Abstract
Vaccination promotion is a crucial strategy to end the COVID-19 pandemic; however, individual autonomy should also be respected. This study aimed to discover other-regarding information nudges that can reinforce people's intention to receive the COVID-19 vaccine without impeding their autonomous decision-making. In March 2021, we conducted an online experiment with 1595 people living throughout Japan, and randomly assigned them either of one control group and three treatment groups that received messages differently describing peer information: control, comparison, influence-gain, and influence-loss. We compared each message's effects on vaccination intention, autonomous decision-making, and emotional response. We found that the influence-gain nudge was effective in increasing the number of older adults who newly decided to receive the vaccine. The comparison and influence-loss nudges further reinforced the intention of older adults who had already planned to receive it. However, the influence-loss nudge, which conveys similar information to the influence-gain nudge but with loss-framing, increased viewers' negative emotion. These messages had no promoting effect for young adults with lower vaccination intentions at baseline. Based on the findings, we propose governments should use different messages depending on their purposes and targets, such as comparison instead of influence-loss, to encourage voluntary vaccination behavior.
Highlights
Promoting vaccination is a crucial strategy to end the COVID-19 pandemic
We investigated whether nudge-based messages, which provided information on others’ vaccination decisions and behaviors, strengthen people’s intentions to receive the COVID-19 vaccine
3.3.2 Secondary Outcomes: Autonomy and Emotional Burden After the willingness to pay (WTP) question, we presented the following four questions to clarify whether adding nudge-based messages inhibits respondents’ autonomous decision-making and generates negative emotions compared to the common explanations in the control group: “Did you want to receive the vaccine voluntarily?”, “Did you think you were being forced to receive the vaccine?”, “Did you feel distressed when you received the explanation of the vaccine?”, and “Did you feel that the explanation of the vaccine needed to be improved?”
Summary
Promoting vaccination is a crucial strategy to end the COVID-19 pandemic. Promotion measures potentially include options from simple information provision to legal mandates. Compulsory measures are rare, and some degree of self-selection is preferred, because public health is guided by the least restrictive alternative, which states that we must select measures that place the least restrictions on individual freedom and rights, to achieve a public good, including herd immunity (Giubilini, 2021). Since the COVID-19 vaccine has been newly developed and there are uncertainties and ambiguity regarding its long-term efficacy and adverse reactions, it is important to respect individual autonomy. Behavioral economics defines nudge as “an aspect of choice architecture that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives” (Thaler and Sunstein, 2008, p.6). Nudge has been used for promoting COVID-19 social distancing (Lunn et al, 2020; Sasaki et al, 2021), and will be relevant in the above setting
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