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Shen Y, Wang J, Wang J, Nicholas S, Maitland E, Lv M, Yin T, Zhu D. Effectiveness of financial incentives on influenza vaccination among older adults in China: a randomized clinical trial. Clin Microbiol Infect 2024; 30:911-916. [PMID: 38341143 DOI: 10.1016/j.cmi.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the short-term and long-term effectiveness of different levels of financial incentives on increasing the willingness to vaccinate and vaccine uptake. METHODS A randomized controlled trial was conducted to investigate the effectiveness of financial incentives of three groups with monetary incentives (CNY 20, CNY 40, and CNY 60; 1 CNY = 0.13 EUR) vs. a control group-CNY 0-on influenza vaccine uptake among 720 older adults (≥60 years) in Beijing, China. The primary outcome was vaccine uptake, and the secondary outcomes were intention to vaccinate and length of time to immunization. RESULTS Financial incentive significantly promoted higher intention to influenza vaccination (120/178 [67.42%] vs. 442/542 [81.55%]; Relative Risk [RR], 1.21; 95% CI, 1.02-1.42) and higher vaccination participation (74/178 [41.57%] vs. 316/542 [58.30%]; RR, 1.39; 95% CI, 1.10-1.75). CNY 60 had the largest impact on the intention to vaccinate (15.00% vs. 13.48% and 13.90%) and vaccination uptake (19.42% vs. 14.05% and 16.67%) compared with CNY 20 and CNY 40. Time to vaccination was significantly lower among participants receiving incentives than those without ([37.21 days; 95% CI, 34.33-39.99] vs. [48.27 days; 95% CI, 43.47-53.07]; Hazard Ratio [HR] 1.57, 95% CI 1.22-2.03). We found no long-term influence of financial incentives on vaccination decisions in the following year (217/542, 40.04% vs. 65/178, 36.52%; RR 1.08, 95% CI 0.82-1.42). DISCUSSION Our study suggests that modest financial incentives will boost short-term influenza vaccination rates and shorten the length of time to immunization in China. No one single-time financial incentive had a long-term effect on future vaccination behaviours or helped establish regular vaccination behaviours.
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Affiliation(s)
- Yang Shen
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingyu Wang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China; Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan, China
| | - Stephen Nicholas
- Health Services Research and Workforce Innovation Centre, Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia; Australian National Institite of Management and Commerce, Eveleigh, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China.
| | - Tao Yin
- Department of Technology, Capital Institute of Pediatrics, Beijing, China.
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing, China.
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2
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Campos-Mercade P, Schneider FH. Monetary incentives for vaccination: effectiveness and unintended consequences. Clin Microbiol Infect 2024; 30:845-847. [PMID: 38556210 DOI: 10.1016/j.cmi.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Pol Campos-Mercade
- Department of Economics, Lund University and Institute for Future Studies, Lund, Sweden
| | - Florian H Schneider
- Department of Economics and Center for Economic Behavior and Inequality (CEBI), University of Copenhagen, Copenhagen, Denmark.
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3
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Ambuehl S. An experimental test of whether financial incentives constitute undue inducement in decision-making. Nat Hum Behav 2024; 8:835-845. [PMID: 38459262 PMCID: PMC11132984 DOI: 10.1038/s41562-024-01817-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/04/2024] [Indexed: 03/10/2024]
Abstract
Around the world, laws limit the incentives that can be paid for transactions such as human research participation, egg donation or gestational surrogacy. A key reason is concerns about 'undue inducement'-the influential but empirically untested hypothesis that incentives can cause harm by distorting individual decision-making. Here I present two experiments (n = 671 and n = 406), including one based on a highly visceral transaction (eating insects). Incentives caused biased information search-participants offered a higher incentive to comply more often sought encouragement to do so. However, I demonstrate theoretically that such behaviour does not prove that incentives have harmful effects; it is consistent with Bayesian rationality. Empirically, although a substantial minority of participants made bad decisions, incentives did not magnify them in a way that would suggest allowing a transaction but capping incentives. Under the conditions of this experiment, there was no evidence that higher incentives could undermine welfare for transactions that are permissible at low incentives.
