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Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

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Are you looking to write a persuasive essay about the Covid-19 pandemic?

Writing a compelling and informative essay about this global crisis can be challenging. It requires researching the latest information, understanding the facts, and presenting your argument persuasively.

But don’t worry! with some guidance from experts, you’ll be able to write an effective and persuasive essay about Covid-19.

In this blog post, we’ll outline the basics of writing a persuasive essay . We’ll provide clear examples, helpful tips, and essential information for crafting your own persuasive piece on Covid-19.

Read on to get started on your essay.

• 1. Steps to Write a Persuasive Essay About Covid-19
• 2. Examples of Persuasive Essay About COVID-19
• 3. Examples of Persuasive Essay About COVID-19 Vaccine
• 4. Examples of Persuasive Essay About COVID-19 Integration
• 5. Examples of Argumentative Essay About Covid 19
• 6. Examples of Persuasive Speeches About Covid-19
• 7. Tips to Write a Persuasive Essay About Covid-19
• 8. Common Topics for a Persuasive Essay on COVID-19 

Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

• COVID-19 vaccination effectiveness data
• Information on vaccine mandates in different countries
• Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

• Introduction
• Background Information
• Body Paragraphs (with supporting evidence)
• Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences , evidence, and analysis. Here's an example:

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About COVID-19

When writing a persuasive essay about the COVID-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Here is another example explaining How COVID-19 has changed our lives essay:

Let’s look at another sample essay:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

If you're in search of a compelling persuasive essay on business, don't miss out on our “ persuasive essay about business ” blog!

Examples of Persuasive Essay About COVID-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of COVID-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the COVID-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

Interested in thought-provoking discussions on abortion? Read our persuasive essay about abortion blog to eplore arguments!

Examples of Persuasive Essay About COVID-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get an idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively. 

Here are some tips to help you craft a compelling persuasive essay on this topic:

• Choose a Specific Angle: Narrow your focus to a specific aspect of COVID-19, like vaccination or public health measures.
• Provide Credible Sources: Support your arguments with reliable sources like scientific studies and government reports.
• Use Persuasive Language: Employ ethos, pathos, and logos , and use vivid examples to make your points relatable.
• Organize Your Essay: Create a solid persuasive essay outline and ensure a logical flow, with each paragraph focusing on a single point.
• Emphasize Benefits: Highlight how your suggestions can improve public health, safety, or well-being.
• Use Visuals: Incorporate graphs, charts, and statistics to reinforce your arguments.
• Call to Action: End your essay conclusion with a strong call to action, encouraging readers to take a specific step.
• Revise and Edit: Proofread for grammar, spelling, and clarity, ensuring smooth writing flow.
• Seek Feedback: Have someone else review your essay for valuable insights and improvements.

Tough Essay Due? Hire Tough Writers!

Common Topics for a Persuasive Essay on COVID-19 

Here are some persuasive essay topics on COVID-19:

• The Importance of Vaccination Mandates for COVID-19 Control
• Balancing Public Health and Personal Freedom During a Pandemic
• The Economic Impact of Lockdowns vs. Public Health Benefits
• The Role of Misinformation in Fueling Vaccine Hesitancy
• Remote Learning vs. In-Person Education: What's Best for Students?
• The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
• The Mental Health Crisis Amidst the COVID-19 Pandemic
• The Long-Term Effects of COVID-19 on Healthcare Systems
• Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
• The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

If you need professional writing help, don't worry! We've got that for you as well.

MyPerfectWords.com is a professional persuasive essay writing service that can help you craft an excellent persuasive essay on Covid-19. Our experienced essay writer will create a well-structured, insightful paper in no time!

So don't hesitate and place your ' write my essay online ' request today!

Frequently Asked Questions

What is a good title for a covid-19 essay.

A good title for a COVID-19 essay should be clear, engaging, and reflective of the essay's content. Examples include:

• "The Impact of COVID-19 on Global Health"
• "How COVID-19 Has Transformed Our Daily Lives"
• "COVID-19: Lessons Learned and Future Implications"

How do I write an informative essay about COVID-19?

To write an informative essay about COVID-19, follow these steps:

• Choose a specific focus: Select a particular aspect of COVID-19, such as its transmission, symptoms, or vaccines.
• Research thoroughly: Gather information from credible sources like scientific journals and official health organizations.
• Organize your content: Structure your essay with an introduction, body paragraphs, and a conclusion.
• Present facts clearly: Use clear, concise language to convey information accurately.
• Include visuals: Use charts or graphs to illustrate data and make your essay more engaging.

How do I write an expository essay about COVID-19?

To write an expository essay about COVID-19, follow these steps:

• Select a clear topic: Focus on a specific question or issue related to COVID-19.
• Conduct thorough research: Use reliable sources to gather information.
• Create an outline: Organize your essay with an introduction, body paragraphs, and a conclusion.
• Explain the topic: Use facts and examples to explain the chosen aspect of COVID-19 in detail.
• Maintain objectivity: Present information in a neutral and unbiased manner.
• Edit and revise: Proofread your essay for clarity, coherence, and accuracy.

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To what extent do you support or oppose the governments' mandatory vaccination policies against the Covid-19 pandemic?

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Should COVID-19 vaccines be mandatory? Two experts discuss

Senior Research Fellow, Oxford Uehiro Centre for Practical Ethics, University of Oxford

NIHR Academic Clinical Fellow in Public Health Medicine, UCL

Disclosure statement

Alberto Giubilini receives funding from the Arts and Humanities Research Council/UK Research and Innovation (AHRC/UKRI) and has previously received funding from the Wellcome Trust.

Vageesh Jain is affiliated with Public Health England under an honorary contract as a speciality registrar.

University College London provides funding as a founding partner of The Conversation UK.

University of Oxford provides funding as a member of The Conversation UK.

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To be properly protective, COVID-19 vaccines need to be given to most people worldwide. Only through widespread vaccination will we reach herd immunity – where enough people are immune to stop the disease from spreading freely. To achieve this, some have suggested vaccines should be made compulsory , though the UK government has ruled this out . But with high rates of COVID-19 vaccine hesitancy in the UK and elsewhere , is this the right call? Here, two experts to make the case for and against mandatory COVID-19 vaccines.

Alberto Giubilini, Senior Research Fellow, Oxford Uehiro Centre for Practical Ethics, University of Oxford

COVID-19 vaccination should be mandatory – at least for certain groups. This means there would be penalties for failure to vaccinate, such as fines or limitations on freedom of movement.

The less burdensome it is for an individual to do something that prevents harm to others, and the greater the harm prevented, the stronger the ethical reason for mandating it.

Being vaccinated dramatically reduces the risk of seriously harming or killing others. Vaccines such as the Pfizer , AstraZeneca or Moderna ones with 90-95% efficacy at preventing people from getting sick are also likely to be effective at stopping the virus from spreading, though possibly to a lower degree. Such benefits would come at a very minimal cost to individuals.

Lockdown is mandatory. Exactly like mandatory vaccination, it protects vulnerable people from COVID-19. But, as I have argued in detail elsewhere, unlike mandatory vaccination, lockdown entails very large individual and societal costs. It is inconsistent to accept mandatory lockdown but reject mandatory vaccination. The latter can achieve a much greater good at a much smaller cost.

Also, mandatory vaccination ensures that the risks and burdens of reaching herd immunity are distributed evenly across the population. Because herd immunity benefits society collectively, it’s only fair that the responsibility of reaching it is shared evenly among society’s individual members.

Of course, we might achieve herd immunity through less restrictive alternatives than making vaccination mandatory – such as information campaigns to encourage people to be vaccinated. But even if we reach herd immunity, the higher the uptake of vaccines, the lower the risk of falling below the herd immunity threshold at a later time. We should do everything we can to prevent that emergency from happening – especially when the cost of doing so is low.

Fostering trust and driving uptake by making people more informed is a nice narrative, but it’s risky. Merely giving people information on vaccines does not always result in increased willingness to vaccinate and might actually lower confidence in vaccines. On the other hand, we’ve seen mandatory vaccination policies in Italy recently successfully boost vaccine uptake for other diseases.

Mandatory seatbelt policies have proven very successful in reducing deaths from car accidents, and are now widely endorsed despite the (very small) risks that seatbelts entail. We should see vaccines as seatbelts against COVID-19. In fact, as very special seatbelts, which protect ourselves and protect others.

Vageesh Jain, NIHR Academic Clinical Fellow in Public Health Medicine, UCL

Mandatory vaccination does not automatically increase vaccine uptake. An EU-funded project on epidemics and pandemics, which took place several years before COVID-19, found no evidence to support this notion. Looking at Baltic and Scandinavian countries, the project’s report noted that countries “where a vaccination is mandatory do not usually reach better coverage than neighbour or similar countries where there is no legal obligation”.

According to the Nuffield Council of Bioethics, mandatory vaccination may be justified for highly contagious and serious diseases. But although contagious, Public Health England does not classify COVID-19 as a high-consequence infectious disease due to its relatively low case fatality rate.

COVID-19 severity is strongly linked with age, dividing individual perceptions of vulnerability within populations. The death rate is estimated at 7.8% in people aged over 80, but at just 0.0016% in children aged nine and under. In a liberal democracy, forcing the vaccination of millions of young and healthy citizens who perceive themselves to be at an acceptably low risk from COVID-19 will be ethically disputed and is politically risky.

Public apprehensions for a novel vaccine produced at breakneck speed are wholly legitimate. A UK survey of 70,000 people found 49% were “very likely” to get a COVID-19 vaccine once available. US surveys are similar . This is not because the majority are anti-vaxxers.

Despite promising headlines, the trials and pharmaceutical processes surrounding them have not yet been scrutinised. With the first trials only beginning in April , there is limited data on long-term safety and efficacy. We don’t know how long immunity lasts for. None of the trials were designed to tell us if the vaccine prevents serious disease or virus transmission.

To disregard these ubiquitous concerns would be counterproductive. As a tool for combating anti-vaxxers – estimated at around 58 million globally and making up a small minority of those not getting vaccinated – mandatory vaccines are also problematic. The forces driving scientific and political populism are the same . Anti-vaxxers do not trust experts, industry and especially not the government. A government mandate will not just be met with unshakeable defiance, but will also be weaponised to recruit others to the anti-vaxxer cause.

In the early 1990s, polio was endemic in India , with between 500 and 1,000 children getting paralysed daily. By 2011, the virus was eliminated. This was not achieved through legislation. It was down to a consolidated effort to involve communities, target high-need groups, understand concerns, inform, educate, remove barriers, invest in local delivery systems and link with political and religious leaders.

Mandatory vaccination is rarely justified. The successful roll-out of novel COVID-19 vaccines will require time, communication and trust. We have come too far, too fast, to lose our nerve now.

• Mandatory vaccination
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• Published: 14 May 2021

Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation

• Sarah Kreps 1 ,
• Nabarun Dasgupta 2 ,
• John S. Brownstein 3 , 4 ,
• Yulin Hswen 5 &
• Douglas L. Kriner   ORCID: orcid.org/0000-0002-9353-2334 1  

npj Vaccines volume  6 , Article number:  73 ( 2021 ) Cite this article

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While efficacious vaccines have been developed to inoculate against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; also known as COVID-19), public vaccine hesitancy could still undermine efforts to combat the pandemic. Employing a survey of 1096 adult Americans recruited via the Lucid platform, we examined the relationships between vaccine attributes, proposed policy interventions such as financial incentives, and misinformation on public vaccination preferences. Higher degrees of vaccine efficacy significantly increased individuals’ willingness to receive a COVID-19 vaccine, while a high incidence of minor side effects, a co-pay, and Emergency Use Authorization to fast-track the vaccine decreased willingness. The vaccine manufacturer had no influence on public willingness to vaccinate. We also found no evidence that belief in misinformation about COVID-19 treatments was positively associated with vaccine hesitancy. The findings have implications for public health strategies intending to increase levels of community vaccination.

