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Addressing Vaccine Hesitancy Using Local Ambassadors: A Randomized Controlled Trial in Indonesia

Author

Listed:
  • Islam, Asadul

    (Monash University)

  • Kusnadi, Gita

    (CISDI)

  • Rezki, Jahen

    (University of Indonesia)

  • Sim, Armand

    (Monash University)

  • van Empel, Giovanni

    (Monash University)

  • Vlassopoulos, Michael

    (University of Southampton)

  • Zenou, Yves

    (Monash University)

Abstract

In settings where resistance and rampant misinformation against vaccines exist, the prospect of containing infectious diseases remains a challenge. Can delivery of information regarding the benefits of vaccination through personal home visits by local ambassadors increase vaccine uptake? We conduct a door-to-door randomized information campaign targeted towards COVID-19 unvaccinated individuals in rural Indonesia. We recruited ambassadors from local villages tasked to deliver information about COVID-19 vaccines and promote vaccination through one-on-one meetings, using an interpersonal behavioral change communication approach. To investigate which type of ambassador—health cadres, influential individuals, and laypersons—is the most effective, we randomly vary the type of ambassador that delivers the information at the village level. We find that the overall vaccination take-up is quite moderate and that there are no differences in vaccination outcomes across the treatment groups. These results highlight the challenge of boosting vaccine uptake in late stages of a pandemic.

