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How does nudging the COVID-19 vaccine play out in people who are in doubt about vaccination?

Author

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  • de Ridder, Denise
  • Adriaanse, Marieke
  • van Gestel, Laurens
  • Wachner, Jonas

Abstract

In spite of the growing availability of COVID-19 vaccines, a substantial number of people is reluctant or uncertain about getting the vaccine. Nudges may improve vaccine uptake but it is unclear how this plays out with the experience of autonomous choice, decision competence, decision satisfaction, and being pressured to make a choice. In an online experiment among a representative sample (N = 884), we examined whether a social norm nudge or a default nudge (either or not transparent) was effective in steering the desired choice of making a hypothetical early vaccination appointment as compared to making a later appointment or no appointment. We also examined how both nudges affected autonomy and related downstream consequences. None of the nudges proved effective in making the desired choice of early vaccination and neither did they impact on downstream consequences. Rather, our results indicate that participants who were certain about their choice (i.e., opted for the earliest available vaccination opportunity or not getting vaccinated at all) reported higher levels of autonomy, competence and satisfaction than participants who did not know yet about vaccination or who postponed the moment of getting their vaccination. We conclude that the experience of autonomy and related downstream consequences is determined by having made up one's mind about vaccination, and is not affected by attempts to nudge the individual.

Suggested Citation

  • de Ridder, Denise & Adriaanse, Marieke & van Gestel, Laurens & Wachner, Jonas, 2023. "How does nudging the COVID-19 vaccine play out in people who are in doubt about vaccination?," Health Policy, Elsevier, vol. 134(C).
  • Handle: RePEc:eee:hepoli:v:134:y:2023:i:c:s0168851023001434
    DOI: 10.1016/j.healthpol.2023.104858
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    References listed on IDEAS

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    1. Klüver, Heike & Hartmann, Felix & Humphreys, Macartan & Geissler, Ferdinand & Giesecke, Johannes, 2021. "Incentives can spur COVID-19 vaccination uptake," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 118(36), pages 1-1.
    2. Katherine L. Milkman & Mitesh S. Patel & Linnea Gandhi & Heather N. Graci & Dena M. Gromet & Hung Ho & Joseph S. Kay & Timothy W. Lee & Modupe Akinola & John Beshears & Jonathan E. Bogard & Alison But, 2021. "A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 118(20), pages 2101165118-, May.
    3. Jonas Wachner & Marieke A Adriaanse & Denise T D De Ridder, 2021. "The effect of nudges on autonomy in hypothetical and real life settings," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-16, August.
    4. Schwartz, Barry & Cheek, Nathan N., 2017. "Choice, freedom, and well-being: considerations for public policy," Behavioural Public Policy, Cambridge University Press, vol. 1(1), pages 106-121, May.
    5. Sebastian Neumann-Böhme & Nirosha Elsem Varghese & Iryna Sabat & Pedro Pita Barros & Werner Brouwer & Job van Exel & Jonas Schreyögg & Tom Stargardt, 2020. "Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 977-982, September.
    6. Katya Tentori & Stefania Pighin & Giulia Giovanazzi & Andrea Grignolio & Benjamin Timberlake & Antonio Ferro, 2022. "Nudging COVID-19 Vaccine Uptake by Changing the Default: A Randomized Controlled Trial," Medical Decision Making, , vol. 42(6), pages 837-841, August.
    7. François Sainfort & Bridget C. Booske, 2000. "Measuring Post-decision Satisfaction," Medical Decision Making, , vol. 20(1), pages 51-61, January.
    8. T. M. Wilkinson, 2013. "Nudging and Manipulation," Political Studies, Political Studies Association, vol. 61(2), pages 341-355, June.
    9. Katrine Bach Habersaat & Cornelia Betsch & Margie Danchin & Cass R. Sunstein & Robert Böhm & Armin Falk & Noel T. Brewer & Saad B. Omer & Martha Scherzer & Sunita Sah & Edward F. Fischer & Andrea E. S, 2020. "Ten considerations for effectively managing the COVID-19 transition," Nature Human Behaviour, Nature, vol. 4(7), pages 677-687, July.
    10. Lucia A. Reisch & Cass R. Sunstein, 2016. "Do Europeans like nudges?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 11(4), pages 310-325, July.
    11. Jachimowicz, Jon M. & Duncan, Shannon & Weber, Elke U. & Johnson, Eric J., 2019. "When and why defaults influence decisions: a meta-analysis of default effects," Behavioural Public Policy, Cambridge University Press, vol. 3(2), pages 159-186, November.
    12. Wachner, Jonas & Adriaanse, Marieke & Hoven, Mariette van den & de Ridder, Denise, 2022. "Does default organ donation registration compromise autonomous choice? Public responses to a new donor registration system," Health Policy, Elsevier, vol. 126(9), pages 899-905.
    13. Reisch, Lucia A. & Sunstein, Cass R., 2016. "Do Europeans like nudges?," Judgment and Decision Making, Cambridge University Press, vol. 11(4), pages 310-325, July.
    14. Hengchen Dai & Silvia Saccardo & Maria A. Han & Lily Roh & Naveen Raja & Sitaram Vangala & Hardikkumar Modi & Shital Pandya & Michael Sloyan & Daniel M. Croymans, 2021. "Behavioural nudges increase COVID-19 vaccinations," Nature, Nature, vol. 597(7876), pages 404-409, September.
    15. Vugts, Anastasia & Van Den Hoven, Mariëtte & De Vet, Emely & Verweij, Marcel, 2020. "How autonomy is understood in discussions on the ethics of nudging," Behavioural Public Policy, Cambridge University Press, vol. 4(1), pages 108-123, March.
    16. Harsha Thirumurthy & Katherine L Milkman & Kevin G Volpp & Alison M Buttenheim & Devin G Pope, 2022. "Association between statewide financial incentive programs and COVID-19 vaccination rates," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-7, March.
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    1. Rinaldi, Anna & Dellino, Pierfrancesco & Paradiso, Massimo, 2025. "Framing the loss: Preferences for vaccine hesitancy and gender effect in France and Italy," Health Policy, Elsevier, vol. 155(C).
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