‘Nudging’ Patients Increase Vaccination Rates

The reason most people don’t get their vaccinations isn’t due to ‘fake anti-vax news’, says a new study.

The primary reason for people being under-vaccinated is perceived inconveniences or obstacles.

And these researchers says the best tactic healthcare providers can deploy to increase vaccination rates are indirect behavioral nudges.

This means healthcare providers should ‘just-say-it.’

This new report examined the psychological principles as applied to understanding and increasing vaccination coverage.

But, the success of vaccination programs has left people largely unaware of, and unconcerned about, diseases they have never seen and heard little about.

Which means, the public-health benefits are established or threatened by the behavior of individuals. Psychology offers insight into why people engage in health behaviors, including vaccination.

As an example in this study, doctors could increase vaccination rates simply by limiting their discussion to brief, assertive statements.

The more time doctors spent talking about the vaccination, the study found, the more suspicious and worried the parents became about the vaccine.

But when the doctors made short statements that present vaccinations as routine, vaccine rates increased.

In this study, 38 percent of adolescent boys received a human papillomavirus (HPV) vaccine if their parents received a provider recommendation, but only 2% received the vaccine if the parents did not receive a recommendation.

In another study, a company that prompted its employees to name the date when they would get their next flu shot saw vaccinations rise by 1.5 percent.

But, when employees who received a more specific prompt to write down both a date and a time, they had a 4.2 percentage point higher vaccination rate.

Which is a difference that is both statistically significant and of meaningful magnitude.

"Four percent may not mean that much, but in the world of vaccinations, it can be huge," Noel Brewer, PhD, a professor in the department of health behavior at University of North Carolina Gillings School of Global Public Health in Chapel Hill and the study's lead author, told The Washington Post.

The impact of vaccines on society is enormous.

According to the U.S. Centers for Disease Control and Prevention (CDC), vaccines have saved $295 billion in direct costs, such as medical expenses, and a total of more than $1.3 trillion in societal costs, because children who were spared from sometimes-devastating illnesses will be able to contribute to society.

"When it comes to vaccines, I think we have this optimistic belief that just by telling people facts you can change their behavior.”

The impact of provider recommendation was found to be true across all vaccines studied.  

This research study said Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable.

• The first proposition is that thoughts and feelings can motivate getting vaccinated.
• The second proposition is that social processes can motivate getting vaccinated.
• The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel.

Although identification of principles for changing thoughts and feelings to motivate vaccination is a work in progress, these researchers conclude that the most effective method for facilitating vaccination was for a healthcare provider to intervene on the patient’s behavior directly.

Rather than attempting to change what people think and feel or their social context.