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Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA

Vaccine hesitancy and monetary incentives

Providing normative information increases intentions to accept a COVID-19 vaccine

Introduction.

In less than a year, an array of vaccines was developed to bring an end to the SARS-CoV-2 pandemic. As impressive as the speed of development was the efficacy of vaccines such as Moderna and Pfizer, which are over 90%. Despite the growing availability and efficacy, however, vaccine hesitancy remains a potential impediment to widespread community uptake. While previous surveys indicate that overall levels of vaccine acceptance may be around 70% in the United States 1 , the case of Israel may offer a cautionary tale about self-reported preferences and vaccination in practice. Prospective studies 2 of vaccine acceptance in Israel showed that about 75% of the Israeli population would vaccinate, but Israel’s initial vaccination surge stalled around 42%. The government, which then augmented its vaccination efforts with incentive programs, attributed unexpected resistance to online misinformation 3 .

Research on vaccine hesitancy in the context of viruses such as influenza and measles, mumps, and rubella, suggests that misinformation surrounding vaccines is prevalent 4 , 5 . Emerging research on COVID-19 vaccine preferences, however, points to vaccine attributes as dominant determinants of attitudes toward vaccination. Higher efficacy is associated with greater likelihood of vaccinating 6 , 7 , whereas an FDA Emergency Use Authorization 6 or politicized approval timing 8 is associated with more hesitancy. Whether COVID-19 misinformation contributes to vaccine preferences or whether these attributes or policy interventions such as incentives play a larger role has not been studied. Further, while previous research has focused on a set of attributes that was relevant at one particular point in time, the evidence and context about the available vaccines has continued to shift in ways that could shape public willingness to accept the vaccine. For example, governments, employers, and economists have begun to think about or even devise ways to incentivize monetarily COVID-19 vaccine uptake, but researchers have not yet studied whether paying people to receive the COVID-19 vaccine would actually affect likely behavior. As supply problems wane and hesitancy becomes a limiting factor, understanding whether financial incentives can overcome hesitancy becomes a crucial question for public health. Further, as new vaccines such as Johnson and Johnson are authorized, knowing whether the vaccine manufacturer name elicits or deters interest in individuals is also important, as are the corresponding efficacy rates of different vaccines and the extent to which those affect vaccine preferences. The purpose of this study is to examine how information about vaccine attributes such as efficacy rates, the incidence of side effects, the nature of the governmental approval process, identity of the manufacturers, and policy interventions, including economic incentives, affect intention to vaccinate, and to examine the association between belief in an important category of misinformation—false claims concerning COVID-19 treatments—and willingness to vaccinate.

General characteristics of study population

Table 1 presents sample demographics, which largely reflect those of the US population as a whole. Of the 1335 US adults recruited for the study, a convenience sample of 1100 participants consented to begin the survey, and 1096 completed the full questionnaire. The sample was 51% female; 75% white; and had a median age of 43 with an interquartile range of 31–58. Comparisons of the sample demographics to those of other prominent social science surveys and U.S. Census figures are shown in Supplementary Table 1 .

Vaccination preferences

Each subject was asked to evaluate a series of seven hypothetical vaccines. For each hypothetical vaccine, our conjoint experiment randomly assigned values of five different vaccine attributes—efficacy, the incidence of minor side effects, government approval process, manufacturer, and cost/financial inducement. Descriptions of each attribute and the specific levels used in the experiment are summarized in Table 2 . After seeing the profile of each vaccine, the subject was asked whether she would choose to receive the vaccine described, or whether she would choose not to be vaccinated. Finally, subjects were asked to indicate how likely they would be to take the vaccine on a seven-point likert scale.

Across all choice sets, in 4419 cases (58%) subjects said they would choose the vaccine described in the profile rather than not being vaccinated. As shown in Fig. 1 , several characteristics of the vaccine significantly influenced willingness to vaccinate.

Circles present the estimated effect of each attribute level on the probability of a subject accepting vaccination from the attribute’s baseline level. Horizontal lines through points indicate 95% confidence intervals. Points without error bars denote the baseline value for each attribute. The average marginal component effects (AMCEs) are the regression coefficients reported in model 1 of Table 3 .

Efficacy had the largest effect on individual vaccine preferences. An efficacy rate of 90% increased uptake by about 20% relative to the baseline at 50% efficacy. Even a high incidence of minor side effects (1 in 2) had only a modest negative effect (about 5%) on willingness to vaccinate. Whether the vaccine went through full FDA approval or received an Emergency Use Authorization (EUA), an authority that allows the Food and Drug Administration mechanisms to accelerate the availability and use of treatments or medicines during medical emergencies 9 , significantly influenced willingness to vaccinate. An EUA decreased the likelihood of vaccination by 7% compared to a full FDA authorization; such a decline would translate into about 23 million Americans. While a $20 co-pay reduced the likelihood of vaccination relative to a no-cost baseline, financial incentives did not increase willingness to vaccinate. Lastly, the manufacturer had no effect on vaccination attitudes, despite the public pause of the AstraZeneca trial and prominence of Johnson & Johnson as a household name (our experiment was fielded before the pause in the administration of the Johnson & Johnson shot in the United States).

Model 2 of Table 3 presents an expanded model specification to investigate the association between misinformation and willingness to vaccinate. The primary additional independent variable of interest is a misinformation index that captures the extent to which each subject believes or rejects eight claims (five false; three true) about COVID-19 treatments. Additional analyses using alternate operationalizations of the misinformation index yield substantively similar results (Supplementary Table 4 ). This model also includes a number of demographic control variables, including indicators for political partisanship, gender, educational attainment, age, and race/ethnicity, all of which are also associated with belief in misinformation about the vaccine (Supplementary Table 2 ). Finally, the model also controls for subjects’ health insurance status, past experience vaccinating against seasonal influenza, attitudes toward the pharmaceutical industry, and beliefs about vaccine safety generally.

Greater levels of belief in misinformation about COVID-19 treatments were not associated with greater vaccine hesitancy. Instead, the relevant coefficient is positive and statistically significant, indicating that, all else being equal, individuals who scored higher on our index of misinformation about COVID-19 treatments were more willing to vaccinate than those who were less susceptible to believing false claims.

Strong beliefs that vaccines are safe generally was positively associated with willingness to accept a COVID-19 vaccine, as were past histories of frequent influenza vaccination and favorable attitudes toward the pharmaceutical industry. Women and older subjects were significantly less likely to report willingness to vaccinate than men and younger subjects, all else equal. Education was positively associated with willingness to vaccinate.

This research offers a comprehensive examination of attitudes toward COVID-19 vaccination, particularly the role of vaccine attributes, potential policy interventions, and misinformation. Several previous studies have analyzed the effects of vaccine characteristics on willingness to vaccinate, but the modal approach is to gauge willingness to accept a generic COVID-19 vaccine 10 , 11 . Large volumes of research show, however, that vaccine preferences hinge on specific vaccine attributes. Recent research considering the influence of attributes such as efficacy, side effects, and country of origin take a step toward understanding how properties affect individuals’ intentions to vaccinate 6 , 7 , 8 , 12 , 13 , but evidence about the attributes of actual vaccines, debates about how to promote vaccination within the population, and questions about the influence of misinformation have moved quickly 14 .

Our conjoint experiment therefore examined the influence of five vaccine attributes on vaccination willingness. The first category of attributes involved aspects of the vaccine itself. Since efficacy is one of the most common determinants of vaccine acceptance, we considered different levels of efficacy, 50%, 70%, and 90%, levels that are common in the literature 7 , 15 . Evidence from Phase III trials suggests that even the 90% efficacy level in our design, which is well above the 50% threshold from the FDA Guidance for minimal effectiveness for Emergency Use Authorization 16 , has been exceeded by both Pfizer’s and Moderna’s vaccines 17 , 18 . The 70% efficacy threshold is closer to the initial reports of the efficacy of the Johnson & Johnson vaccine, whose efficacy varied across regions 19 . Our analysis suggests that efficacy levels associated with recent mRNA vaccine trials increases public vaccine uptake by 20% over a baseline of a vaccine with 50% efficacy. A 70% efficacy rate increases public willingness to vaccinate by 13% over a baseline vaccine with 50% efficacy.

An additional set of epidemiological attributes consisted of the frequency of minor side effects. While severe side effects were plausible going into early clinical trials, evidence clearly suggests that minor side effects are more common, ranging from 10% to 100% of people vaccinated depending on the number of doses and the dose group (25–250 mcg) 20 . Since the 100 mcg dose was supported in Phase III trials 21 , we include the highest adverse event probability—approximating 60% as 1 in 2—and 1 in 10 as the lowest likelihood, approximating the number of people who experienced mild arthralgia 20 . Our findings suggest that a the prevalence of minor side effects associated with recent trials (i.e. a 1 in 2 chance), intention to vaccinate decreased by about 5% versus a 1 in 10 chance of minor side effects baseline. However, at a 25% rate of minor side effects, respondents did not indicate any lower likelihood of vaccination compared to the 10% baseline. Public communications about how to reduce well-known side effects, such as pain at the injection site, could contribute to improved acceptance of the vaccine, as it is unlikely that development of vaccine-related minor side effects will change.

We then considered the effect of EUA versus full FDA approval. The influenza H1N1 virus brought the process of EUA into public discourse 22 , and the COVID-19 virus has again raised the debate about whether and how to use EUA. Compared to recent studies also employing conjoint experimental designs that showed just a 3% decline in support conditional on EUA 6 , we found decreases in support of more than twice that with an EUA compared to full FDA approval. Statements made by the Trump administration promising an intensely rapid roll-out or isolated adverse events from vaccination in the UK may have exacerbated concerns about EUA versus full approval 8 , 23 , 24 , 25 . This negative effect is even greater among some subsets of the population. As shown in additional analyses reported in the Supplementary Information (Supplementary Fig. 5 ), the negative effects are greatest among those who believe vaccines are generally safe. Among those who believe vaccines generally are extremely safe, the EUA decreased willingness to vaccinate by 11%, all else equal. This suggests that outreach campaigns seeking to assure those troubled by the authorization process used for currently available vaccines should target their efforts on those who are generally predisposed to believe vaccines are safe.

Next, we compared receptiveness as a function of the manufacturer: Moderna, Pfizer, Johnson and Johnson, and AstraZeneca, all firms at advanced stages of vaccine development. Vaccine manufacturers in the US have not yet attempted to use trade names to differentiate their vaccines, instead relying on the association with manufacturer reputation. In other countries, vaccine brand names have been more intentionally publicized, such as Bharat Biotech’s Covaxin in India and Gamaleya Research Institute of Epidemiology and Microbiology Sputnik V in Russia. We found that manufacturer names had no impact on willingness to vaccinate. As with hepatitis and H. influenzae vaccines 26 , 27 , interchangeability has been an active topic of debate with coronavirus mRNA vaccines which require a second shot for full immunity. Our research suggests that at least as far as public receptiveness goes, interchangeability would not introduce concerns. We found no significant differences in vaccination uptake across any of the manufacturer treatments. Future research should investigate if a manufacturer preference develops as new evidence about efficacy and side effects becomes available, particularly depending on whether future booster shots, if needed, are deemed interchangeable with the initial vaccination.

Taking up the question of how cost and financial incentives shape behavior, we looked at paying and being paid to vaccinate. While existing research suggests that individuals are often willing to pay for vaccines 28 , 29 , some economists have proposed that the government pay individuals up to $1,000 to take the COVID-19 vaccine 30 . However, because a cost of $300 billion to vaccinate the population may be prohibitive, we posed a more modest $100 incentive. We also compared this with a $10 incentive, which previous studies suggest is sufficient for actions that do not require individuals to change behavior on a sustained basis 31 . While having to pay a $20 co-pay for the vaccine did deter individuals, the additional economic incentives had no positive effect although they did not discourage vaccination 32 . Consistent with past research 31 , 33 , further analysis shows that the negative effect of the $20 co-pay was concentrated among low-income earners (Supplementary Fig. 7 ). Financial incentives failed to increase vaccination willingness across income levels.

