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Vaccine policies: When people are willing to accept more stringent measures

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The COVID-19 pandemic resulted in substantial government-imposed restrictions for citizens and a drive towards a mass vaccination programme, but to what extent does the effectiveness of a vaccine affect public support and an appetite for more stringent policies. New research from Brunel University London investigated.

During the COVID-19 pandemic, the government urged people to get vaccinated to save lives, to hug their grandparents and to enjoy mass gatherings. High-profile celebrities featured in vaccination television adverts, and longed-for holidays abroad were in touching distance for the double jabbed.

Vaccines require a certain level of uptake to ensure population-level benefits, and uptake needs to increase when vaccines are less effective. During the pandemic, governments were led by medics and scientists and wanted to ensure that the vaccine was effective in curbing the spread of the infection.

New research led by Brunel and King’s College London, in an international team with Canada's Universities of Toronto and McMasters and Amsterdam’s Vrije University, investigated the relationship between vaccine effectiveness and citizen support for coercive and stringent policies. Are people more supportive of stringent policies when vaccines are less effective because individual uptake is necessary to achieve broad population uptake, or more supportive when vaccines are more effective because an increase in uptake will provide both individual and population-level protection?

Dr Manu Savani, a senior lecturer in Behavioural Public Policy at Brunel University London, who co-led the research, explains that people generally express a preference for less stringent interventions in areas such as public health, savings and the environment – and prefer being offered the freedom to choose rather than being mandated to comply.

“Although recent research suggests that people prefer policies that preserve freedom of choice, such as behavioural nudges, many citizens accepted stringent policy interventions during the COVID‑19 pandemic, such as fines and travel restrictions, to promote vaccination,” said Dr Savani.

“The compliance we observed with such coercive policies could be explained in part by the unusually high effectiveness of the COVID-19 vaccines — a factor potentially affecting public support for coercive policies.”

As part of the study, published in the journal Scientific Reports, the researchers conducted two large online surveys in seven different countries – the UK, Canada, America, France, Germany, Italy and Japan. Almost 40,000 people took part in the cross-national study and were split into two groups.

Both groups were presented with the same question about a hypothetical future scenario in which the government encouraged people to get a new booster vaccine for a new COVID-19 variant.

The first group was given a survey that described the booster’s effectiveness numerically as 50%, 60%, 70%, 80%, or 90% effective, and the second group was given a survey that described the booster’s effectiveness as “less effective,” “as effective” or “more effective” than previous COVID-19 vaccines.

After receiving information about the effectiveness of the hypothetical booster, participants were then asked whether they would support a series of policies that the government could use to encourage greater uptake of the vaccine.

The policies ranged from less stringent ones, such as freely available boosters, to more stringent ones, such as fines for the unvaccinated, restrictions on accessing public spaces for the unvaccinated and tax breaks for the vaccinated.

Following an analysis of the results, Dr Savani found that the participants were more willing to accept stringent policies when the booster’s effectiveness was as effective as the previous vaccine or when its effectiveness was greater. If it was seen as less effective than the previous vaccine, the participants supported stringent policies less.

“Although the participants were more willing to accept more stringent policies as the effectiveness of the booster increased, there was a threshold for their acceptance,” said Richard Koenig, a doctoral researcher from King’s College.

“When the hypothetical booster’s effectiveness was above 70%, or “more effective” than previous vaccines, there was no significant increase in support for more stringent policies,” he said.

“This shows that people are willing to comply up to a certain point, but there appears to be a limit to how much stringency people will accept.

“Even if a vaccine is 90% effective, that does not mean that people are going to accept ever more stringent policies.”

Dr Savani believes that the study can have direct implications for policy makers.

“The findings from the study can inform discussions about vaccine behaviour and support policy makers, public health communicators and campaigners in the design of future vaccine promotion policies and information campaigns,” she said.

“If future vaccines are presented as, and/or perceived to be, less effective than the initial vaccines, then we would expect citizens to be less accepting of the kind of vaccine promotion policies we saw during the pandemic.

“Similarly, claims of a more effective vaccine may not result in the public accepting further stringent policies after a certain point.”

Public support for more stringent vaccine policies increases with vaccine effectiveness’, by Manu Savani, Peter John, Richard Koenig, Andrew Hunter, Blake Lee-Whiting, John McAndrews, Sanchayan Banerjee, Peter John Loewen and Brendan Nyhan, is published in Scientific Reports.

Reported by:

Nadine Palmer, Media Relations
+44 (0)1895 267090
nadine.palmer@brunel.ac.uk