The Best Evidence for How to Overcome COVID Vaccine Fears

Operation Warp Speed has certainly lived up to its name. The arrival of the first coronavirus vaccines less than a year after the pandemic began blew away the previous development record of four years, which was held by the mumps vaccine. Now social scientists and public health communications pros must clear another hurdle: ensuring that enough people actually roll up their sleeves and give the shots a shot—two doses per person for the Pfizer-BioNTech and Moderna vaccines that won emergency use authorization from the U.S. Food and Drug Administration in mid-December. Somewhere between 60 and 90 percent of adults and children must be vaccinated or have antibodies resulting from infection in order to arrive at the safe harbor known as herd immunity, where the whole community is protected.

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Research shows that some surprisingly simple interventions can make a difference. The one with the biggest proved impact, Milkman says, is to make the desired action—in this case, vaccination—the default. A 2010 study at Rutgers University showed that informing people that a dose of flu vaccine was waiting for them at a specified time and place (although the appointment could be changed) boosted their vaccination rate by 36 percent, compared with a control group that was e-mailed a Web link to schedule their own appointment. In other words, opt out works better than opt in.

Another effective tactic is sending relentless reminders. Milkman points to a 2019 study involving 1,104 patients with tuberculosis in Kenya. Its goal was to get more people to complete their drug treatment regimen. About half of the participants were assigned to a control group. The others got daily text messages reminding them to take their meds. If they did not respond in the affirmative, they got two more text reminders that day and, if that failed, phone calls. The strategy was, “basically, just nagging the heck out of them,” as Milkman puts it. Nearly 96 percent of patients in the nagged group were treated successfully, compared with about 87 percent of the control group.

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