Behavioral Nudges Increase COVID-19 Vaccinations

108 Pages Posted: 5 Apr 2021 Last revised: 22 Jul 2021

See all articles by Hengchen Dai

Hengchen Dai

University of California, Los Angeles (UCLA) - Anderson School of Management

Silvia Saccardo

Carnegie Mellon University, Department of Social and Decision Sciences

Maria Han

University of California, Los Angeles (UCLA) - UCLA Health System

Lily Roh

University of California, Los Angeles (UCLA) - UCLA Health System

Naveen Raja

University of California, Los Angeles (UCLA) - UCLA Health System

Sitaram Vangala

University of California, Los Angeles (UCLA) - UCLA Health System

Hardikkumar Modi

University of California, Los Angeles (UCLA) - UCLA Health System

Shital Pandya

University of California, Los Angeles (UCLA) - UCLA Health System

Michael Sloyan

University of California, Los Angeles (UCLA) - UCLA Health System

Daniel Croymans

University of California, Los Angeles (UCLA) - UCLA Health System

Date Written: July 21, 2021

Abstract

Enhancing vaccine uptake is a critical public health challenge. Overcoming vaccine hesitancy and failure to follow-through on vaccination intentions requires effective communication strategies. We present two sequential randomized controlled trials (RCTs) to test the impact of behavioral interventions on COVID-19 vaccine uptake. We designed text-based reminders that make vaccination salient and easy, and delivered them to patients of a healthcare system one day (first RCT; N=93,354, clinicaltrials #NCT04800965) and eight days (second RCT; N=67,092, NCT04801524) after they received notification of vaccine eligibility. The first reminder boosted appointments and vaccination rates within the healthcare system by 6.07 (84%) and 3.57 (26%) percentage points, respectively; the second reminder increased those outcomes by 1.65 and 1.06 percentage points, respectively. The first reminder was more impactful when it made patients feel the vaccine was already theirs. However, we find no evidence that combining it with an information intervention addressing vaccine hesitancy heightened its effect. Online studies (N=3,181) examining vaccination intentions reveal divergent patterns from the first RCT, underscoring the importance of pilot-testing interventions in the field. These findings inform the design of behavioral nudges for promoting health decisions, highlighting the value of making vaccination easy and inducing feelings of ownership.

Note: *The first two authors contributed equally to this work. Trial Registration: clinicaltrials.gov numbers: NCT04800965 and NCT04801524

Funding Statement: Funding support for this research was provided by UCLA Health, Anderson School of Management, and Carnegie Mellon University.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This research was approved by the UCLA Institutional Review Board, which granted a waiver of informed consent.

Keywords: vaccination, COVID-19, nudges, RCT, psychological ownership, information intervention

JEL Classification: I12

Suggested Citation

Dai, Hengchen and Saccardo, Silvia and Han, Maria and Roh, Lily and Raja, Naveen and Vangala, Sitaram and Modi, Hardikkumar and Pandya, Shital and Sloyan, Michael and Croymans, Daniel, Behavioral Nudges Increase COVID-19 Vaccinations (July 21, 2021). Available at SSRN: https://ssrn.com/abstract=3817832 or http://dx.doi.org/10.2139/ssrn.3817832

Hengchen Dai (Contact Author)

University of California, Los Angeles (UCLA) - Anderson School of Management ( email )

110 Westwood Plaza
Los Angeles, CA 90095-1481
United States

Silvia Saccardo

Carnegie Mellon University, Department of Social and Decision Sciences ( email )

Pittsburgh, PA 15213-3890
United States

Maria Han

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Lily Roh

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Naveen Raja

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Sitaram Vangala

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Hardikkumar Modi

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Shital Pandya

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Michael Sloyan

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Daniel Croymans

University of California, Los Angeles (UCLA) - UCLA Health System ( email )

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

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