Study identifies barriers to COVID-19 vaccine uptake and the powerful influence of family and friends
Brown University
That’s
according to a study published
on the cover of the July 19 issue of the Proceedings of the National Academy of
Sciences. Therefore, the most promising public health interventions to promote
COVID-19 vaccine uptake should seek ways to leverage social norms among close
ties, the findings assert.
“One
of the takeaways is the importance of people’s perceptions of the intentions of
the people around them,” said Nathaniel Rabb, a project manager at the Policy
Lab at Brown University and the lead author of the study. “It lends further
credence to the idea about changing disclosure norms. It’s likely given other
survey data we’ve seen that in groups where vaccination is less common, people
read the norms and talk about it less, even if they are vaccinated.
It’s almost taboo.”
The
research team posits there’s a feedback loop that needs to be disrupted, Rabb
said.
“It will certainly need a very different public health policy approach than putting up a billboard with how many people in your state got vaccinated, or berating people into doing it or telling them they’re at terrible risk of peril,” Rabb said. “It’s going to require a long-game strategy. In our results, it seems like you have to break these taboos about talking about it — and that’s not trivial.”
The
findings were based on surveys of Rhode Island respondents and the general U.S.
population in 2020 during the first year of the pandemic, and again in March
2021 once vaccines were becoming available to segments of the general
population. The data were collected and analyzed in partnership with the Rhode
Island Department of Health.
“
The challenge is figuring out how to normalize it at the friend and family
level — and that challenge puts a public health authority in a bind. ”
NATHANIEL RABB Project manager at the
Policy Lab
Participants
answered questions about their intentions to get vaccinated and how many people
they believe would get vaccinated among various groups — including their family
and friends, neighbors, people in their city and state, and among Democrats,
Republicans and independents.
Willingness
to vaccinate depended on the perceived extent to which others would vaccinate.
The strongest relationship was between vaccination intentions and social norms
for respondents’ friends and family. It weakened as the reference group
expanded to people in one’s neighborhood, city and state.
“The
strength of the relationship goes down as the groups become more
heterogeneous,” Rabb noted.
The
findings can help inform public health policy as well as provide a jumping-off
point to explore ways to disrupt the pattern the data illuminated.
“In
the paper, we struggle with the implication mightily and walk through the
options,” Rabb said. “Touting vaccination rates at the city or state level is
unlikely to change anyone’s mind. But touting them at the friend and family
level may not feel plausible or believable. The challenge is figuring out how
to normalize it at the friend and family level — and that challenge puts a
public health authority in a bind.”
Rabb
led the study in collaboration with Jake Bowers, an associate professor of
political science and statistics at the University of Illinois
Urbana-Champaign, David Glick, an associate professor of political science at
Boston University, Policy Lab Head of Data Science Kevin H. Wilson and Policy
Lab Director David Yokum. The study is part of an ongoing partnership between
the Policy Lab and the Rhode Island Department of Health related to COVID-19
response.