Dr. Abhijit Banerjee on November 16, 2012 in New Delhi, India. Banerjee was awarded the Nobel Prize in economics in 2019 along with his wife Esther Duflo and Harvard professor Michael Kremer for their research on how to alleviate poverty, which has revolutionized the field of development economics. Arijit Sen/Hindustan Times via Getty Images
Nobel laureate Abhijit Banerjee has studied what motivates vaccine-hesitant people to change their minds.
He’s found that most people don’t have “strong ideological views,” rather, they just need some time to get comfortable with new vaccines, and to hear about the benefits from people they know and trust.
“My worry, actually, is that people eventually will be persuaded to take the first dose, but then they’ll think they’re immune and forget to take the second dose,” Banerjee told Insider.
He thinks $10 gift cards, or lottery tickets, could help people remember to come back for shot number two.
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Nobel laureate Abhijit Banerjee has heard all the dismal poll numbers, suggesting roughly a third of Americans aren’t ready to take a COVID-19 vaccine.
But he remains convinced that’s no reason to panic, or to worry that the country won’t reach herd immunity.
Banerjee, who won the 2019 Nobel Prize in economics, along with his wife Esther Duflo and their colleague Michael Kremer, pioneered a brand of more precise, useful experiments, that have revolutionized the field of economics, by studying what actually works, when it comes to helping lift people out of poverty. His methods, which often tackle questions related to education and health, have even been applied to vaccination campaigns, with some telling results.
Banerjee says his own research, coupled with other compelling findings from around the world, are what give him reason to dismiss lukewarm appetites for COVID-19 vaccination right now. He doesn’t think that any strong, hard-set ideological views against vaccines are what’s driving the hesitation.
“The whole thing is new, and that’s both the promise, and the source of some fear,” he told Insider, saying some amount of vaccine hesitation is perfectly understandable, at this juncture, with Pfizer and Moderna’s new mRNA vaccines.
“It’s also very abstract right now, nobody they know has taken it.”
Here are the two strategies he (and evidence) suggests can really work to change the game in the coming months, for most people who don’t yet want to get vaccines:
Peer pressure is real, and it works pretty well for vaccinesThe UK National Health Service at work in Portsmouth, where mobile immunization vans like this one helped reduced the risk of diphtheria cases from 776 twenty years prior to 1 in 1950. Doctors gave more than 37,000 various injections. Popperfoto/Getty Images
With any new technology, there are going to be the early adopters, and then there are others who will wait and see how it goes. Banerjee expects this phenomenon to play out no differently, when it comes to COVID-19 vaccines.
“There will be a round of people who are already vulnerable for one reason or another, or who are just more optimistic about vaccines, who will take it first,” he said. “And then we’ll see the next round of people who will then see that their friends have taken it, and see them going out without feeling scared and all that, and feel jealous about it, and take it.”
This kind of peer pressure isn’t just something that happens in the schoolyard, and it isn’t necessarily a bad thing. Such “peer effects,” as Banerjee calls them, have been widely documented in studies around the world, for everything from adoption of novel farming techniques, to uptake of new forms of contraception.
“The feedback loop from some people taking it to other people taking it is always a critical part of adoption of new, general technologies,” he said. “There are people who will wait until others take it, before taking it.”
Banerjee says that once vaccine-hesitant people see others taking Pfizer and Moderna’s shots are doing fine, they’ll feel much more comfortable, and even eager, to get their own vaccines.
Evidence suggests he’s right, and that this mind-changing phenomenon is already well underway in the US. A Pew Research Center poll conducted in November (after drug companies had submitted their data on how well their shots worked, but before people started getting vaccinated) suggests more and more Americans are readying to roll up their sleeves, in the face of more information about how well these new shots work.
According to the Pew poll, 60% of people across the US said they’d “definitely” or “probably” get a vaccine, if one was made available to them right now, a steep 9 percentage point rise from the 51% of poll respondents who said the same thing in September. Among those who still said they’re unlikely to get a vaccine, half agreed they might be willing to change their minds, once more information becomes available, or, once other people go ahead of them and try out the vaccines first.
Getting people out ‘spreading the word’ helps, tooDr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, prepares to receive his first dose of a COVID-19 vaccine at the National Institutes of Health on December 22, 2020 in Bethesda, Maryland. Patrick Semansky-Pool/Getty Images
Aside from the peer pressure technique, Banerjee’s studies of successful childhood vaccination campaigns in India suggest that “one of the things that seems to also be influential is having people spreading the word.”
He says that such “agents of change” are generally “someone who’s very chatty” in the community, and makes it their business to let others know the vaccines are coming, and they should go ahead and get in line, by “saying, ‘you know, everybody’s doing it’.”
In the US, these chatty agents of change may turn out to be our own doctors, nurses, esteemed health experts, community leaders, friends, and family. In general, they should be people that individuals already know and trust well, not just figureheads on TV.
“Just to have someone who you know come and tell you ‘look, you might as well do it,'” Banerjee said, can be a great motivator.
His own vaccination studies have found that this nudging strategy “works as well as giving people a non-trivial incentive,” like a bit of food, or some money.
National vaccination campaigns, like the ones that the Ad Council is working on, and advice from celebrities or vaccine pros on Instagram can likely help sway crowds too, but they have to be done right.
“I think the messaging is going to be quite important to design it right, so that it doesn’t feel somehow too hectoring, too top-down,” Banerjee said. “If the messages are sympathetic and not too hectoring, I think people will respond.”
Small gifts would be a good way to get people to remember to take their second vaccine doseNobel laureate Abhijit Banerjee at South Club on January 27, 2020 in Kolkata, India. Samir Jana/Hindustan Times via Getty Images
In the end, Banerjee’s greatest concern isn’t whether people will trust the vaccines. It’s that they will forget to take them.
“My worry, actually, is that people eventually will be persuaded to take the first dose, but then they’ll think they’re immune and forget to take the second dose,” he said. “This is a peculiar vaccine in the sense that it is a double-dose vaccine.”
Pfizer and Moderna’s vaccines are both taken as two shots in the arm, given three (for Pfizer) to four (for Moderna) weeks apart.
“I think one of the problems we’ll have to start thinking about quickly is how to get people to take the second dose,” he said.
In the US, he suggested $10 might be enough to get most people coming back in for shot number two.
“People like gift cards,” he said, suggesting one strategy could be a $10 gift card in exchange for a second shot. “People like lottery tickets. You can choose between a [$10] gift card, and 10 tickets to the lottery, or something like that.”
It’s a strategy he’s already seen work well in practice. In India, he was told by local experts that a certain segment of the population would not get their children vaccinated, because of their deep beliefs against vaccines. Yet when people were offered a kilogram of dry lentils in exchange for bringing their kids in for vaccination, rates went up.
“I’m less convinced that everybody has strong ideological views,” he recently told journalists at the National Press Foundation. “A lot of people just don’t do it because they don’t do it.”
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