Behavioral Nudges Increase COVID-19 Vaccinations
108 Pages Posted: 5 Apr 2021 Last revised: 22 Jul 2021
Date Written: July 21, 2021
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: Suggested Citation