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Affiliation(s)
- Sandro Ambuehl
- Department of Economics and UBS Center for Economics in Society, University of Zurich, Zürich, Switzerland.
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4
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Koneru A, Wells K, Amanda Carnes C, Drumhiller K, Chatham-Stephens K, Melton M, Oliphant H, Hall S, Dennison C, Fiscus M, Vogt T. A survey of state and local practices encouraging pediatric COVID-19 vaccination of children ages 6 months through 11 years. Vaccine 2024:S0264-410X(24)00369-4. [PMID: 38594121 DOI: 10.1016/j.vaccine.2024.03.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/12/2024] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This report highlights state and local practices for optimizing the pediatric COVID-19 vaccination program for children ages 6 months through 11 years. METHODS State and local practices designed to optimize pediatric COVID-19 vaccine uptake were identified from a range of sources, including immunization program, CDC, and partner staff; and media stories or program descriptions identified via online searches. RESULTS A range of practices were identified across different categories: provider-focused practices, school-based practices, jurisdiction or health department-based activities, community-focused practices involving partners, use of vaccination incentives, and Medicaid-related practices. CONCLUSIONS Immunization programs and stakeholders implemented a variety of practices to meet the challenge of the pediatric COVID-19 vaccination program. The key findings may serve to inform not only the current pediatric COVID-19 vaccination program, but also future outbreak response work and routine immunization activities.
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Affiliation(s)
- Alaya Koneru
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States.
| | - Katelyn Wells
- Association of Immunization Managers, 451 Hungerford Drive, Suite 225, Rockville, MD 20850, United States
| | - Catherine Amanda Carnes
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Kathryn Drumhiller
- Association of Immunization Managers, 451 Hungerford Drive, Suite 225, Rockville, MD 20850, United States
| | - Kevin Chatham-Stephens
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Mackenzie Melton
- Association of Immunization Managers, 451 Hungerford Drive, Suite 225, Rockville, MD 20850, United States
| | - Hilary Oliphant
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Stacy Hall
- Contractor for Association of Immunization Managers, 451 Hungerford Drive, Suite 225, Rockville, MD 20850, United States
| | - Cori Dennison
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Michelle Fiscus
- Association of Immunization Managers, 451 Hungerford Drive, Suite 225, Rockville, MD 20850, United States
| | - Tara Vogt
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
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5
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Prati A, Saucet C. The causal effect of a health treatment on beliefs, stated preferences and memories. JOURNAL OF HEALTH ECONOMICS 2024; 94:102864. [PMID: 38359587 DOI: 10.1016/j.jhealeco.2024.102864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Abstract
The paper estimates the causal effect of a health treatment on patients' beliefs, preferences and memories about the treatment. It exploits a natural experiment which occurred in the United Kingdom during the COVID-19 vaccination campaign. UK residents could choose to opt into the vaccination program, but not which vaccine they received. The assignment to a vaccine offered little objective information for learning about its qualities, but triggered strong psychological demand for reassuring beliefs. We surveyed a sample of UK residents about their beliefs on the different COVID-19 vaccines before and after receiving their jab. Before vaccination, individuals exhibit similar prior beliefs and stated preferences about the different vaccines. After vaccination, however, they update their beliefs overly optimistically about the safety and effectiveness of the vaccine they received, state that they would have chosen it if they could, and have distorted memories about their past beliefs. These results cannot be explained by conventional experience effects. At the aggregated level, they show that random assignment to a health treatment predicts a polarization of opinions about its quality. At the individual level, these findings provide evidence in line with the predictions of motivated beliefs and over-inference from weak signals in a real-world health setting.
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Affiliation(s)
- Alberto Prati
- University College London, United Kingdom; University of Oxford, United Kingdom; London School of Economics, United Kingdom.