Our study also yields important insights into the relationship between one prominent category of COVID-19 misinformation and vaccination preferences. We find that susceptibility to misinformation about COVID-19 treatments—based on whether individuals can distinguish between factual and false information about efforts to combat COVID-19—is considerable. A quarter of subjects scored no higher on our misinformation index than random guessing or uniform abstention/unsure responses (for the full distribution, see Supplementary Fig. 2 ). However, subjects who scored higher on our misinformation index did not exhibit greater vaccination hesitancy. These subjects actually were more likely to believe in vaccine safety more generally and to accept a COVID-19 vaccine, all else being equal. These results run counter to recent findings of public opinion in France where greater conspiracy beliefs were negatively correlated with willingness to vaccinate against COVID-19 34 and in Korea where greater misinformation exposure and belief were negatively correlated with taking preventative actions 35 . Nevertheless, the results are robust to alternate operationalizations of belief in misinformation (i.e., constructing the index only using false claims, or measuring misinformation beliefs as the number of false claims believed: see Supplementary Table 4 ).

We recommend further study to understand the observed positive relationship between beliefs in COVID-19 misinformation about fake treatments and willingness to receive the COVID-19 vaccine. To be clear, we do not posit a causal relationship between the two. Rather, we suspect that belief in misinformation may be correlated with an omitted factor related to concerns about contracting COVID-19. For example, those who believe COVID-19 misinformation may have a higher perception of risk of COVID-19, and therefore be more willing to take a vaccine, all else equal 36 . Additional analyses reported in the Supplementary Information (Supplementary Fig. 6 ) show that the negative effect of an EUA on willingness to vaccinate was concentrated among those who scored low on the misinformation index. An EUA had little effect on the vaccination preferences of subjects most susceptible to misinformation. This pattern is consistent with the possibility that these subjects were more concerned with the disease and therefore more likely to vaccinate, regardless of the process through which the vaccine was brought to market.

We also observe that skepticism toward vaccines in general does not correlate perfectly with skepticism toward the COVID-19 vaccine. Therefore, it is important not to conflate people who are wary of the COVID-19 vaccine and those who are anti-vaccination, as even medically informed individuals may be hesitant because of the speed at which the COVID-19 vaccine was developed. For example, older people are more likely to believe vaccines are safe but less willing to receive the COVID-19 vaccine in our survey, perhaps following the high rates of vaccine skepticism among medical staff expressing concerns regarding the safety of a rapidly-developed vaccine 2 . This inverse relationship between age and willingness to vaccinate is also surprising. Most opinion surveys find older adults are more likely to vaccinate than younger adults 37 . However, most of these survey questions ask about willingness to take a generic vaccine. Two prior studies, both recruiting subjects from the Lucid platform and employing conjoint experiments to examine the effects of vaccine attributes on public willingness to vaccinate, also find greater vaccine hesitancy among older Americans 6 , 7 . Future research could explore whether these divergent results are a product of the characteristics of the sample or of the methodological design in which subjects have much more information about the vaccines when indicating their vaccination preferences.

An important limitation of our study is that it necessarily offers a snapshot in time, specifically prior to both the election and vaccine roll-out. We recommend further study to understand more how vaccine perceptions evolve both in terms of the perceived political ownership of the vaccine—now that President Biden is in office—and as evidence has emerged from the millions of people who have been vaccinated. Similarly, researchers should consider analyzing vaccine preferences in the context of online vaccine controversies that have been framed in terms of patient autonomy and right to refuse 38 , 39 . Vaccination mandates may evoke feelings of powerlessness, which may be exacerbated by misinformation about the vaccines themselves. Further, researchers should more fully consider how individual attributes such as political ideology and race intersect with vaccine preferences. Our study registered increased vaccine hesitancy among Blacks, but did not find that skepticism was directly related to misinformation. Perceptions and realities of race-based maltreatment could also be moderating factors worth exploring in future analyses 40 , 41 .

Overall, we found that the most important factor influencing vaccine preferences is vaccine efficacy, consistent with a number of previous studies about attitudes toward a range of vaccines 6 , 42 , 43 . Other attributes offer potential cautionary flags and opportunities for public outreach. The prospect of a 50% likelihood of mild side effects, consistent with the evidence about current COVID-19 vaccines being employed, dampens likelihood of uptake. Public health officials should reinforce the relatively mild nature of the side effects—pain at the injection site and fatigue being the most common 44 —and especially the temporary nature of these effects to assuage public concerns. Additionally, in considering policy interventions, public health authorities should recognize that a $20 co-pay will likely discourage uptake while financial incentives are unlikely to have a significant positive effect. Lastly, belief in misinformation about COVID-19 does not appear to be a strong predictor of vaccine hesitancy; belief in misinformation and willingness to vaccinate were positively correlated in our data. Future research should explore the possibility that exposure to and belief in misinformation is correlated with other factors associated with vaccine preferences.

Survey sample and procedures

This study was approved by the Cornell Institutional Review Board for Human Participant Research (protocol ID 2004009569). We conducted the study on October 29–30, 2020, prior to vaccine approval, which means we captured sentiments prospectively rather than based on information emerging from an ongoing vaccination campaign. We recruited a sample of 1096 adult Americans via the Lucid platform, which uses quota sampling to produce samples matched to the demographics of the U.S. population on age, gender, ethnicity, and geographic region. Research has shown that experimental effects observed in Lucid samples largely mirror those found using probability-based samples 45 . Supplementary Table 1 presents the demographics of our sample and comparisons to both the U.S. Census American Community Survey and the demographics of prominent social science surveys.

After providing informed consent on the first screen of the online survey, participants turned to a choice-based conjoint experiment that varied five attributes of the COVID-19 vaccine. Conjoint analyses are often used in marketing to research how different aspects of a product or service affect consumer choice. We build on public health studies that have analyzed the influence of vaccine characteristics on uptake within the population 42 , 46 .

Conjoint experiment

We first designed a choice-based conjoint experiment that allowed us to evaluate the relative influence of a range of vaccine attributes on respondents’ vaccine preferences. We examined five attributes summarized in Table 2 . Past research has shown that the first two attributes, efficacy and the incidence of side effects, are significant drivers of public preferences on a range of vaccines 47 , 48 , 49 , including COVID-19 6 , 7 , 13 , 50 . In this study, we increased the expected incidence of minor side effects from previous research 6 to reflect emerging evidence from Phase III trials. The third attribute, whether the vaccine received full FDA approval or an EUA, examines whether the speed of the approval process affects public vaccination preferences 6 . The fourth attribute, the manufacturer of the vaccine, allows us to examine whether the highly public pause in the AstraZeneca trial following an adverse event, and the significant differences in brand familiarity between smaller and less broadly known companies like Moderna and household name Johnson & Johnson affects public willingness to vaccinate. The fifth attribute examines the influence of a policy tool—offsetting the costs of vaccination or even incentivizing it financially—on public willingness to vaccinate.

Attribute levels and attribute order were randomly assigned across participants. A sample choice set is presented in Supplementary Fig. 1 . After viewing each profile individually, subjects were asked: “If you had to choose, would you choose to get this vaccine, or would you choose not to be vaccinated?” Subjects then made a binary choice, responding either that they “would choose to get this vaccine” or that they “would choose not to be vaccinated.” This is the dependent variable for the regression analyses in Table 3 . After making a binary choice to take the vaccine or not be vaccinated, we also asked subjects “how likely or unlikely would you be to get the vaccine described above?” Subjects indicated their vaccination preference on a seven-point scale ranging from “extremely likely” to “extremely unlikely.” Additional analyses using this ordinal dependent variable reported in Supplementary Table 3 yield substantively similar results to those presented in Table 3 .

To determine the effect of each attribute-level on willingness to vaccinate, we followed Hainmueller, Hopkins, and Yamamoto and employed an ordinary least squares (OLS) regression with standard errors clustered on respondent to estimate the average marginal component effects (AMCEs) for each attribute 51 . The AMCE represents the average difference in a subject choosing a vaccine when comparing two different attribute values—for example, 50% efficacy vs. 90% efficacy—averaged across all possible combinations of the other vaccine attribute values. The AMCEs are nonparametrically identified under a modest set of assumptions, many of which (such as randomization of attribute levels) are guaranteed by design. Model 1 in Table 3 estimates the AMCEs for each attribute. These AMCEs are illustrated in Fig. 1 .

Analyzing additional correlates of vaccine acceptance

To explore the association between respondents’ embrace of misinformation about COVID-19 treatments and vaccination willingness, the survey included an additional question battery. To measure the extent of belief in COVID-19 misinformation, we constructed a list of both accurate and inaccurate headlines about the coronavirus. We focused on treatments, relying on the World Health Organization’s list of myths, such as “Hand dryers are effective in killing the new coronavirus” and true headlines such as “Avoiding shaking hands can help limit the spread of the new coronavirus 52 .” Complete wording for each claim is provided in Supplementary Appendix 1 . Individuals read three true headlines and five myths, and then responded whether they believed each headline was true or false, or whether they were unsure. We coded responses to each headline so that an incorrect accuracy assessment yielded a 1; a correct accuracy assessment a -1; and a response of unsure was coded as 0. From this, we created an additive index of belief in misinformation that ranged from -8 to 8. The distribution of the misinformation index is presented in Supplementary Fig. 2 . A possible limitation of this measure is that because the survey was conducted online, some individuals could have searched for the answers to the questions before responding. However, the median misinformation index score for subjects in the top quartile in terms of time spent taking the survey was identical to the median for all other respondents. This may suggest that systematic searching for correct answers is unlikely.

To ensure that any association observed between belief in misinformation and willingness to vaccinate is not an artifact of how we operationalized susceptibility to misinformation, we also constructed two alternate measures of belief in misinformation. These measures are described in detail in the Supplementary Information (see Supplementary Figs. 3 and 4 ). Additional regression analyses using these alternate measures of misinformation beliefs yield substantively similar results (see Supplementary Table 4 ). Additional analyses examining whether belief in misinformation moderates the effect of efficacy and an FDA EUA on vaccine acceptance are presented in Supplementary Fig. 6 .

Finally, model 2 of Table 3 includes a range of additional control variables. Following past research, it includes a number of demographic variables, including indicator variables identifying subjects who identify as Democrats or Republicans; an indicator variable identifying females; a continuous variable measuring age (alternate analyses employing a categorical variable yield substantively similar results); an eight-point measure of educational attainment; and indicator variables identifying subjects who self-identify as Black or Latinx. Following previous research 6 , the model also controlled for three additional factors often associated with willingness to vaccinate: an indicator variable identifying whether each subject had health insurance; a variable measuring past frequency of influenza vaccination on a four-point scale ranging from “never” to “every year”; beliefs about the general safety of vaccines measured on a four-point scale ranging from “not at all safe” to “extremely safe”; and a measure of attitudes toward the pharmaceutical industry ranging from “very positive” to “very negative.”

Reporting summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

All data and statistical code to reproduce the tables and figures in the manuscript and Supplementary Information are published at the Harvard Dataverse via this link: 10.7910/DVN/ZYU6CO.

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Acknowledgements

S.K. and D.K. would like to thank the Cornell Atkinson Center for Sustainability for financial support.

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S.K. and D.K. designed the experiment/survey instrument and conducted the statistical analysis. S.K., N.D., J.B., Y.H., and D.K. all contributed to the conceptual design of the research and to the writing of the paper.

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Kreps, S., Dasgupta, N., Brownstein, J.S. et al. Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation. npj Vaccines 6 , 73 (2021). https://doi.org/10.1038/s41541-021-00335-2

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A Top Vaccine Expert Answers Important Questions About a COVID-19 Vaccine

The covid-19 vaccine is on track to become the fastest-developed vaccine in history. that doesn’t mean the process is skipping any critical steps..

