Biologists, virologists, and pharmaceutical companies have played an invaluable role in stemming the devastation caused by the COVID-19 pandemic via a concerted global effort of rapid vaccine development, the speed and scale of which has been unprecedented in human history. However, while the biological sciences have played their role in producing the tools necessary to end the pandemic, the process of convincing others to use the tools now at our disposal (i.e. ensuring high levels of vaccine uptake) falls squarely on the shoulders of practitioners within the social sciences. On June 1st, the Cambridge University Behavioural Insights Team (CUBIT) hosted an event called Thinking Fast and Slow about Vaccine Hesitancy. The panel, moderated by Dr. Lee de-Wit, featured six individuals – each leaders in their respective fields – providing perspectives on how individuals, groups, and societies may leverage insights gleaned from behavioural science as a means of assuaging vaccine hesitancy, improving public comprehension of vaccine benefits, and catalyzing collective action in light of the ongoing COVID-19 pandemic.
Nicole Basta led off with a discussion on whether the benefits of herd immunity may motivate those unwilling to be vaccinated. While the notion of herd immunity has been a popular topic within the public discourse throughout the pandemic, experts are quick to point out that it is also widely misunderstood. Communicable disease epidemiologist Paul Fine notes that even within the academic fields dedicated to investigating the phenomenon, it can be challenging to find consensus on how precisely the term should be defined (McDermott, 2021). Fine suggests a non-controversial framing might be “the proportion of people [in a given area] that need to be immune for the rate of new infections to decline.” In order to forward the case for an understanding of herd immunity potentially being leveraged as a motivator for the unvaccinated, Basta first shared findings from a 2018 study concerning willingness to get the flu vaccine (Logan et. al., 2018). The research found that not only were adults with a better understanding of herd immunity more willing to get vaccinated, but that a short intervention aimed at teaching participants about herd immunity could significantly increase the willingness of those previously unaware of or unfamiliar with the phenomenon to get vaccinated. Basta concluded by pointing to recent evidence she and her team have uncovered showing that sentiments such as “protecting loved ones” and “contributing to ending COVID-19 outbreaks” are both strong predictors of getting vaccinated, suggesting that herd immunity interventions similar to the one utilized in the flu vaccine study might be able to tap into these prosocial motivations and catalyze greater vaccine uptake.
gateio followed with a discussion on the perils of “myth-busting,” or attempting to combat false or misleading information by referencing the incorrect information prior to making attempts to refute it. While this is a common (and perhaps even intuitive) tactic, Nicolson warns that it often has unintended consequences. Namely, this approach has been found capable of exacerbating the myth’s impact via three primary mechanisms:
- The unintentional proliferation of the myth: When you bring up, for instance, a conspiracy theory in order to debunk it, you may accidentally expose people to the theory who otherwise may have never come upon it. Some might come to be intrigued by the theory following exposure, and ultimately may come to accept it.
- Perpetuating a “two sides” falsehood: By pitting a myth and facts against each other, you may inadvertently signal to others that there are actually two sides of the argument, each of which warrants consideration.
- Challenging worldviews: Myth-busting is, by definition, telling others why something is wrong. If an individual’s belief in such false information is closely tied to their worldview, attempting to disprove it may cause them to fight back, thus shielding themselves from having to accept identity-threatening information.
Nicolson suggests that one of the best alternatives to myth-busting is to simply repeat the true information, thereby increasing public familiarity with the facts while avoiding any accidental broadcast (and potential popularization) of falsehoods.
Stephan Lewandowsky joined to discuss what he termed the COVID-19 “infodemic.” He began with a brief history lesson about the tight linkage between health crises and conspiracy theories, noting that back in 1892, frenzied crowds in Russia – convinced that doctors had spread cholera – chased anyone wearing a white coat through the streets. While conspiracy theories are an especially pernicious subcategory of misinformation, Lewandowsky argues that any type of misinformation should be treated as potentially hazardous, pointing specifically to a 2020 study undertaken by Simonov and colleagues which showed that watching Fox News caused people to reduce compliance with social distancing mandates. While Lewandowsky, the lead author on a number of handbooks designed to assist practitioners in effective communication and conspiracy debunking, shared several useful tips in combating misinformation, he made special efforts to highlight a tactic known as inoculation. Similar to how inoculation in the medical context refers to administering a weakened strain of a virus, providing the body with an opportunity to prepare its’ defenses should it ever be confronted with a full-strength strain, psychological inoculation refers to preemptively exposing an individual to a variation of an argument (e.g. one relying on or forwarding misinformation) and then teaching them why such an argument is flawed. In essence, inoculation readies individuals for misinformation “attacks,” and shows them how to “defend” themselves against them.