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6
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Jilke S, Keppeler F, Ternovski J, Vogel D, Yoeli E. Policy makers believe money motivates more than it does. Sci Rep 2024; 14:1901. [PMID: 38253624 PMCID: PMC10803740 DOI: 10.1038/s41598-024-51590-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
To motivate contributions to public goods, should policy makers employ financial incentives like taxes, fines, subsidies, and rewards? While these are widely considered as the classic policy approach, a substantial academic literature suggests the impact of financial incentives is not always positive; they can sometimes fail or even backfire. To test whether policy makers are overly bullish about financial incentives, we asked county heads, mayors, and municipal government representatives of medium-to-large towns in Germany to predict the effects of a financial incentive on COVID-19 vaccination, and tested the exact same incentive in a field experiment involving all 41,548 inhabitants (clustered in 10,032 addresses) of the German town of Ravensburg. Whereas policy makers overwhelmingly predict that the financial incentive will increase vaccination-by 15.3 percentage points on average-the same financial incentive yielded a precisely estimated null effect on vaccination. We discuss when financial incentives are most likely to fail, and conclude that it is critical to educate policy makers on the potential pitfalls of employing financial incentives to promote contributions to public goods.
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Affiliation(s)
| | - Florian Keppeler
- Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark
- Zeppelin University, Fallenbrunnen 3, 88045, Friedrichshafen, Germany
| | - John Ternovski
- U.S. Airforce Academy, 2354 Fairchild Drive, Air Force Academy, CO, 80840, Germany
| | - Dominik Vogel
- University of Hamburg, Von-Melle-Park 9, 20146, Hamburg, Germany
| | - Erez Yoeli
- Massachusetts Institute of Technology, 100 Main Street, Cambridge, MA, 02142, USA
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7
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Campos-Mercade P, Meier AN, Pope D, Schneider FH. Motivating vaccination with financial incentives. Trends Cogn Sci 2023; 27:1099-1101. [PMID: 37716894 DOI: 10.1016/j.tics.2023.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 09/18/2023]
Abstract
Governments and organizations often offer cash payments for vaccination. How effective are such payments? A literature review shows that incentives usually increase vaccination, especially for nonhesitant populations and when using guaranteed payments. Concerns about negative unintended consequences are unsupported. We also discuss open questions and avenues for future research.
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Affiliation(s)
- Pol Campos-Mercade
- Lund University, Lund, Sweden; Institute for Future Studies, Stockholm, Sweden.
| | - Armando N Meier
- Unisanté & Lausanne Center for Health Economics, Behavior, and Policy (LCHE), University of Lausanne, Lausanne, Switzerland; Faculty of Business and Economics, University of Basel, Basel, Switzerland.
| | - Devin Pope
- University of Chicago Booth School of Business, Chicago, USA; National Bureau of Economic Research, Cambridge, MA, USA.
| | - Florian H Schneider
- Department of Economics and Center for Economic Behavior and Inequality (CEBI), University of Copenhagen, Copenhagen, Denmark; CESifo, Munich, Germany.
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8
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Duch R, Asiedu E, Nakamura R, Rouyard T, Mayol A, Barnett A, Roope L, Violato M, Sowah D, Kotlarz P, Clarke P. Financial incentives for COVID-19 vaccines in a rural low-resource setting: a cluster-randomized trial. Nat Med 2023; 29:3193-3202. [PMID: 38012315 PMCID: PMC10719106 DOI: 10.1038/s41591-023-02670-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023]
Abstract
We implemented a clustered randomized controlled trial with 6,963 residents in six rural Ghana districts to estimate the causal impact of financial incentives on coronavirus disease 2019 (COVID-19) vaccination uptake. Villages randomly received one of four video treatment arms: a placebo, a standard health message, a high cash incentive (60 Ghana cedis) and a low cash incentive (20 Ghana cedis). For the first co-primary outcome-COVID-19 vaccination intentions-non-vaccinated participants assigned to the cash incentive treatments had an average rate of 81% (1,733 of 2,168) compared to 71% (1,895 of 2,669) for those in the placebo treatment arm. For the other co-primary outcome of self-reported vaccinations 2 months after the initial intervention, the average rate for participants in the cash treatment was 3.5% higher than for participants in the placebo treatment (95% confidence interval (CI): 0.001, 6.9; P = 0.045): 40% (602 of 1,486) versus 36.3% (672 of 1,850). We also verified vaccination status of participants: in the cash treatment arm, 36.6% (355 of 1,058) of verified participants had at least one dose of the COVID-19 vaccine compared to 30.3% (439 of 1,544) for those in the placebo-a difference of 6.3% (95% CI: 2.4, 10.2; P = 0.001). For the intention and the vaccination outcomes, the low cash incentive (20 Ghana cedis) had a larger positive effect on COVID-19 vaccine uptake than the high cash incentive (60 Ghana cedis). Trial identifier: AEARCTR-0008775 .