Understanding what we know—and still don’t—about a vaccine for COVID-19 can help shed light on its safety and efficacy.

Ruth Karron, MD , is one of the top vaccine experts in the world, serving on vaccine committees for the CDC, the WHO, and the FDA. Karron, who leads the  Center for Immunization Research  at the Johns Hopkins Bloomberg School of Public Health, recently spoke with  Josh Sharfstein  and answered a list of important questions about the COVID-19 vaccine.

How close are we to a vaccine?

There are some very encouraging developments. We have a few vaccines now that will go into Phase 3 clinical trials, also known as efficacy trials. That means that those vaccines have passed certain goalposts in terms of initial evaluations of safety and immune response such that they can be evaluated in larger trials.

We know that these vaccines are promising, but we don’t yet know if they are going to work. That’s what the purpose of an efficacy trial is—as well as to provide a broader assessment of safety of the vaccine in a large number of people.

Tell me more about these efficacy trials. What do they actually entail?

They involve large numbers of people: In these particular trials for COVID vaccines, there are going to be about 30,000 people enrolled per trial. Individuals are given a vaccine, and then they are followed both to make sure that the side effects from the vaccine are acceptable and to see whether they develop a SARS-CoV-2 infection along with some symptoms.

These are placebo-controlled trials, meaning that some individuals will get a COVID vaccine and some will get a placebo. Then, the rates of disease will be compared in the people who got placebo and the people who got the vaccine to determine the efficacy of the vaccine.

How successful does a vaccine have to be in one of these studies for it to be considered effective?

Recently, the FDA issued guidance about the development of COVID vaccines. The guidance that they issued to vaccine manufacturers— this is a document that is available to the general public —is that a vaccine would need to be at least 50% effective. This means that an individual who was vaccinated would be 50% less likely to get COVID disease—or whatever the particular endpoint is that’s measured in the trial—than individuals that weren’t vaccinated.

This is a reasonable goal for a number of reasons. Typically, the more severe a disease is, the better chance a vaccine has of preventing that disease. So, a vaccine that’s 50% effective against mild COVID disease—which might be the endpoint that’s measured in a clinical trial, or  any  evidence of COVID infection with any symptom, which is how a lot of trials are designed—might be more effective against severe disease. 

When you have a disease that’s as prevalent as COVID—and if we think about what the U.S. has experienced in the past several months in terms of severe disease and death—even if we were only able to cut those numbers in half, that would be a major achievement.

How long would a vaccine be effective for? If you get 50% effectiveness or more, that’s good news. But if it’s only effective for a few months, that’s not such good news. 

Time will tell for that. The short answer is that we don’t yet know. Even for the data we have on the vaccine so far in smaller studies, we haven’t yet had the opportunity to follow individuals for very long. The very first people who got the very first vaccine were immunized in March and it’s only July. So, we don’t know very much about the durability of the immune response in people.

Our hope would be [that protection would last] at least a year or more and then people might need boosters.

It’s also possible that a vaccine might not entirely protect against mild disease. So you might actually experience mild disease and then have a boost in your immune response and not suffer severe disease. From a public health perspective, that would be completely acceptable. If we turned a severe disease not into “ no disease ” but into mild disease, that would be a real victory.

Let’s talk about safety. What are they looking for in a 30,000-person study to figure out whether a vaccine is considered safe enough to use?

Every person who is enrolled in the trial will complete information about the kinds of acute symptoms that you might expect following an infection. People will need to provide information about swelling, redness, tenderness around the injection site, fever, and any other symptoms they might experience in the three to seven days following vaccination.

More long term, people will be looking to make sure that when COVID disease is experienced, there’s not any evidence of more severe disease with vaccination [which is known as disease enhancement]. 

There was a lot of discussion as these vaccines were being developed of a concern about disease enhancement. This is based on some animal models—not with SARS-CoV-2 but with other coronaviruses. We haven’t seen any evidence of enhanced disease thus far and there are a number of scientific reasons why we don’t think it should occur with these vaccines. But, of course, it’s something we would still watch for very carefully just as with any other safety signal.

How should we think about the possibility of adverse effects that might come up after the period of the vaccine trial?

There are a couple of things to mention about that, and one is that individuals with these trials will be followed for a year or longer. It may be that a vaccine is either approved for emergency use or licensed before all of that long-term follow up is completed. Nevertheless, companies will be obligated to complete that follow up and report those results back to the FDA. 

It’s important to enroll older adults in these studies. All of these large efficacy trials will be stratified so there will be some younger adults and some older adults enrolled. 

In addition, it’s very likely—and this would not just happen with COVID vaccines, but whenever the FDA licenses vaccines—that there is an obligation for post-licensure assessments. If a COVID vaccine is licensed, the companies will work with the FDA to determine exactly what kind of post-licensure safety assessments will need to be done.

COVID affects certain populations more than others—particularly older adults and people with chronic illnesses. What do these studies need [in order] to address the question of whether a vaccine will be protective for them?

I also think it will be important to enroll older adults across an age span. A 65-year-old is not the same as an 85-year-old. Also, a healthy older adult is not the same as a frail older adult who might be living in a care facility. 

We’ll need some information about diverse elderly populations in order to think about how to allocate vaccines. There may also be other alternatives for older adults if they don’t respond well to vaccines. There’s a lot of work going on on development of monoclonal antibodies [ learn more about lab-produced antibodies in a recent podcast episode with Arturo Casadevall ] as an alternative for groups that don’t respond well to vaccines such as elderly, frail adults.

Let’s say there are 30,000 patients in the study and only a few hundred who are over 80 years old. What can you learn about a relatively small population of much older adults that would be informative about that group?

We may not have a large enough number of people in that subgroup to directly look at efficacy of a vaccine. But we might have enough to look at the immune response—the antibody response, for example, of a vaccine. 

If, in the course of these trials, we can determine a correlative protection—for example, a laboratory measure like a level of a particular kind of antibody that correlates with protection against COVID disease—we can at least look at the immune responses in that subset of very elderly and decide if they are the same or different than the younger groups’. If they are the same, we may be more comfortable making the leap to say that it’s likely those individuals will also be protected by the vaccine.

So, we will learn more from a vaccine trial than just whether or not a vaccine works. We’re going to find out, perhaps, what predicts whether the vaccine works. That information might help us understand—without having to do a whole new trial—who might be protected by a vaccine.

It’s certainly a hope. 

The majority of vaccines that we use today don’t have such a marker of protection and they’re very effective. Just because we can’t detect a marker doesn’t mean that a vaccine is not effective. It means that we’re not smart enough to figure out what that marker should be. 

We really hope that there will be such a marker of protection because then we can link that—and, in FDA speak, that’s called “bridging”—to another population where we can just look at that marker of immunity rather than doing a whole efficacy trial.

How should we think about the need for racial and ethnic diversity in these clinical trials?

It’s critically important that we have racial and ethnic diversity. 

We know that COVID causes increased rates of severe disease in Latinx and Black populations and in Native American populations. We will certainly want to be able to offer these COVID vaccines to these high-risk populations and encourage their use. But we need to know how well these vaccines work in these populations—if different vaccines work differently—so that we can offer the most effective vaccines. 

It would not be an understatement to say that there can be a measure of distrust from some communities that have experienced discrimination from the health care system. How does that play into vaccine research?

It’s really important to engage those communities in a number of ways. One way is to engage local leaders early in the process. Lay leaders and leaders of faith communities can have focus groups to find out what their concerns are and how those can be allayed. 

I think a very important issue that has been raised by some people who might potentially volunteer for some of these trials has to do with eventual access. People want to have some sense that if they participate in a trial, not only might they have access to the vaccine at the end of that trial, but their families and their communities would, too. Ensuring access among these high risk and vulnerable communities is really critical. 

A clear policy decision to make sure that a vaccine is widely available without charge might actually help with the studies to prove whether or not that vaccine is safe and effective?

That’s absolutely the case. It’s great that you brought up the “without charge” piece, too, because a vaccine that’s made available but costs something to the individual may not be used. Particularly for people who don’t have health insurance or people who are undocumented. It has to be broadly and freely available.

Let’s talk about other specific populations. One of those is pregnant women. We know that they can certainly get COVID-19 and that there are some signs that they can have a more severe course. How do you think about the issue of pregnant women in vaccine studies?

I’ve done some work in this area —particularly with  Ruth Faden  and  Carleigh Krubiner  in the  Berman Institute of Bioethics —specifically related to ensuring that pregnant women are considered and included in vaccine development and implementation for vaccines against epidemic and pandemic diseases. 

When thinking about trials, there needs to be a justification for  excluding  pregnant women from trials rather than a justification for  including  them. The justification often is—and certainly is the case with these early COVID vaccines—that we don’t know enough yet about the vaccine or the vaccine platform or the safety of the vaccine to do a study in pregnant people. 

With the mRNA vaccine, for example, [the type of vaccine being considered for COVID-19] we don’t currently have a licensed mRNA vaccine. It’s a new platform and we’re just learning about the safety of that platform so it wouldn’t have been appropriate to include pregnant women in the early stage trials. 

But these 30,000-person studies are going to be really big studies. They will certainly enroll people of child-bearing potential. And even though there’s what we call an exclusion criterion—women are not supposed to be pregnant at the time they are enrolled, and usually women of child-bearing potential will take a pregnancy test prior to enrollment and immunization—we know from previous experience that it’s quite likely that some women will become pregnant in the months immediately following immunization. It happens quite frequently. So, it’s important for companies and the government to anticipate that this will be the case and to think about how they will systematically collect data from women who do become pregnant during these trials. 

It’s not that the data needs to be interpreted cautiously—because pregnant women aren’t being formally randomized and we don’t have that kind of trial design—but there are things that could be learned and it’s important to think now about how to collect those data. It’s also important to think about how pregnant women could be directly included in both trials and deployment later down the road. 

What about young children who are less likely to get severe disease? Would your approach to clinical trials be different?

Yes. I think we need to learn a bit more about the epidemiology in children. Fortunately, children don’t seem to suffer from acute COVID disease at the rates that adults do. But we need to learn more about that and we also need to learn from our trials in adults before we make decisions about how and whether children will be included in vaccine trials. 

Once we have a vaccine that has made it through these various stages and we’re ready to start immunizing people outside of a pure clinical trial, how close are we to really getting the benefit of the vaccine? How does all the work it takes to develop a vaccine compare to what comes next?

The best vaccine in the world won’t work if it isn’t used. 

Use has two parts to it: One is availability and access, and the other part is acceptance.

We need to think about what kind of infrastructure we should be planning now for what we’re going to need to deliver this vaccine. We’ll set priorities; certainly not everyone is going to get a vaccine all at once. But certainly, over time we will expect that all adults will receive the vaccine and perhaps children. So we’ll need to have systems in place that can deliver the vaccine. At the same time, we need to make sure that the vaccine is acceptable. We need to communicate the importance of vaccination to the public and address their concerns so that we can not only be able to deliver vaccines, but have those be accepted by the public.

So, there’s a lot of work to be done. But this isn’t science fiction: We are really on a path to a vaccine for a brand new infectious disease.

Yes. If you think back to the fact that in January, we barely knew what this virus was, and here we are, seven months later, embarking on efficacy trials, it’s really a remarkable accomplishment. We have a lot to do yet, but in the time that we’re assessing the efficacy of these vaccines and making sure that they can be delivered to the public, people really need to stay safe and to do all the things we’ve been encouraging them to do all along. 

But we are well on our way to developing vaccines not only for people in the U.S., but for people all over the world.

Public Health On Call

This conversation is excerpted from the July 31 episode of Public Health On Call. 

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Vaccine Persuasion

Many vaccine skeptics have changed their minds.