John Kerr’s discussion focused on the most effective ways to communicate COVID-19 risks. He led off with a warning about comparing COVID-19 risks to extremely rare events such as being struck by lightning – a strategy he referred to as “pulling from the big book of tiny risks.” Although this is a popular approach, Kerr cautioned that just because risks are equally likely does not mean they are weighed or interpreted in the same manner. Instead, Kerr suggested that vaccine risks should be placed in the context of vaccine benefits, with an eye towards identifying risks and benefits that “feel similar” in terms of their impact. Putting the theory into practice, Kerr and his colleagues at the Winton Centre assisted the UK government in disseminating the benefits and harms of receiving the Astra-Zeneca vaccine. Responding to salient public fears about vaccine-induced blood clots, Kerr and his team juxtaposed the risk of experiencing such a side effect with what they deemed to be an equivalent benefit: ICU admissions due to COVID-related complications prevented. The final product of the team’s work, a visual representation of the corresponding risks and benefits of receiving the Astra-Zeneca vaccine for various age groups (seen below), proved not only to be easily comprehensible by the wider public, but also an intuitively appealing way to conceptualize the risk-benefit tradeoff, as evidenced by how many news outlets ended up utilizing the graphic.
If Kerr’s discussion could be summarized as how we should communicate COVID-19 risks, Michael B. Petersen’s could be thought of as its natural complement: how we should not communicate COVID-19 risks. Petersen began his presentation with a warning about what he referred to as vague reassurances, or generic statements designed to assuage one’s doubts or fears (e.g. “don’t worry, it’ll be fine”). While Petersen acknowledges that bad news concerning vaccine safety or efficacy is bound to engender negative reactions from the public, he argues that attempting to dismiss or downplay unflattering facts with vague reassurances may be an even more disastrous long-term strategy. Petersen cites prior research demonstrating how vague communication can elicit feelings of uncertainty (Hanganu & Popa, 1977) before revealing one of the key variables identified to be a trigger of vaccine skepticism: uncertainty (Marchlewska et al. 2018; Prooijen & Jostmann, 2013). To bolster his argument, Petersen shared data from an in-press publication which investigated the effects of “transparent negative communication” versus “vague reassuring communication” on vaccine acceptance, conspiracy beliefs, and trust in health authorities. The findings showed that while both transparent negative communication and vague reassuring communication decreased vaccine acceptance among participants, vague reassuring communication lead to an increase in conspiratorial thinking (whereas transparent negative communication had no effect), and, perhaps most importantly, where vague reassuring communication decreased trust in health authorities, transparent negative communication increased trust. Petersen argues that if we are to maintain a long-term view of public health, the opposing impacts of the two communication styles on trust in health authorities is of the utmost importance, for if trust is compromised, “you have lost the possibility of reaching your audience.” Petersen concluded by suggesting that while the honest presentation of (unflattering) data may sometimes result in “lost battles,” the manner in which such communication preserves public trust will make societies more receptive to the advice of healthcare professionals during future crises, putting scientists in a better position to win the proverbial war.
Finally, the panel concluded with a talk by Patricia Andrews Fearon on the link between zero-sum mindsets and vaccine hesitancy. Andrews Fearon started with a summary of one of the ways in which researchers commonly measure trust: as a byproduct of assessments of warmth and competence (the two components of the Stereotype Content Model developed by Susan Fiske, Amy Cuddy, and colleagues). However, Andrews Fearon is quick to point out that such context-independent judgments of trust can quickly shift when one is provided with a compelling context. For example, Andrews Fearon contends that regardless of your evaluation of how much you can trust an individual named Dave in the abstract, such an evaluation is likely to change dramatically if you’re suddenly thrust into a Gladiator-style arena across from Dave (“now how much can you trust him?” mused Andrews Fearon). The point being that regardless of how warm or competent Dave might be judged to be as an individual in a vacuum, in a zero-sum situation like a fight to the death – where for one to win, the other must necessarily lose – even the otherwise trustworthy can no longer be trusted. Andrews Fearon proceeded to explain that individuals who possess zero-sum mindsets, or a tendency to believe that life is mostly a series of zero-sum games, are likely to perceive ambiguous situations as more hostile than their non-zero-sum counterparts, and continued on to discuss the role that zero-sum mindsets have on vaccine hesitancy. The crux of her findings, derived from a large, multi-national sample, indicated that zero-sum mindsets are stronger predictors of vaccine hesitancy than even more widely-cited variables such as level of education.
The event was replete with novel perspectives, rich discussions, and actionable insights on addressing what is arguably one of the greatest collective challenges the world has encountered in centuries. Some of the key takeaways included:
- Being cautious not to resort to “myth-busting” under conditions when the attempt to do so might actually promote the myth and counter-productive behavior.
- Considering inoculation tactics as a means of preparing our “psychological immune systems” for the presence of bad arguments in the same way we prepare our physical immune system for the presence of harmful strains of virus.
- Avoiding vague reassurances and instead opting to maintain transparency – even with unflattering data – as a way to preserve long-term public trust.
While behavioural scientists acknowledge that there is no magic potion when it comes to human behavior – no simple fix or perfect solution destined for success regardless of individual proclivity or contextual idiosyncrasy – the lessons shared permit us an opportunity to bolster our understanding of the challenges that face us as well as the solutions available to us. With any luck, these additions to our behavioural science repertoire can be used to improve outcomes for future generations, particularly during the emergence of new public health crises.