COVID-19 vaccination: intentions are not enough

In this Insights paper, we recognise that medical science has stunningly developed the COVID-19 vaccine in record-breaking time. We now need to leverage the science of human behaviour to deliver the vaccine to at least 65% of the Australian population.

Inside this challenge, three distinct groups have been identified from independent research:

science of human behaviour

While this research reveals 80% of Australians expressed positive intentions to get the jab, there should be no assumption that this figure translates to rolling-up the sleeves to receive it. Even for those whose intentions are secure, there remains the fact that people’s intentions are only translated into action about half the time (Sheeran & Webb, 2016).

Important to government health authorities, is that there will be many reasons why some people won’t act on their intentions – behavioural scientists call this the intention-action gap.

Intention-action gap

We have every intention of doing something with the knowledge and understanding of why to back it up, yet somehow it never happens.

Failing to close this gap for Australia’s COVID-19 vaccine program will be socially and economically damaging at the very least, and fatal at worst.

The key message here is that we cannot take those who hold pro-vaccination intentions for granted. A separate strategy must be developed to tackle this group, which we discuss below.

How can governments address the intention-action gap?

There are many successful case studies around the world where a behaviourally-informed approach has helped to close the intention-action gap on critical one-off behaviours, such as voting, organ donation, and the flu vaccination. A key insight from these cases is that solutions to these challenges is not so much about creating greater awareness, but it’s about facilitating action.

A proven solution is to identify barriers to action, and develop targeted behavioural strategies to address them.  Drawing on practice, there are two common types of behavioural barriers:

behavioural barriers

By identifying, monitoring and mapping these different barriers, health authorities and vaccination service providers can develop behavioural interventions specifically targeting those mitigating factors.

The below tables lists several examples:

behavioural interventions

“Spending as little as ten minutes on an anti-vaccination website can influence vaccine hesitancy, demonstrating the powerful impact exposure to misinformation can have on some people.”

Strategies

When designing actionable strategies to address each barrier, it’s critical that they are grounded in behavioural insights and informed by local evidence. The following table is a simple snapshot of mapping and bridging the intention-action gap with targeted strategies:

COVID19 vaccination: behavioural strategy

COVID19 vaccination" behavioural interventions mock-up texts

 

Testing

It is paramount that health authorities conduct rapid experiments on what interventions work to close the intention-action gap – especially for the second dose. The staged roll-out of the vaccine over several months should provide opportunities to test efforts and importantly, share evidence with neighbouring jurisdictions on which approaches worked and which do not. Like the vaccine itself, any solutions used to tackle the gap must be tested to create the confidence in scaling-up. We cannot afford to waste time and resources on strategies that won’t be effective at driving the necessary vaccinations to reach herd immunity.

In summary, it is vital that the gap between vaccination intention and people actually rolling-up their sleeves is addressed as part of the overall uptake strategy. We need to go beyond the traditional approach of providing more vaccination information and education campaigns.

Applying a behavioural insights lens to address the physical and internal barriers, will allow health authorities, employers, and vaccination service providers to design actionable and effective interventions that will boost vaccine uptake.

If you would like to discuss any part of this article, or are interested in engaging with us, please contact us.

Author: Elisabeth Spits – Behavioural Strategist
E: espits@phillipsgroup.com.au 
M: 0402 792 264