By David Leonhardt

When the Kaiser Family Foundation conducted a poll at the start of the year and asked American adults whether they planned to get vaccinated, 23 percent said no.

But a significant portion of that group — about one quarter of it — has since decided to receive a shot. The Kaiser pollsters recently followed up and asked these converts what led them to change their minds . The answers are important, because they offer insight into how the millions of still unvaccinated Americans might be persuaded to get shots, too.

First, a little background: A few weeks ago, it seemed plausible that Covid-19 might be in permanent retreat, at least in communities with high vaccination rates. But the Delta variant has changed the situation. The number of cases is rising in all 50 states .

Although vaccinated people remain almost guaranteed to avoid serious symptoms, Delta has put the unvaccinated at greater risk of contracting the virus — and, by extension, of hospitalization and death. The Covid death rate in recent days has been significantly higher in states with low vaccination rates than in those with higher rates:

(For more detailed state-level charts, see this piece by my colleagues Lauren Leatherby and Amy Schoenfeld Walker. The same pattern is evident at the county level, as the health policy expert Charles Gaba has been explaining on Twitter.)

Nationwide, more than 99 percent of recent deaths have occurred among unvaccinated people, and more than 97 percent of recent hospitalizations have occurred among the unvaccinated, according to the C.D.C. “Look,” President Biden said on Friday, “the only pandemic we have is among the unvaccinated.”

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Persuasive messaging to increase COVID-19 vaccine uptake intentions

Affiliations.

• 1 Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
• 2 Institution for Social and Policy Studies, Yale University, New Haven, CT, USA; Center for the Study of American Politics, Yale University, New Haven, CT, USA.
• 3 Institution for Social and Policy Studies, Yale University, New Haven, CT, USA; Center for the Study of American Politics, Yale University, New Haven, CT, USA; Department of Political Science, Yale University, New Haven, CT, USA.
• 4 Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale School of Nursing, West Haven, CT, USA.
• 5 Institution for Social and Policy Studies, Yale University, New Haven, CT, USA; Center for the Study of American Politics, Yale University, New Haven, CT, USA; Department of Political Science, Yale University, New Haven, CT, USA. Electronic address: [email protected].
• PMID: 34774363
• PMCID: PMC8531257
• DOI: 10.1016/j.vaccine.2021.10.039

Widespread vaccination remains the best option for controlling the spread of COVID-19 and ending the pandemic. Despite the considerable disruption the virus has caused to people's lives, many people are still hesitant to receive a vaccine. Without high rates of uptake, however, the pandemic is likely to be prolonged. Here we use two survey experiments to study how persuasive messaging affects COVID-19 vaccine uptake intentions. In the first experiment, we test a large number of treatment messages. One subgroup of messages draws on the idea that mass vaccination is a collective action problem and highlighting the prosocial benefit of vaccination or the reputational costs that one might incur if one chooses not to vaccinate. Another subgroup of messages built on contemporary concerns about the pandemic, like issues of restricting personal freedom or economic security. We find that persuasive messaging that invokes prosocial vaccination and social image concerns is effective at increasing intended uptake and also the willingness to persuade others and judgments of non-vaccinators. We replicate this result on a nationally representative sample of Americans and observe that prosocial messaging is robust across subgroups, including those who are most hesitant about vaccines generally. The experiments demonstrate how persuasive messaging can induce individuals to be more likely to vaccinate and also create spillover effects to persuade others to do so as well. The first experiment in this study was registered at clinicaltrials.gov and can be found under the ID number NCT04460703 . This study was registered at Open Science Framework (OSF) at: https://osf.io/qu8nb/?view_only=82f06ecad77f4e54b02e8581a65047d7.

Copyright © 2021 Elsevier Ltd. All rights reserved.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Experiment 1. Messages that frame…

Experiment 1. Messages that frame vaccination as a cooperative action to protect others…

Experiment 2. The Not Bravery,…

Experiment 2. The Not Bravery, Community Interest, and Community Interest + Embarrassment messages…

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Debate on the report “COVID-19 vaccines: ethical, legal and practical considerations”

Parliamentary assembly of the council of europe (pace).

Mr Rik Daems, President of the Parliamentary Assembly of the Council of Europe,

Ms Jennifer De Temmerman, Rapporteur of the Resolution,

Excellencies, honourable members of the Parliamentary Assembly of the Council of Europe,

Thank you for inviting me to join you today.

Let me start by commending the Parliamentary Assembly for your commitment to keeping the COVID-19 pandemic response at the top of national agendas. 

I also commend the report under discussion today for its emphasis on international cooperation for the fair and equitable distribution of vaccines, which was echoed in the Council of Europe’s recent statement. 

And I commend the resolution you will discuss today, which recognizes COVID-19 vaccines as a global public good.

It is in times of crisis such as these that our higher principles are most important.

This pandemic has tested us like never before, and now, even as we have developed vaccines in record time, it is testing us again.

Vaccine equity is not just a moral imperative. Ending this pandemic depends upon it.

This fundamental principle is one that many European governments and the European Commission recognized with their support of the Access to COVID-19 Tools Accelerator.

For the last nine months, this landmark partnership has been laying the groundwork for the equitable distribution and deployment of life-saving tools.

We have new rapid tests that provide results in less than 30 minutes, which are being rolled out soon. 

We have identified dexamethasone to treat severe disease, which is being stockpiled for use in low and lower-middle income countries. 

And the development and approval of safe and effective vaccines less than a year after the emergence of this new virus is a stunning scientific achievement. It gives us all a much-needed source of hope.

One vaccine now has WHO emergency use listing, and three are authorized for emergency use by stringent regulatory authorities. 

WHO is working to expedite the regulatory review of several other vaccines for emergency use listing, in collaboration with national governments and regional bodies such as the European Medicines Agency.

COVAX has now secured two billion doses from five producers, with options on more than one billion more doses for 2021 and early 2022. We expect COVAX to make its first deliveries next month. 

In short, COVAX is ready to deliver what it was created for.

I want to thank our partners Gavi and CEPI for their exceptional work to bring us to this point. 

Together, we have overcome scientific barriers, legal barriers, logistical barriers and regulatory barriers. 

But even as the first vaccines begin to be deployed, the promise of equitable access is at serious risk.

We now face the real danger that even as vaccines bring hope to those in wealthy countries, much of the world could be left behind. 

Some countries and companies are making bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. 

COVID-19 vaccines are now being administered in 50 countries around the world, nearly all of which are wealthy nations.  Seventy-five percent of doses have been deployed in only ten countries. 

It is understandable that governments want to prioritize vaccinating their own health workers and older people first.

But it is not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries. I hope you will understand this.

The situation is compounded by the fact that most manufacturers have prioritized regulatory approval in rich countries, rather than submitting full dossiers to WHO for Emergency Use Listing.

We must work together to prioritize those most at risk of severe disease and death, in all countries.

The emergence of rapidly-spreading variants makes the speedy and equitable rollout of vaccines all the more important. 

A me-first approach leaves the world’s poorest and most vulnerable people at risk.

It is also self-defeating. These actions will only prolong the pandemic, the restrictions needed to contain it, and the human and economic suffering.

A study published this week by the International Chamber of Commerce Research Foundation found that vaccine nationalism could cost the global economy up to 9.2 trillion US dollars, and almost half of that – 4.5 trillion dollars – would be incurred in the wealthiest economies.

Prompt and equitable dose sharing is critical if we are to overcome this pandemic.

While many European countries have made generous financial contributions to COVAX, funds to complete the purchase of the two billion dose target are still needed. 

It is just as important that COVAX receives timely donations of extra doses of vaccine that so many countries have secured.

This is another critical means by which COVAX can equitably allocate vaccine doses to protect additional populations.   

To put it bluntly: many countries have bought more vaccine than they need. It is critical that COVAX receives those extra doses soon, not the leftovers many months from now. 

Lives depend on it. 

We need urgent action from governments, vaccine producers and the global community to walk the talk on vaccine equity. 

My request to all countries is to act in solidarity. Only by working together can we bring this pandemic to an end. 

I have five critical actions countries must take: 

First, to prioritize: We need to protect the COVAX Facility and ensure it can work as envisaged. WHO must be provided with vaccine data at the same time as other regulators, so that provision of vaccines to all countries can be sped up;

Second, to act in fairness: Excess doses should be shared, or countries should suspend their rights to access COVAX doses, once they have vaccinated their health workers and older people, to allow other countries to do the same;

Third, to be accountable: All partners must live up to the promises they have made and do everything possible to increase volumes of approved vaccines, including through increased production, technology transfer, and licensing;

Fourth, to be ready: All countries need to ensure that the regulatory and logistical mechanisms are in place to roll out and scale up tests, treatments and vaccines, and ensure that no dose is wasted; 

And fifth, to be transparent: We call on all countries with bilateral contracts – and control of supply – to be transparent on these contracts with COVAX, including on volumes, pricing and delivery dates. 

Parliaments have a critical role to play, in both advocacy and community engagement, in keeping government accountable, in countering misinformation, and in allocating adequate budgets for policy priorities. 

Finally, I’d like to note that WHO’s Emergency Committee, convened under the International Health Regulations, has determined that requiring proof of vaccination for international travellers does not make sense at the current time.

Travellers are not considered a high-risk group, nor is there any evidence that vaccines reduce transmission.

Colleagues and honourable members, 2021 can be and should be a year of renewed hope, when we overcome the acute phase of the pandemic.

Together, we must ensure that vaccination of health workers and older people is underway in all countries within the first 100 days of this year.

We have 74 days left. Time is short, and the stakes could not be higher.

Every moment counts.

I wish you a fruitful discussion, and thank you so much for inviting me, it’s an honour to join you.

Scientific arguments to use when talking to COVID-19 vaccine sceptics

Photo: Sam Moqadam / Unsplash

Recent reports on certain COVID-19 vaccines , coupled with the decision by some states and authorities to restrict their use within certain age groups, have prompted mistrust , notably decelerating the rhythm of vaccination.

According to the most recent CIS survey, some 6.5% of Spanish society will refuse the vaccine when their turn comes around, and 5% are still hesitant or have not yet decided what they will do. This percentage has also increased following recent reports. 

After reports from the European Medicines Agency on rare cases of blood clots among recipients of one of the vaccines, the number of people failing to turn up for their vaccination appointments or directly refusing the vaccine, explicitly motivated by the issues raised and the potential associated risks, has multiplied. In the Community of Madrid, to give just one example, figures show that the number of people refusing to be vaccinated jumped from 3% in late March to over 60% , owing to recent reports and to decisions made in mid April regarding the administration of the vaccine in some age groups. 

"Information mismanagement and decisions based on unscientific, anti-statistical criteria have dealt a heavy blow to vaccine confidence. Caution is a fundamental aspect and we need to remain alert and investigate each case, but we also have to be aware that all drugs have secondary effects and that these vaccines are no different from the thousands of other drugs that we have taken before and that we take every day", says Salvador Macip i Maresma, doctor and lecturer at the UOC Faculty of Health Sciences , Head of the Mechanisms of Cancer and Ageing Laboratory at Leicester University and science writer, who considers that the issue has been exaggerated.

Arguments of anti-vaxxers

The following are some of the arguments based on individual liberties , secondary effects or risk, used by people to turn down the vaccine or raise doubts about the campaign. "While getting vaccinated or not is an individual issue, it is also a community one, as not getting vaccinated affects society and those around us, so it is partly a civic matter ", says Macip.

In this regard, Manuel Armayones, psychologist, lecturer in Psychology and Education Science, and researcher with the UOC eHealth Center , points out that agreeing to get the vaccine is an altruistic move, benefiting not only oneself but also wider society . "By getting vaccinated, we are contributing to building a safer society, one that cares for the wellbeing of all citizens , including its most fragile and vulnerable members, such as old people, and people who, for whatsoever reason, cannot be vaccinated", says Armayones.