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Affiliation(s)
- Raymond Duch
- Nuffield College, University of Oxford, Oxford, UK.
| | - Edward Asiedu
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- City University of New York (CUNY) Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Alberto Mayol
- Department of Public Administration, FAE University of Santiago Chile, Santiago, Chile
| | - Adrian Barnett
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Dorcas Sowah
- Edward Asiedu and Dorcas Sowah University of Ghana Business School, University of Ghana, Accra, Ghana
| | | | - Philip Clarke
- University of Oxford, Oxford, UK
- University of Melbourne, Melbourne, Victoria, Australia
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9
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Tchernichovski O, Frey S, Jacoby N, Conley D. Incentivizing free riders improves collective intelligence in social dilemmas. Proc Natl Acad Sci U S A 2023; 120:e2311497120. [PMID: 37931106 PMCID: PMC10655583 DOI: 10.1073/pnas.2311497120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/05/2023] [Indexed: 11/08/2023] Open
Abstract
Collective intelligence challenges are often entangled with collective action problems. For example, voting, rating, and social innovation are collective intelligence tasks that require costly individual contributions. As a result, members of a group often free ride on the information contributed by intrinsically motivated people. Are intrinsically motivated agents the best participants in collective decisions? We embedded a collective intelligence task in a large-scale, virtual world public good game and found that participants who joined the information system but were reluctant to contribute to the public good (free riders) provided more accurate evaluations, whereas participants who rated frequently underperformed. Testing the underlying mechanism revealed that a negative rating bias in free riders is associated with higher accuracy. Importantly, incentivizing evaluations amplifies the relative influence of participants who tend to free ride without altering the (higher) quality of their evaluations, thereby improving collective intelligence. These results suggest that many of the currently available information systems, which strongly select for intrinsically motivated participants, underperform and that collective intelligence can benefit from incentivizing free riding members to engage. More generally, enhancing the diversity of contributor motivations can improve collective intelligence in settings that are entangled with collective action problems.
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Affiliation(s)
- Ofer Tchernichovski
- Department of Psychology, Hunter College, The City University of New York, New York, NY10065
| | - Seth Frey
- Department of Communication, University of California, Davis, CA95616
- Ostrom Workshop, Indiana University Bloomington, Bloomington, IN47408
| | - Nori Jacoby
- Computational Auditory Perception Group, Max Planck Institute for Empirical Aesthetics, Frankfurt60322, Germany
| | - Dalton Conley
- Princeton and National Bureau of Economic Research, Department of Sociology and Office of Population Research, Princeton University, Princeton, NJ08544
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10
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Elinder M, Erixson O, Öhman M. Cognitive ability, health policy, and the dynamics of COVID-19 vaccination. JOURNAL OF HEALTH ECONOMICS 2023; 91:102802. [PMID: 37672962 DOI: 10.1016/j.jhealeco.2023.102802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023]
Abstract
We examine the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden. We find a strong positive association between cognitive ability and swift vaccination, which remains even after controlling for confounding variables with a twin-design. The results suggest that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination. Consistent with this, we show that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.
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Affiliation(s)
- Mikael Elinder
- Department of Economics, Uppsala University, Uppsala, Sweden
| | - Oscar Erixson
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden.
| | - Mattias Öhman
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
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11
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Ockenfels A. Behavioral market design. Behav Brain Sci 2023; 46:e171. [PMID: 37646281 DOI: 10.1017/s0140525x23001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
When it comes to behavioral change, economic design and behavioral science are complements, not substitutes. Chater & Loewenstein give examples from policy design. In this commentary, I use examples, often from my own research, to show how behavioral insights inform the design of the rules that govern market transactions.
