Behavioral Economics & Vaccine Hesitancy

Behavioral Economics is the science of how people make decisions. What does it tell us about vaccine hesitancy?

1. The old way of thinking is that people are like calculators and robots, as in information and rules in, and behavior will just match to that. Sidewalks end up being designed at right angles instead of how we really move. But it’s not just sidewalks, it’s all kinds of policies and programs that are mismatched.

2. And it goes further: we expect the world to match to our wants and needs, but sometimes that means we change our perception of reality to fit our underlying values. Motivated reasoning is a very powerful and dangerous bias that preys on our political ideology; if we fundamentally value freedom and small government, then social problems that genuinely require big social intervention (eg government regulation) will lead us to not even agreeing on the problem itself (in other words, if we don’t like the “means” to solve a problem, it influences our objective evaluation of the “ends”, the problem itself).

3. Vaccine hesitancy is highest amongst people who don’t like big government, but also score very poorly on scientific knowledge (is an atom bigger than an electron), view personal beliefs as more important than evidence (strongly agree with: “just because evidence conflicts with my current beliefs, does not mean my beliefs are wrong” and “regardless of the topic, what you believe to be true is more important than evidence against your beliefs.”), and fail at cognitive reflection tasks such as “if a bat and ball cost $1.10, and the bat costs $1.00 more than the ball, how much does the ball cost?” and “a lilly pad is growing in a pond and doubles every day. After 30 days it covers the entire pond. On what day does it cover one half?”). Further, they often believe that the “vaccines might contain gels to carry nanobots that can be drive mind control through 5G cell towers by the global elite to create a New World Order.” Of the 4,000 people surveyed, 10% were firmly opposed to vaccines because of these beliefs, and another 1/3 were on the fence.

4. Addressing concerns of vaccine confidence will require a portfolio of strategies. Some of it is about addressing scientific concerns such as how safe are the vaccines given the speed at which they were developed and the EUA status, are there long term effects, and will it affect my unborn child. Other concerns were around the nature of the creation of pharmaceutical products themselves and “Big Pharma.” Asking people how they believe medicine ought to be discovered and distributed leads to complex conversations (AstraZeneca is being sold not for profit; others are sold for relatively low cost, but in most places they are wholly subsidized even in non-socialized medicine countries). And some conversations aren’t about vaccines and pharmaceuticals at all, but either fundamental science questions (eg the immune system can’t be “boosted” through vitamins, sunshine), statistical fallacies (misunderstanding of the social consequences of the fatality rate of the disease), and just finding a common ground through working through a broader understanding of the grievances that some feel about the current state of the world and how that affects their understanding of the safety and efficacy of the vaccines (and the possible need for boosters if we continue to have variants emerging as a function of people perpetuating the spread of this virulent virus.)

5. It is very hard to recognize and accept biases in our thinking. Some argue in a way that is guilty of gish galloping; that is, throwing so many arguments on the table without any good faith intent to work through any of the points.

6. If we want to really dig in to why we are here now, we need to think about:

a. The absence of scientific knowledge to understand how science evolves

b. The inability to distinguish between pseudoscience and science

c. Lack of media literacy to see past exploitative headlines

d. The role of social media in creating algorithms that fuel echo chambers

e. The role of eating meat, the use of antibiotics in the livestock, encroachment on wild habitat

Let’s end the pandemic together.