Taking the information in context, we see that among vulnerable groups, such as the elderly, who are more prone to health problems and complications, deaths in nursing homes fell from 700 a week in January and February, to just two a week in March, according to IMSERSO records , a drop that can be attributed to mass vaccination in nursing homes over the first few months of the year. 

Another misgiving of anti-vaxxers is the speed with which the vaccines have been developed, overlooking the massive financial and professional investment made over the past year. 

"Europe is using very innovative vaccines , but that does not mean that they are new or that they were invented last year. RNA vaccines were first put forward 20 or 30 years ago and a lot of research has gone into developing them since then. What's more, clinical trials were already underway before the pandemic hit , but the results have been expedited because of the pandemic and the huge investment that has been put into them," says Macip. 

Increased motivation

Another of the fundamental aspects towards gaining social acceptance and massive COVID-19 vaccination is human behaviour. In other words, we need to create an environment that favours our goal. For this to be possible, three essential factors need to concur, i.e. people must be able to receive the vaccine , they must be motivated to do so and they must receive a "signal" to do so . 

"We have the capacity to be vaccinated, because everybody will be offered vaccination free of charge and because, as a group, we are fortunate to have skilled professionals and a healthcare system that provides the time and place in which to do it. On the other hand, the third component required for vaccination to take place, i.e. the signal, is transmitted to each person individually, by means of a call or message. If this is not possible for whatsoever reason, each Autonomous Community is equipped with the means to let everybody to know when they are due for vaccination", says Armayones.

Armayones also agrees with other investigators around the world that the main challenge to mass vaccination is motivating people , particularly right now, when we are being bombarded with disinformation in the media and particularly social media. He adds that, that in order for the message to be effective, it must be easily understood and adapted to each social group , and that people's doubts must be listened to and clear answers offered in response. Another strategy for increasing motivation is to recruit influential persons as role models, to persuade people who may still be hesitant by their example. 

In this way, information must be used in a balanced manner, using verifiable facts to help people understand the enormous benefits of COVID-19 vaccines compared to the risks of failure to take action. "Unfortunately, there will always be a percentage of sceptics who won't listen to reason, but if we provide scientifically validated data in a clear, graphic manner, and establish reliable channels of communication , via social media and platforms, this percentage will be minimal and will not be an issue. However, if the percentage increases, the social risk is far more serious," says Macip. 

Keys to overcoming doubts 

In this regard, the best tools for winning over vaccine sceptics and other people with qualms about possible risks are based on transparency of information and a positive focus on the current vaccination situation and the benefits of herd immunity to society. 

"We need to highlight the positive aspects of vaccination compared to the negative effects of not being vaccinated, basically the high death rate and the null possibilities of economic and social recovery , when vaccination is part of the solution. The fact is that vaccination offers benefits not only to the recipient as an individual, but also to society as a whole", says Armayones, who suggests looking at the flip side as a bleak alternative: what would happen if scientists had not developed vaccines against the pandemic? How much longer would society have been able to hold out without a much harder global crash than the one we are already living through, particularly in certain sectors?

Likewise, we have to emphasize the importance of accurate, verifiable information, easily understood by the general public, to explain the data in context, instead of extraordinary occurrences, such as the rare incidence of blood clots when certain therapies are used, but also using real figures, such as the percentage of people do get blood clots, compared to the adverse effects of much more commonly-used drugs or the number of people that the vaccine is saving from dying of SARS-CoV-2.

"In the field of public health, we need to explain the benefits that society as a whole will be seeing thanks to increased vaccination and herd immunity, such as the dramatic reduction in deaths in nursing homes since the vaccine campaign was rolled out, or the fact that a higher level of immunization among the population will allow us to set and meet goals in regard to gradually recovering activities we miss so badly, in relation to work, culture and leisure . By seeding hope among the population and highlighting the huge collective effort involved in the vaccination campaign, most people will accept it as working towards a common goal, " he adds. 

Thus, the dual combination of transparency and mass vaccination will prove that the vaccines are working and get most people to see how important they are. " Once we have the information, the example of the real effect of the vaccine in society will be more important , as people see the situation improving. Thus, little by little, we will gain the trust of more people and the number of sceptics will drop ", says Macip.

Ten points to use when talking to anti-vaxxers

Experts UOC

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Persuasive messaging to increase COVID-19 vaccine uptake intentions

Erin k. james.

a Yale Institute for Global Health, New Haven, CT, USA

b Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA

Scott E. Bokemper

c Institution for Social and Policy Studies, Yale University, New Haven, CT, USA

d Center for the Study of American Politics, Yale University, New Haven, CT, USA

Alan S. Gerber

e Department of Political Science, Yale University, New Haven, CT, USA

Saad B. Omer

f Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA

g Yale School of Nursing, West Haven, CT, USA

Gregory A. Huber

Associated data.

Widespread vaccination remains the best option for controlling the spread of COVID-19 and ending the pandemic. Despite the considerable disruption the virus has caused to people’s lives, many people are still hesitant to receive a vaccine. Without high rates of uptake, however, the pandemic is likely to be prolonged. Here we use two survey experiments to study how persuasive messaging affects COVID-19 vaccine uptake intentions. In the first experiment, we test a large number of treatment messages. One subgroup of messages draws on the idea that mass vaccination is a collective action problem and highlighting the prosocial benefit of vaccination or the reputational costs that one might incur if one chooses not to vaccinate. Another subgroup of messages built on contemporary concerns about the pandemic, like issues of restricting personal freedom or economic security. We find that persuasive messaging that invokes prosocial vaccination and social image concerns is effective at increasing intended uptake and also the willingness to persuade others and judgments of non-vaccinators. We replicate this result on a nationally representative sample of Americans and observe that prosocial messaging is robust across subgroups, including those who are most hesitant about vaccines generally. The experiments demonstrate how persuasive messaging can induce individuals to be more likely to vaccinate and also create spillover effects to persuade others to do so as well.

The first experiment in this study was registered at clinicaltrials.gov and can be found under the ID number NCT04460703. This study was registered at Open Science Framework (OSF) at: https://osf.io/qu8nb/?view_only=82f06ecad77f4e54b02e8581a65047d7.

1. Introduction

The global spread of COVID-19 created an urgent need for safe and effective vaccines against the disease. However, even though several successful vaccines have become available, vaccine hesitancy in the general population has the potential to limit the efficacy of vaccines as a tool for ending the pandemic. For instance, in the United States, the public’s willingness to receive a vaccine has declined from 72 % saying they would be likely to get a COVID-19 vaccine in May 2020 to 60 % of people reporting that they would receive a vaccine as of November 2020 [ 1 ]. Given the considerable amount of skepticism about the safety and efficacy of a COVID-19 vaccine, it has become increasingly important to understand how public health communication can play a role in increasing COVID-19 vaccine uptake.

Vaccination is both a self-interested and a prosocial action [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ]. By getting vaccinated, people protect themselves from a disease, but they also reduce the chance that they become a vector through which the disease spreads to others. If enough people receive a vaccine, the population gains protection through herd immunity, but this also creates an incentive for an individual to not get vaccinated because they can forgo vaccination and receive protection from others who do vaccinate. Recent research on vaccination in general has demonstrated that people view vaccination as a social contract and are less willing to cooperate with those who choose not to get inoculated [ 10 ]. This work also implies that highlighting the reputational costs of choosing not to vaccinate could be an effective strategy for increasing uptake. Further, appeals to herd immunity and the prosocial aspect of vaccination have been shown to increase uptake intentions [ [11] , [12] , [13] ], but emphasizing the possibility of free riding on other’s immunity reduces the willingness to get vaccinated [ 14 ].

Focusing specifically on vaccination against COVID-19, recent studies have found that messages that explain herd immunity increase willingness to receive a vaccine [ 15 ] and reduces the time that people would wait to get vaccinated when a vaccine becomes available to them [ 16 ]. However, other work has found that prosocial appeals did not increase average COVID-19 vaccination intentions [ 17 ] and the effect of prosocial concerns was present in sparsely populated places, but absent in more densely populated ones [ 18 ]. Given the current state of evidence, it is unclear whether appealing to getting a COVID-19 vaccine as a way to protect others will increase willingness to vaccinate.

Viewing vaccination through the lens of a collective action problem suggests that in addition to increasing individuals’ intentions to receive a vaccine, effective public health messages would also increase people’s willingness to encourage those close to them to vaccinate and to hold negative judgments of those who do not vaccinate. By encouraging those close to them to vaccinate, people are both promoting compliance with social norms and increasing their own level of protection against the disease. Also, by judging those who do not vaccinate more negatively, they apply social pressure to others to promote cooperative behavior. This would be consistent with theories of cooperation, like indirect reciprocity or partner choice, that rely on free riders being punished or ostracized for their past actions to encourage prosocial outcomes [ [19] , [20] , [21] , [22] , [23] ]. Thus, effective messaging could have outsized effects on promoting vaccination if it both causes people to vaccinate themselves and to encourage those around them to do so.

We conducted two pre-registered experiments to study how different persuasive messages affect intentions to receive a COVID-19 vaccine, willingness to persuade friends and relatives to receive one, and negative judgments of people who choose not to vaccinate. In the first experiment, we tested the efficacy of a large number of messages against an untreated control condition (see Table 1 for full text of messages). A subgroup of the messages in Experiment 1 drew on this collective action framework of vaccination and emphasized who benefits from vaccination or how choosing not to vaccinate hurts one’s social image. A second subgroup drew on contemporary arguments about restrictions on liberty and economic activity during the COVID-19 pandemic. In Experiment 2, we retested the most effective messages from Experiment 1 on a nationally representative sample of American adults. By utilizing this test and re-test design, we guard against false positive results that are observed by chance among the large number of messages tested in Experiment 1. In our analysis of both experiments, we examined whether specific messages were more effective among certain subgroups of the population.

Experimental treatment messages for Experiment 1 and Experiment 2. All messages add the prose in the table to the content of the Baseline informational control. All of the messages in the table were tested in Experiment 1. The messages that are bolded were retested in Experiment 2.

Experiment 1 was fielded in early July 2020. Participants were randomly assigned to either a placebo control condition in which they read a story about the effectiveness of bird feeders or one of eleven treatment messages. The first message is a Baseline informational control condition that describes how it is important to receive a vaccine to reduce your risk of contracting COVID-19 or spreading it to others. Informational messages have been shown to be effective at increasing COVID-19 vaccine uptake intentions [ 24 ]. This message also emphasized that vaccines are safe and estimated to save millions of lives per year. The other messages add additional content to this baseline message.

The subgroup of messages that emphasized collective action varied who would benefit from vaccination or what other people might think of someone who chooses to be a free rider by not vaccinating. Focusing on who benefits from vaccination, the second message invoked Self Interest and reinforced the idea that vaccination is a self-protecting action (“Remember, getting vaccinated against COVID-19 is the single best way to protect yourself from getting sick.”). The third message, Community Interest, instead argued that vaccination is a cooperative action to protect other people (“Stopping COVID-19 is important because it reduces the risk that members of your family and community could get sick and die.”). This message also invoked reciprocity by emphasizing the importance of every-one working together to protect others.

The fourth, fifth, and sixth messages added an invocation of an emotion, Guilt, Embarrassment, or Anger, to the Community Interest message. These messages prompted people to think about how they would feel if they chose not to get vaccinated and spread COVID-19 to someone else in the future. Emotions are thought to play a role in cooperation, either by motivating an individual to take an action because of a feeling that they experience or restraining them from taking an action because of the emotional response it would provoke in others [ [25] , [26] , [27] ]. Further, anticipated emotional states have been shown to promote various health behaviors, like vaccination [ [28] , [29] ].

