Intra-Household Dynamics and Attitudes toward Vaccines : Experimental and Survey Evidencefrom Zambia

This paper explores how intra-household dynamics relate to attitudes toward vaccinesin low-income countries, by drawing on three novel surveys from Zambia. The first is a nationally representative,in-person survey of over 10,000 households that asked all household members individually about their willingness toget a COVID-19 vaccine. The second and third surveys involved conducting randomized experiments with over 2,000participants using Facebook and SMS messages. They tested how the impact of information about the benefits fromreceiving a COVID-19 vaccine on people’s willingness to get vaccinated varied based on intra-household dynamics. Thesedata sources showed that people’s willingness (unwillingness) to get a COVID-19 vaccine was stronglyassociated with whether other household members were also willing (unwilling). Both experiments found that respondentswho received information emphasizing either individual or household benefits from getting a COVID-19 vaccine were morewilling to get vaccinated than those in the control group. This information was more potent among respondents whobelieved other members of their household would not get vaccinated but did not have a larger impact on respondentswho were involved in household decision making. There was also some evidence of positive “second-round” effectswhereby respondents who received the information treatments were more likely to encourage other household members to geta COVID-19 vaccine. An important implication that flows from this analysis is that although household members tend tohave similar attitudes toward vaccines, communicating accurate information about the benefits of gettingvaccinated can counter intra-household dynamics that undermine acceptance.