Advertisement

Behavioral Economics as a Model to Improve Adolescent and Adult Vaccination

      Despite that fact that the first scientifically based smallpox vaccine was developed in the late 1700s, in 2021 we struggle to fully vaccinate adolescents and adults in the United States. Decades of scientific data support the efficacy and tolerability of vaccines in general, yet vaccine hesitancy remains common. Fear sits much deeper than logic within the human psyche, especially when it comes to vaccine decision making. The complexities of human psychology and decision making are the footings of vaccine hesitancy and yet may also provide an opportunity to shift vaccination behavior.
      • Thaler RH
      • Susteind CR
      Nudge.
      To read this article in full you will need to make a payment
      Subscribe to Clinical Therapeutics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Thaler RH
        • Susteind CR
        Nudge.
        Penguin. 2009;
      1. World Health Organization. https://www.who.int/news-room/facts-in-pictures/detail/immunization. Published 2021. Accessed July 1, 2021.

        • Andre FE
        • Booy R
        • Bock HL
        • et al.
        Vaccination greatly reduces disease, disability, death and inequity worldwide.
        Bull World Health Organ. 2008; 86: 140-146
        • Bazin H.
        [Eradication of smallpox, already 20 years ago].
        Bull Acad Natl Med. 2000; 184 (discussion 99–104): 89-99
      2. American Academy of Pediatrics. Periodicity Schedule. https://www.aap.org/en-us/professional-resources/practice-transformation/managing-patients/Pages/Periodicity-Schedule.aspx. Published 2021. Accessed May 30, 2021.

        • Hill HA
        • Yankey D
        • Elam-Evans LD
        • Singleton JA
        • Pingali SC
        • Santibanez TA.
        Vaccination Coverage by Age 24 Months Among Children Born in 2016 and 2017-National Immunization Survey-Child, United States, 2017-2019.
        Mmwr-Morbid Mortal W. 2020; 69: 1505-1511
        • Lu PJ
        • Hung MC
        • Srivastav A
        • et al.
        Surveillance of Vaccination Coverage Among Adult Populations - United States, 2018.
        MMWR Surveill Summ. 2021; 70: 1-26
        • Elam-Evans LD
        • Yankcy D
        • Singleton JA
        • et al.
        National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2019.
        MMWR Morbid Mortal Wkly. 2020; 69: 1109-1116
      3. Centers for Disease Control and Prevention. Flu Vaccination Coverage, United States, 2018–19 Influenza Season. https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm. Published 2019. Accessed May 1, 2021.

      4. Centers for Disease Control and Prevention. Flu Vaccination Coverage, United States, 2019–20 Influenza Season. https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.htm. Published 2020. Accessed April 11, 2021.

        • Betsch C
        • Böhm R
        • Chapman GB.
        Using Behavioral Insights to Increase Vaccination Policy Effectiveness.
        Policy Insights from the Behavioral and Brain Sciences. 2015; 2: 61-73
        • NEM Sarah Lane
        • Marti Melanie
        • Dumolard Laure
        Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015–2017.
        Vaccine. 2018; 36: 3861-3867
      5. World Health Organization. Report of the SAGE Working Group on Vaccine Hesitancy. 2014.

        • Haselton MG
        • Nettle D
        • Andrews PW.
        The Evolution of Cognitive Bias.
        The handbook of evolutionary psychology. John Wiley & Sons, Inc., Hoboken, NJ, US2005: 724-746
        • Kahneman D
        • Tversky A.
        Subjective Probability - Judgment of Representativeness.
        Cognitive Psychol. 1972; 3: 430-454
        • Nickerson RS.
        Confirmation Bias: A Ubiquitous Phenomenon in Many Guises.
        Review of General Psychology. 1998; 2: 175-220
        • Esgate AG
        • David
        An Introduction to Applied Cognitive Pscyhology.
        Psychology Press, 2005
        • Niccolai LM
        • Pettigrew MM.
        The Role of Cognitive Bias in Suboptimal HPV Vaccine Uptake.
        Pediatrics. 2016; 138e20161537
        • Hansen CE
        • North A
        • Niccolai LM.
        Cognitive Bias in Clinicians’ Communication about Human Papillomavirus Vaccination.
        Health Communication. 2020; 35: 430-437
        • Voinson M
        • Billiard S
        • Alvergne A.
        Correction: Beyond Rational Decision-Making: Modelling the Influence of Cognitive Biases on the Dynamics of Vaccination Coverage.
        PLoS One. 2016; 11e0167842
        • Chen F
        • Stevens R.
        Applying lessons from behavioral economics to increase flu vaccination rates.
        Health Promotion International. 2016; 32: 1067-1073
        • Benartzi S
        • Thaler RH.
        Behavioral Economics and the Retirement Savings Crisis.
        Science. 2013; 339: 1152-1153
        • Johnson EJ
        • Medicine Goldstein D.
        Do defaults save lives?.
        Science. 2003; 302: 1338-1339
        • Chapman GB
        • Li M
        • Colby H
        • Yoon H.
        Opting In vs Opting Out of Influenza Vaccination.
        JAMA. 2010; 304: 43-44
        • Kim RH
        • Day SC
        • Small DS
        • Snider CK
        • Rareshide CAL
        • Patel MS.
        Variations in Influenza Vaccination by Clinic Appointment Time and an Active Choice Intervention in the Electronic Health Record to Increase Influenza Vaccination.
        JAMA Network Open. 2018; 1 (–e181770)e181770
        • Patel MS
        • Volpp KG
        • Small DS
        • et al.
        Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates.
        Journal of General Internal Medicine. 2017; 32: 790-795
        • Caskey R
        • Sherman EG
        • Beskin K
        • Rapport R
        • Xia Y
        • Schwartz A.
        A Behavioral Economic Approach to Improving Human Papillomavirus Vaccination.
        J Adolesc Health. 2017; 61: 755-760
      6. United Healthcare. Rally. https://www.uhc.com/member-resources/health-care-programs/rally. Accessed 2021, July 1.

      7. Anthem BCBS. Employee Health & Wellness Programs. https://www.uhc.com/member-resources/health-care-programs/rally. Accessed 2021, July 1.

        • Pardi N
        • Hogan MJ
        • Porter FW
        • Weissman D.
        mRNA vaccines — a new era in vaccinology.
        Nature Reviews Drug Discovery. 2018; 17: 261-279
      8. U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws#D. Published 2021. Accessed July 1, 2021.

      9. Sumermarket News. Kroger offers workers $100 payment to get COVID-19 vaccination. https://www.supermarketnews.com/issues-trends/kroger-offers-workers-100-payment-get-covid-19-vaccination. Published 2021. Accessed.

      10. Illinois General Assembly. Bill Status of SB0104 Hospitality-Pandemic Recovery. https://ilga.gov/legislation/BillStatus.asp?DocTypeID=SB&DocNum=104&GAID=16&SessionID=110&LegID=128650. Published 2021. Accessed July 1, 2021.

      11. Krispy Kreme. COVID-19 VACCINE OFFER. https://www.krispykreme.com/promos/vaccineoffer. Accessed July 1, 2021.