The seventh and eighth messages evoked concerns about one’s reputation and social image, which influences their attractiveness as a cooperative partner to others. The seventh, a Not Bravery message, reframed the idea that being unafraid of the virus is not a brave action, but instead selfish, and that the way to demonstrate bravery is by getting vaccinated because it shows strength and concern for others (“To show strength get the vaccine so you don’t get sick and take resources from other people who need them more”). The eighth message was a Trust in Science message that highlights that scientists believe a vaccine will be an effective way of limiting the spread of COVID-19. This message suggests that those who do not get vaccinated do not understand science and signal this ignorance to others (“Not getting vaccinated will show people that you are probably the sort of person who doesn’t understand how infection spreads and who ignores or are confused about science.”).

The final three messages drew on concerns about restrictions on freedom and economic activity that were widespread during the COVID-19 pandemic. A pair of messages focused on how vaccination would allow for a restoration of Personal Freedom (“Government policies to prevent the spread of COVID-19 limit our freedom of association and movement”) or Economic Freedom (“Government policies to prevent the spread of COVID-19 have stopped businesses from opening up”). These messages take a value that is commonly invoked in individuals’ decision to not vaccinate [ [30] , [31] ] and reframed vaccination as something that would actually restore freedoms that had been taken away. The final message, Community Economic Benefit, argues that a vaccine will help return people’s financial security and strengthen the economy This message is similar to the Community Interest messages that are described above, but instead focuses on cooperating to restore the economy (“We can all end this outbreak and strengthen the national economy by working together and getting vaccinated”).

2.1. Experiment 1 results

Panel A of Fig. 1 plots the effect of each vaccine message relative to the untreated control group on intention to vaccinate. The intention to vaccinate measure was formed by combining responses to a question about the likelihood of getting a COVID-19 vaccine within the first 3 months that one is available with a question about getting a vaccine within the first year that one is available. Specifically, for respondents who did not answer that they were very likely to vaccinate within the first three months that a vaccine is available to them, we asked how likely they would be to vaccinate within a year. This measure coded those who are very likely in the first three months at the highest value on the scale followed by very likely within a year descending down to very unlikely within the first year. Analyzing the vaccination item separately does not substantively change the results. All outcome variables were scored 0 to 1, with higher values indicating greater willingness to endorse the pro-vaccine action or belief (Underlying regressions appear in Table S1 and unless otherwise noted, all analyses were pre-registered).

Experiment 1. Messages that frame vaccination as a cooperative action to protect others or emphasize how non-vaccination might negatively affect one’s social image increase reported willingness to advise a friend, and judgment of non-vaccinators. Panel A displays treatment effects for the combined measure of intention to vaccinate, Panel B displays the advise a friend outcome, and Panel C displays the judging a non-vaccinator outcome. Treatment effects for both panels were estimated using OLS regression that included covariates. The effects displayed are a comparison against the placebo control baseline and are presented with 95% confidence intervals. The dashed vertical line is the effect of the Baseline informational control for each outcome.

Compared to the untreated control, the Baseline informational message was associated with modest increases in intention to vaccinate by 0.034 units (95 % CI:0.002, 0.065; p < .05). This effect represents an increase of approximately 6 % in the scale score compared to the outcome in the control condition.

By comparison, the Community Interest, Community Interest + Guilt, Embarrassment, or Anger, Not Bravery, Trust in Science and Personal Freedom messages all produce larger effects, at least qualitatively, than the Baseline informational message on the intention to vaccinate outcome. Effects for the Self-Interest, Economic Freedom, and Community Economic benefit messages were not consistently distinguishable from the untreated control group outcomes, and their effects were indistinguishable from the effects of the Baseline informational message.

The most promising messages were the Not Bravery, Community Interest, and Community Interest + Embarrassment messages. These messages were associated with effects that were statistically distinguishable from the untreated control group (Not Bravery: 0.077 units, 95 % CI: 0.035, 0.119; p < .01, Community Interest: 0.090 units, 95 % CI: 0.050, 0.129; p < .01, Community Interest + Embarrassment: 0.094 units, 95 % CI: 0.054, 0.134; p < .01) at p < .01. Moreover, their effects were always more than twice as large as the Baseline informational treatment and these differences were significant at p < .05 (two-tailed tests). The effects of the Trust in Science message and the Personal Freedom message were not statistically significant when compared to the Baseline informational message.

To put the magnitudes of the effects into context, we re-estimated our analysis after dichotomizing the intended vaccine uptake measure such that those who report they were “somewhat” or “very” likely to get the vaccine, either with three months or a year, are coded as 1 and those who do not are coded 0 (this analysis was not pre-registered). This produced a predicted rate of intended vaccination in the control group of 58.2 %. Respondents who read the Baseline informational message were 7.4 percentage points (95 % CI: 2.9 pp, 12.0 pp; p < .01) more likely to receive a vaccine. Among those assigned to the Not Bravery or Community Interest messages it was predicted to increase by 10.4 percentage points and 12.7 percentage points (Not Bravery: 95 % CI: 4.3 pp, 16.4 pp; p < .01, Community Interest: 95 % CI: 6.7 pp, 18.7 pp; p < .01) respectively, while among those assigned to the Community Interest + Embarrassment message it was predicted to increases by 15.9 percentage points (95 % CI: 10.2 pp, 21.6 pp; p < .01). This last difference was substantively large, representing a proportional increase of 27 % (0.159/0.582) compared to the control condition and a 13 % increase compared to the Baseline informational condition (0.159-0.074)/(0.582 + 0.074).

Turning to the other regarding outcomes that focused on spurring action by others, Panel B plots the effects of each vaccine message relative to the untreated control for advising a friend to receive a vaccine and Panel C plots the effects for negatively judging someone who refuses to receive one. Here, the effect of the Baseline informational intervention was modest and statistically insignificant. However, the Not Bravery, Trust in Science, Personal Freedom, Community Interest, Community Interest + Guilt, and Community Interest + Embarrassment messages had larger effects on both outcomes that were statistically distinguishable from the control outcome.

The most promising message was the Community Interest + Embarrassment message for the advise a friend outcome, which was associated with a 0.09 unit increase in the scale outcome (95 % CI: 0.049, 0.132; p < .01 two-tailed test), an effect that represents an increase of 27 % compared to the mean scale score in the control group. The effect was 0.067 units compared to the Baseline informational message (95 % CI: 0.027, 0.105; p = .001, two-tailed test). We conducted a similar exercise to the one describe above to gauge the relative magnitude of these treatment effects. For the Community Interest + Embarrassment message we estimated a 15 percentage point increase (95 % CI: 0.088, 0.209; p < .01, two tailed test,) in a binary intention to advise others to vaccinate outcome, a proportional increase of 27 % compared to the control group baseline of 53 % (0.15/0.53). This effect was also 6 percentage points larger than the effect of the baseline message (95 % CI: 0.008, 0.121; p = .03, two-tailed test).

The most promising outcome for the negative judgment of non-vaccinators was the Not Bravery message, which had an effect of 0.09 scale points (95 % CI: 0.052, 0.126; p < .01, two-tailed test) compared to the untreated control and 0.072 scale points versus the Baseline information (95 % CI: 0.037, 0.106; p < .01 Baseline message, two-tailed tests). This corresponded to a 21 % increase compared to the scale outcome in the control group (0.09/0.43). These are both substantively and statistically meaningful effects. The Community Interest, Community Interest + Guilt, Community Interest + Embarrassment, Trust in Science, and Personal Freedom messages all produced effects that were statistically distinguishable from the control condition.

We also investigated the robustness of these findings to sample restrictions and whether certain subgroups were more responsive to specific treatment messages (reported in Figures S2-S12 ). Results were generally robust to restricting the sample to those who were over the 10th percentile and under the 90th percentile for completion time. For subgroup analyses, those scoring low in liberty endorsement appeared more responsive to the Baseline treatment and to the Not Bravery message than are those who scored high in liberty endorsement. Those who report being less likely to take risks appeared robustly more responsive to the Not Bravery message than those who were high in risk taking. Those who were high in risk taking appear more responsive to the Personal Freedom message with regard to their own behavioral intentions. Certain groups appeared generically easier to persuade (Democrats rather than Republicans, an important divide that has emerged during the pandemic [ 32 ], and Women rather than Men), but there were no clear differences in which treatments appeared most effective across these groups. We explored the robustness of these subgroup differences in Experiment 2.

Taken together, the most successful messages in Experiment 1 were those that were theoretically motivated by viewing vaccination as a collective action problem. Consistent with previous work that demonstrates that prosocial appeals are effective in promoting vaccination, the Community Interest message and Community Interest + Guilt, Embarrassment, or Anger messages increased COVID-19 vaccine uptake intentions. Moving beyond who benefits from vaccination, the Not Bravery and Trust in Science messages that invoked concerns about one’s social image if they choose not to vaccinate also increased uptake intentions. All of the collective action oriented messages increased intentions to advise a friend to vaccinate and negative judgments of those who do not, potentially creating spillover effects that induce others to vaccinate. In addition to this subgroup of messages, we found that reframing vaccination as a way to restore freedom was also effective, though the other messages motivated by contemporary debates about the pandemic were generally no more effective than the Baseline condition.

2.2. Experiment 2 results

Experiment 2 tested the subset of the best performing messages from Experiment 1 on a nationally representative sample in September 2020. Notably, in the several month period between Experiment 1 and Experiment 2, the public had grown increasingly skeptical of a potential COVID-19 vaccine [ 1 ]. Panel A of Fig. 2 plots the effect of each vaccine message, relative to the untreated control group, on the same measure of intention to vaccinate used in Experiment 1. (The model specifications shown in the figure were from our pre-registered specifications, underlying regression appear in Table S2.). Given that we observed the messages from Experiment 1 were effective at increasing vaccine uptake, we pre-registered directional hypotheses for Experiment 2 that tested whether the effects could be replicated on a nationally representative sample. Accordingly, we report one-tailed hypothesis tests and 90 % confidence intervals in the results presented below. Results largely confirmed the patterns observed in Experiment 1.

Experiment 2. The Not Bravery, Community Interest, and Community Interest + Embarrassment messages increase both intentions to vaccinate and other-regarding outcomes. Panel A displays treatment effects for intentions to vaccinate, Panel B displays the advise a friend, and Panel C displays the judging a non-vaccinator outcomes. Treatment effects for both panels were estimated using OLS regression that included covariates. The effects displayed are a comparison against the placebo control baseline and are presented with 90 % confidence intervals. The dashed vertical line is the effect of the Baseline informational control for each outcome.

The Baseline informational treatment was associated with a modest increase, 0.029 units, in intention to vaccinate (90 % CI: 0.011, 0.046; p < .01, one-tailed test). This effect was a 6 % increase of the observed scale outcome in the untreated control group.

The Community Interest and Community Interest + Embarrassment messages were associated with qualitatively larger effects on intended vaccine uptake. These messages were associated with increases of 0.045 units (90 % CI: 0.021, 0.070; p < .01, one-tailed test) and 0.043 units (90 % CI: 0.019, 0.067; p < .01, one-tailed test), respectively. As with Experiment 1, we recoded those who stated they were “somewhat” or “very” likely to receive the vaccine as 1 and those who did not report that they were likely to receive it as 0 (this analysis was not pre-registered: for consistency we report 90 % confidence intervals). This binary measure produced a predicted rate of intended vaccination in the control group of 51.4 %. Intended uptake was 3.3 percentage points higher in the Baseline information condition (90 % CI: 0.5 pp, 6.0 pp; p < .05, one-tailed test), 3.5 percentage points higher in the Community Interest + Embarrassment condition (90 % CI: −0.1 pp, 7.0 pp; p = .06, one-tailed test), and 5 percentage points higher in the Community Interest condition (90 % CI: 1.3 pp, 0.8.7 pp; p < .05, one-tailed test). The latter effect was proportionally large—10 % compared to the baseline predict rate in the control group (0.050/0.514).

On average, the Not Bravery, Trust in Science, and Personal Freedom messages were approximately as effective as the informational content to which they were added in increasing intention to vaccinate, which differs from Experiment 1 where they modestly outperformed the Baseline informational condition.

