For a COVID-19 vaccine to succeed, look to behavioral research


After months of battling a deadly disease that has brought the world economy to its knees, killed at least 170,000 people in the U.S. alone and left thousands of others sick or homebound, everyone is clamoring for a vaccine that will help us return to at least some semblance of normalcy. But a vaccine is only effective when enough people get immunized to significantly prevent the spread of the disease. 

While public officials continue to struggle with how to control the pandemic and when and whether to reopen schools and businesses, what’s missing from these discussions is the science of human behavior. It is critical to understand people’s perceptions of risk and safety — both physical and psychological — and how people’s beliefs guide their behavior. 

The recent precipitous rise in infection rates in the U.S. despite knowing how we can slow the spread of the virus clearly illustrates that having solutions isn’t enough. We need to incorporate our understanding of human behavior into the solutions we identify to make them most effective.  

There are already troubling signs that a significant number of people will not get the COVID-19 vaccine when one becomes available. A poll released by CNN in early May found that 33 percent of respondents said they would not attempt to get vaccinated even if a vaccine for COVID-19 were widely available at a low cost. 

We also know that the public doesn’t always take advantage of vaccinations, despite decades of evidence of their safety and efficacy. A recent report showed that, between July 2018 and May 2019, only 47  percent of adults in the U.S. got a flu shot. Given these data, it is clear that we must expend as much effort in preparing the people as we have in preparing a vaccine. Government officials must mobilize now to convince millions of people across the country and around the world to get immunized as soon as a COVID-19 vaccine is available. 

Just as drug manufacturers are preparing millions of doses of experimental vaccines in anticipation that one or more of them may prove effective, we need to launch a public education campaign now that will convince people of the importance of getting vaccinated. To be effective, the campaign must be based on the best psychological research that shows the most effective ways to influence people to get inoculated. That’s why it is important that local, state and federal agencies familiarize themselves with the psychological science that explains how to positively influence public behavior. 

The science shows us that some of the best strategies for getting people vaccinated include.

1. Removing physical and psychological barriers to vaccinations

To be effective, we must make it easy for people to get vaccinations. Officials should allow vaccinations to take place not just in doctors’ offices but at COVID-19 testing sites, local pharmacies, schools, places of worship, town fairs and workplaces. It will also be helpful if the vaccine is provided for free. 

2. Establishing incentives and consequences

Once a vaccine is available, employers should remind employees to get vaccinated, as such nudges have been shown to be effective. They should also think about incentives that will encourage employees to take action, including paid time off to get tested and vaccinated. State lawmakers could require that students get vaccinated before they can return to school.

3. Preparing health care providers

Research shows that recommendations for vaccinations from health care providers are typically viewed as authoritative evidence that vaccines work and are safe. Research also shows that health care providers should speak in definitive terms and talk about the vaccinations as a standard practice rather than as something optional. It will be important that the drug company manufacturing the vaccine is as transparent as possible, including making public the ingredients used in the vaccine. Medical professionals can share that information with patients and help allay any concerns or misconceptions about product safety. Once a vaccine is announced, medical professionals should automatically schedule patients to get vaccinated. 

There is also psychological research showing other forces that shape people’s behavior on medical issues, including:

1. Turning to experts and authority figures

Recognized experts, from state health department directors and elected officials all the way up to national leaders, will need to voice approval for the vaccine and encourage people to get immunized. We have already seen the influence of public officials when it comes to wearing masks, washing hands and staying physically distant. What we need immediately is for these officials to unite behind the message that vaccines are safe.  

2. Making concessions

People are more likely to do something if they feel like it is part of a compromise, according to research. So, for example, a message that getting a vaccination could eliminate the virus and therefore head off burdensome requirements, such as physical distancing and wearing masks, may appeal to people who have been reluctant to take those actions to protect themselves from the virus.

There is little doubt that the best biomedical science will help us develop the tools to beat this virus. But once we have the tools, we need to turn to the science of human behavior to help us get people to use them. 

Arthur C. Evans Jr. is CEO of the American Psychological Association. 


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