing people toward a public goal such as immunity. Now that booster shots are becoming increasingly important with the introduction of the Omicron version, it is imperative that we learn from the past. In this case, behavioral economics tells us that if you want to increase vaccination rates, you must make it as easy as possible for them. Use phone calls, emails and letters to invite people to take the vaccine. Don’t fall prey to the default effect once again.

The authors are part of a team of researchers conducting an experiment in behavioral economics at the University of Oxford. Click Here to participate in their surveys and win prizes 50,000