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Affiliation(s)
- Axel Ockenfels
- Department of Economics, University of Cologne, Köln, Germany ; https://ockenfels.uni-koeln.de/de/ao
- Max Planck Institute for Research on Collective Goods, Bonn, Germany
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12
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Gilan D, Birkenbach M, Wossidlo M, Sprengholz P, Betsch C, Hahad O, Lieb K. Fear of COVID-19 disease and vaccination as predictors of vaccination status. Sci Rep 2023; 13:8865. [PMID: 37258562 DOI: 10.1038/s41598-023-35064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
Vaccination rates are still insufficient to prevent the spread of COVID-19, so immunity must be increased among the population in order to reduce the virus' spread and the associated medical and psychosocial effects. Although previous work has identified various factors associated with a low willingness to get vaccinated, the role of emotions such as fear of vaccination (FVAC) or fear of COVID-19 (FCOV), vaccination as a subjective norm (SN), psychological factors like general control beliefs (CB) or psychological resilience, and their interaction have been investigated less intensively. We used data from three cross-sectional waves of the German Panel COSMO (November 2021, N = 1010; February 2022, N = 1026; March 2022, N = 1031) and multiple logistic regression analyses to test whether vaccination rates are moderated by those factors. After controlling for covariates (age, sex, confidence in own intuition, optimism, well-being), we found that CB was no significant predictor of vaccination status. Higher FCOV and higher ratings in SN, however, were associated with an increased likelihood of being vaccinated. In contrast, higher FVAC was associated with a decreased likelihood of being vaccinated. Psychological resilience did not consistently moderate the associations between fear and vaccination status.
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Affiliation(s)
- Donya Gilan
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Markus Birkenbach
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
- Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marius Wossidlo
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
| | - Philipp Sprengholz
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Omar Hahad
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany.
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Klaus Lieb
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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13
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Hartonen T, Jermy B, Sõnajalg H, Vartiainen P, Krebs K, Vabalas A, Leino T, Nohynek H, Sivelä J, Mägi R, Daly M, Ollila HM, Milani L, Perola M, Ripatti S, Ganna A. Nationwide health, socio-economic and genetic predictors of COVID-19 vaccination status in Finland. Nat Hum Behav 2023:10.1038/s41562-023-01591-z. [PMID: 37081098 PMCID: PMC10365990 DOI: 10.1038/s41562-023-01591-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
Understanding factors associated with COVID-19 vaccination can highlight issues in public health systems. Using machine learning, we considered the effects of 2,890 health, socio-economic and demographic factors in the entire Finnish population aged 30-80 and genome-wide information from 273,765 individuals. The strongest predictors of vaccination status were labour income and medication purchase history. Mental health conditions and having unvaccinated first-degree relatives were associated with reduced vaccination. A prediction model combining all predictors achieved good discrimination (area under the receiver operating characteristic curve, 0.801; 95% confidence interval, 0.799-0.803). The 1% of individuals with the highest predicted risk of not vaccinating had an observed vaccination rate of 18.8%, compared with 90.3% in the study population. We identified eight genetic loci associated with vaccination uptake and derived a polygenic score, which was a weak predictor in an independent subset. Our results suggest that individuals at higher risk of suffering the worst consequences of COVID-19 are also less likely to vaccinate.
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Affiliation(s)
- Tuomo Hartonen
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Bradley Jermy
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Hanna Sõnajalg
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Pekka Vartiainen
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Kristi Krebs
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Andrius Vabalas
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tuija Leino
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Mark Daly
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Massachusetts General Hospital, Cambridge, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Hanna M Ollila
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center of Genomic Medicine, Harvard Medical School, Boston, MA, USA
- Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Markus Perola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Massachusetts General Hospital, Cambridge, MA, USA
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland.
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Massachusetts General Hospital, Cambridge, MA, USA.
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14
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Vaccine incentives do not backfire - policymakers take note. Nature 2023; 613:215. [PMID: 36631655 DOI: 10.1038/d41586-023-00018-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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