Turning to other regarding outcomes, Panel B of Fig. 2 plots effects for advice given to others and Panel C does so for negative judgments of non-vaccinators. The Baseline informational treatment was again associated with statistically significant increases in each outcome. For these outcomes, the Not Bravery, Trust in Science, and both Community Interest messages produced effects that were at least descriptively larger than the Baseline treatment. The effects for the Personal Freedom message were smaller than the Baseline informational treatment, a result that again diverged from Experiment 1.

In terms of advising others to vaccinate, the most effective message was the Community Interest + Embarrassment message, which was also the most effective message in Experiment 1. This effect was 0.07 scale points (90 % CI: 0.043, 0.095; p < .01, one-tailed test), an increase of 14 % compared to the control group average scale score of 0.51 (0.07/0.51). This effect was also statistically distinguishable from the effect of the Baseline informational treatment (difference = 0.045; 90 % CI: 0.020, 0.069; p < .01, one-tailed test). When dichotomizing the advise a friend outcome to better describe the magnitude of the effect, we estimated that the Community interest + Embarrassment message was associated with a 10 percentage point increase (90 % CI: 0.064, 0.140; p < .01, one-tailed test) in intention to advise others to vaccinate compared to the control group, a proportional increase of 27 % compared to the control group baseline of 38 % (0.10/0.38). This effect was approximately 6 points larger than the effect of the Baseline message (90 % CI: 0.026, 0.099; p < .01, one-tailed test).

In terms of judging non-vaccinators, the largest effects were for the Not Bravery and Trust in Science messages, with each effect also statistically distinguishable from the Baseline message. Notably, in this sample the Trust in Science message had large effects on beliefs and actions toward others but appeared ineffective in changing an individual’s own intended vaccination behavior. The Not Bravery message was also the most effective message in this regard in Experiment 1.

We examined three pre-registered differences in subgroup treatment effects to test the patterns observed in Experiment 1. First, confirming Experiment 1 we found that those who did not endorse liberty values were more responsive to the Not Bravery message (compared to the baseline message) than those who endorsed liberty values for the three outcome measures. Second, we did not confirm either preregistered prediction with regard to differences in treatment effects by risk taking that were observed in Experiment 1.

The remaining subgroup comparisons were not pre-registered. Beginning with gender, in comparison to the untreated control, women responded more to the Trust in Science and Community Interest + Embarrassment message than did men (all five outcomes), while men responded more to the Not Bravery and Community Interest (without embarrassment) messages. Democrats were more responsive than Republicans across the board to the different treatment messages, while Republicans appeared to react only to the Community Interest and Community Interest + Embarrassment messages (magnitudes similar to those of Democrats). We observed a similar pattern for differences by baseline vaccine confidence, measured pre-treatment with a multi-item battery of questions [ 33 ]. Those high in vaccine confidence responded to all messages, while those low in confidence responded reliably only to the Community Interest messages.

3. Discussion

Overall, the results point both to a set of effective messages and the potential efficacy of specific messages for some particular subgroups. On average, a simple informational intervention is effective, but it is even more effective to add language framing vaccine uptake as protecting others and as a cooperative action. Not only does emphasizing that vaccination is a prosocial action increase uptake, but it also increases people’s willingness to pressure others to do so, both by direct persuasion and negative judgment of non-vaccinators. The latter social pressure effects may be enhanced by highlighting how embarrassing it would be to infect someone else after failing to vaccinate. The Not Bravery and Trust in Science messages had substantial effects on other regarding outcomes and for some subgroups, but do not appear to be as effective as the Community Interest messages in promoting own vaccination behavior. Importantly, in distinct samples fielded several months apart, the Community Interest, Community Interest + Embarrassment, and the Not Bravery messages produced substantively meaningful increases for all outcomes measures relative to the untreated control, and in some instances did so in comparison to the Baseline information condition.

Our findings are consistent with the idea that vaccination is often treated as a social contract in which people are expected to vaccinate and those who do not are sanctioned [ 10 ]. In addition to messages emphasizing the prosocial element of vaccination, we observed that messages that invoked reputational concerns were successful at altering judgment of those who would free ride on the contributions of others. This work could also help explain why social norm effects appear to overwhelm the incentive to free ride when vaccination rates are higher [ [34] , [35] ]. That is, messages that increased intentions to vaccinate also increased the moralization of non-vaccinators suggesting that they are fundamentally linked to one another. These messages will need to be adapted in specific cultural contexts with relevant partners, such as community leaders.

The robust effect of the Community Interest message advances our current understanding of whether public health messaging that deploys prosocial concerns could be effective at increasing COVID-19 vaccine uptake. The results of both experiments presented here support prior work that demonstrated the effectiveness of communication that explains herd immunity on promoting vaccination [ [15] , [16] ]. It also suggests that a detailed explanation of herd immunity may not be necessary to induce prosocial behavior.

Beyond the theoretical contribution, the results have practical implications for vaccine communication strategies for increasing COVID-19 vaccine acceptance. We identified multiple effective messages that provide several evidence-based options to immunization programs as they develop their vaccine communication strategies. Importantly, the insights into differential effectiveness of various messages by subgroup (e.g. men vs women) could inform messaging targeted to specific groups. Understanding heterogeneous treatment effects and the mechanisms that cause differential responses to persuasive messaging strategies requires additional testing and theoretical development. We view this as a promising avenue for future work.

The experiments presented here are not without limitations. First, we measured intentions to vaccinate at a time when a vaccine was not currently available and the effectiveness and side effects of potential vaccines were not known. This also meant that we could not observe actual vaccination behavior, which is ultimately the outcome of interest. While intentions predict behavior in many contexts [ [36] , [37] ] including vaccination [ [38] , [39] , [40] ], past research examining the effect of behavioral nudges on COVID-19 vaccine uptake has produced divergent evidence when testing the effect of the same treatments in the field on behavior and in a survey experiment on a behavioral intention [ 41 ]. This observation highlights the need for field testing messages that have shown to be successful on increasing uptake intentions in survey experiments to ascertain whether they also increase vaccine uptake. It may be that field tests reveal certain messages are particularly less effective than in the survey context, or that messages are uniformly less effective. Second, given the rapidly evolving nature of the COVID-19 pandemic, attitudes about vaccines may have changed since the experiments were fielded which could also change the efficacy of the messages that we tested. Third, we cannot be sure whether, or how long, the effects we observe here persist. Finally, we only tested text-based messages, but public health messaging is delivered through many mediums, like public service announcements, videos, and images. Future work can adapt the successful messaging strategies found here and test their efficacy when delivered in alternative formats.

Efforts to vaccinate individuals against COVID-19 are currently underway in the United States and it remains important to convince the mass public of the safety and efficacy of COVID-19 vaccines to ensure that the threshold for herd immunity is reached. Our experiments provide robust evidence that appealing to protecting others has effects on intentions to get vaccinated and to apply social pressure to others to do so as well.

4. Materials and methods

4.1. ethics statement.

The experiments reported here were fielded under an exemption granted by the Yale University IRB. Informed consent was obtained from participants and they were informed that they could stop the study at any time. Data was collected anonymously and contained no personally identifiable information.

4.2. Experiment 1

Participants and Procedure. Participants were recruited by the vendor Luc.id to take a survey. Of those who were recruited, 4,361 participants completed the survey. An examination of attrition during the survey reveals that attrition was balanced across groups which minimizes concerns that the treatment effects estimated in the main manuscript are affected by attrition. The survey was programmed using the survey software Qualtrics. The survey was fielded between July 3, 2020 and July 8, 2020.

Experimental Design. Participants first completed basic demographic and pre-treatment attitudinal questions and were asked about their experience with COVID-19. After this, participants read a treatment message. They were required to spend at least 20 s on the survey page that contained the message to given them an adequate amount of time to read it. We allocated 2/15 of the sample to the untreated control condition and 1/5 of the sample to the Information baseline condition due to the number of comparisons that would utilize these conditions. Each of the remaining conditions received 1/15 of the sample. The design and analysis were pre-registered at ClinicalTrials.gov (protocol ID: 2000027983).

Outcome Measures. For COVID-19 vaccine uptake intentions, participants were asked “How likely are you to get a COVID-19 vaccine within the first 3 months that it is available to you?” and “How likely are you to get a COVID-19 vaccine in the first year that it is available to you?” Respondents answered this question on a five-point scale with end points of “Extremely unlikely” and “Extremely likely.” The main text describes how these items were combined for analysis. Turning to the likelihood of advising someone to vaccinate, respondents were asked “How likely are you to advise a close friend or relative to get vaccinated against COVID-19 once a vaccine becomes available?” Respondents also answered this question on a five-point scale with end points of “Extremely unlikely” and “Extremely likely.” Finally, for judging someone who chooses not to vaccinate, respondents read “we would like you to think about a friend or relative who chose not to receive a COVID-19 vaccine when it is available. What would you think about this person? Are they…”. This prompt was followed by four traits: trustworthy, selfish, likeable, and competent. The response options were “not at all”, “slightly”, “somewhat”, “mostly”, and “very.”

Analysis. We used OLS regression with robust Huber-White standard errors and indicators for assigned treatment to estimate treatment effects. We use robust standard errors to address the heteroscedasticity observed when estimating our primary analysis models without them. We included covariates as described in the Supplementary Materials . Comparisons across treatments are from linear combination of coefficients tests. For the subgroup analyses, we restricted the sample to the stated criteria and estimate the model specified here on the subsample. For liberty endorsement and risk taking, we determined who was high and low by splitting the sample at the mean.

4.3. Experiment 2

Participants and Procedure. Participants ( n  = 5,014) were recruited by the vendor YouGov/Polimetrix. YouGov provides subjects using a sampling procedure that is designed to match a number of Census demographics. To determine the sample size, we conducted a power analysis to detect effects that were 80 % as large as those observed in Experiment 1. The experiment was fielded between September 9, 2020 and September 22, 2020.

Experimental Design. Participants first completed basic demographic and pre-treatment attitudinal questions and were asked about their experience with COVID-19. Participants were randomly assigned to one of seven conditions: the untreated control, the Information baseline control, Community Interest, Community Interest + Anticipated Embarrassment, Not Bravery, Trust in Science, or Personal Freedom. As in Experiment 1, more participants were assigned to the untreated control condition and the Baseline information control condition, 1/5 and 3/10 of the sample respectively. The remaining five conditions each received 1/10 of the sample. Participants were required to spend at least 30 s on the survey page that had the treatment message. The design and analysis were pre-registered at Open Science Framework.

Outcome Measures. The outcome measurement was the same as described in Experiment 1 with the exception of intelligent being added to the judgment of a non-vaccinator scale.

Analysis. We used the same modeling approach described above to produce the results displayed in Fig. 2 . We included covariates as described in the Supplementary Materials . For subgroup analyses, we estimated OLS regression models with an indicator variable if a person was a member of a subgroup (e.g. high endorsement of liberty) and zero otherwise.

CRediT authorship contribution statement

Erin K. James: Conceptualization, Writing- original draft, Writing- review and editing. Scott E. Bokemper: Conceptualization, Data curation, Formal analyses. Alan S. Gerber: Conceptualization, Writing- review and editing. Saad B. Omer: Conceptualization, Writing- review and editing. Gregory A. Huber: Conceptualization, Data curation, Formal analyses, Writing- original draft, Writing- review and editing.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

The authors would like to acknowledge support for the Tobin Center for Economic Policy at Yale University. EKJ and SBO were supported by the Yale Institute for Global Health.

SEB, ASG, and GAH received support from the Institution for Social and Policy Studies and the Center for the Study of American Politics at Yale University.

Appendix A Supplementary data to this article can be found online at https://doi.org/10.1016/j.vaccine.2021.10.039 .

Appendix A. Supplementary material

The following are the Supplementary data to this article:

Here Are Arguments That Can Help Overcome COVID-19 Vaccine Hesitancy

August 2024

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