Suggested Citation

  • Islam, Asadul & Kusnadi, Gita & Rezki, Jahen & Sim, Armand & van Empel, Giovanni & Vlassopoulos, Michael & Zenou, Yves, 2023. "Addressing Vaccine Hesitancy Using Local Ambassadors: A Randomized Controlled Trial in Indonesia," IZA Discussion Papers 15899, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp15899
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    1. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    2. 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.
    3. Bicchieri, Cristina & Dimant, Eugen & Gächter, Simon & Nosenzo, Daniele, 2022. "Social proximity and the erosion of norm compliance," Games and Economic Behavior, Elsevier, vol. 132(C), pages 59-72.
    4. Meredith, Jennifer & Robinson, Jonathan & Walker, Sarah & Wydick, Bruce, 2013. "Keeping the doctor away: Experimental evidence on investment in preventative health products," Journal of Development Economics, Elsevier, vol. 105(C), pages 196-210.
    5. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2023. "When reality bites: Local deaths and vaccine take-up," European Economic Review, Elsevier, vol. 156(C).
    6. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2021. "When Reality Bites: Local Deaths and Vaccine Take-Up," GLO Discussion Paper Series 999, Global Labor Organization (GLO).
    7. Jay J. Van Bavel & Katherine Baicker & Paulo S. Boggio & Valerio Capraro & Aleksandra Cichocka & Mina Cikara & Molly J. Crockett & Alia J. Crum & Karen M. Douglas & James N. Druckman & John Drury & Oe, 2020. "Using social and behavioural science to support COVID-19 pandemic response," Nature Human Behaviour, Nature, vol. 4(5), pages 460-471, May.
    8. Lori Beaman & Ariel BenYishay & Jeremy Magruder & Ahmed Mushfiq Mobarak, 2021. "Can Network Theory-Based Targeting Increase Technology Adoption?," American Economic Review, American Economic Association, vol. 111(6), pages 1918-1943, June.
    9. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    10. Rossen, Isabel & Hurlstone, Mark J. & Dunlop, Patrick D. & Lawrence, Carmen, 2019. "Accepters, fence sitters, or rejecters: Moral profiles of vaccination attitudes," Social Science & Medicine, Elsevier, vol. 224(C), pages 23-27.
    11. Alex Armand & Mattia Fracchia & Pedro C. Vicente, 2021. "Let’s call! Using the phone to increase acceptance of COVID-19 vaccines," NOVAFRICA Working Paper Series wp2113, Universidade Nova de Lisboa, Nova School of Business and Economics, NOVAFRICA.
    12. Islam, Asad & Pakrashi, Debayan & Vlassopoulos, Michael & Wang, Liang Choon, 2021. "Stigma and misconceptions in the time of the COVID-19 pandemic: A field experiment in India," Social Science & Medicine, Elsevier, vol. 278(C).
    13. Nava Ashraf & James Berry & Jesse M. Shapiro, 2010. "Can Higher Prices Stimulate Product Use? Evidence from a Field Experiment in Zambia," American Economic Review, American Economic Association, vol. 100(5), pages 2383-2413, December.
    14. Marcella Alsan & Sarah Eichmeyer, 2024. "Experimental Evidence on the Effectiveness of Nonexperts for Improving Vaccine Demand," American Economic Journal: Economic Policy, American Economic Association, vol. 16(1), pages 394-414, February.
    15. Pascaline Dupas, 2014. "Short‐Run Subsidies and Long‐Run Adoption of New Health Products: Evidence From a Field Experiment," Econometrica, Econometric Society, vol. 82(1), pages 197-228, January.
    16. Jalan, Jyotsna & Somanathan, E., 2008. "The importance of being informed: Experimental evidence on demand for environmental quality," Journal of Development Economics, Elsevier, vol. 87(1), pages 14-28, August.
    17. Esther Duflo & Pascaline Dupas & Michael Kremer, 2015. "Education, HIV, and Early Fertility: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 105(9), pages 2757-2797, September.
    18. Lisa Ho & Emily Breza & Abhijit Banerjee & Arun G. Chandrasekhar & Fatima C. Stanford & Renato Fior & Paul Goldsmith-Pinkham & Kelly Holland & Emily Hoppe & Louis- Maël Jean & Lucy Ogbu-Nwobodo & Benj, 2023. "The Impact of Large-Scale Social Media Advertising Campaigns on COVID-19 Vaccination: Evidence from Two Randomized Controlled Trials," AEA Papers and Proceedings, American Economic Association, vol. 113, pages 653-658, May.
    19. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 1-45.
    20. Yang, Dean & Allen, James & Mahumane, Arlete & Riddell, James & Yu, Hang, 2023. "Knowledge, stigma, and HIV testing: An analysis of a widespread HIV/AIDS program," Journal of Development Economics, Elsevier, vol. 160(C).
    21. Madajewicz, Malgosia & Pfaff, Alexander & van Geen, Alexander & Graziano, Joseph & Hussein, Iftikhar & Momotaj, Hasina & Sylvi, Roksana & Ahsan, Habibul, 2007. "Can information alone change behavior? Response to arsenic contamination of groundwater in Bangladesh," Journal of Development Economics, Elsevier, vol. 84(2), pages 731-754, November.
    22. Abhijit Banerjee & Arun G Chandrasekhar & Esther Duflo & Matthew O Jackson, 2019. "Using Gossips to Spread Information: Theory and Evidence from Two Randomized Controlled Trials," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 86(6), pages 2453-2490.
    23. Sahil Loomba & Alexandre Figueiredo & Simon J. Piatek & Kristen Graaf & Heidi J. Larson, 2021. "Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA," Nature Human Behaviour, Nature, vol. 5(3), pages 337-348, March.
    24. Bahety, Girija & Bauhoff, Sebastian & Patel, Dev & Potter, James, 2021. "Texts don’t nudge: An adaptive trial to prevent the spread of COVID-19 in India," Journal of Development Economics, Elsevier, vol. 153(C).
    25. Solís Arce, Julio S. & Warren, Shana S. & Meriggi, Niccolò F. & Scacco, Alexandra & McMurry, Nina & Voors, Maarten & Syunyaev, Georgiy & Malik, Amyn Abdul & Aboutajdine, Samya & Adeojo, Opeyemi & Anig, 2021. "COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 27, pages 1-1.
    26. Sadish, D & Adhvaryu, Achyuta & Nyshadham, Anant, 2021. "(Mis)information and anxiety: Evidence from a randomized Covid-19 information campaign," Journal of Development Economics, Elsevier, vol. 152(C).
    27. Abhijit Banerjee & Marcella Alsan & Emily Breza & Arun G. Chandrasekhar & Abhijit Chowdhury & Esther Duflo & Paul Goldsmith-Pinkham & Benjamin A. Olken, 2020. "Messages on COVID-19 Prevention in India Increased Symptoms Reporting and Adherence to Preventive Behaviors Among 25 Million Recipients with Similar Effects on Non-recipient Members of Their Communiti," NBER Working Papers 27496, National Bureau of Economic Research, Inc.
    28. Leonardo Bursztyn & Aakaash Rao & Christopher Roth & David Yanagizawa-Drott, 2023. "Opinions as Facts," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 90(4), pages 1832-1864.
    29. Tom Chang & Mireille Jacobson & Manisha Shah & Rajiv Pramanik & Samir B. Shah, 2021. "Financial Incentives and Other Nudges Do Not Increase COVID-19 Vaccinations among the Vaccine Hesitant," NBER Working Papers 29403, National Bureau of Economic Research, Inc.
    30. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, September.
    31. 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.
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    More about this item

    Keywords

    misinformation; health behaviors; vaccine hesitancy; Indonesia; COVID-19;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I20 - Health, Education, and Welfare - - Education - - - General
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

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