{"id":3172,"date":"2024-06-26T18:38:55","date_gmt":"2024-06-26T16:38:55","guid":{"rendered":"https:\/\/www.rivistaeco.com\/?p=3172"},"modified":"2024-06-26T18:38:55","modified_gmt":"2024-06-26T16:38:55","slug":"how-to-convince-anti-vaxxers-to-get-vaccinated","status":"publish","type":"post","link":"https:\/\/www.rivistaeco.com\/en\/2024\/06\/26\/how-to-convince-anti-vaxxers-to-get-vaccinated\/","title":{"rendered":"How to Convince Anti-Vaxxers to Get Vaccinated"},"content":{"rendered":"

Vaccine refusal is considered by the WHO as one of the most severe threats to global public health. After the COVID-19 pandemic, vaccine refusal is now also seen for traditional childhood vaccines. Communication and dialogue are fundamental tools to overcome this challenge, through taking into account citizens\u2019 capacities, opportunities, and motivations.<\/span><\/i><\/p>\n

5 May 2024 marked the first anniversary of the end of COVID-19 as a global health emergency and coincided with a significant shift in health policies and public intervention practices. The occasion provided a moment for reflection on the journey and the tools used in managing the crisis: lockdown policies, masks, social distancing, and, most of all, vaccines, which laid the groundwork for this new phase of coexistence with the virus.<\/span><\/p>\n

Closing the Chapter on the AstraZeneca Vaccine<\/b><\/h3>\n

COVID-19 vaccines returned to the spotlight after AstraZeneca\u2019s May 8 announcement that it was withdrawing Vaxzevria from the European market due to the many updated vaccines now available and a significant drop in demand. AstraZeneca described the withdrawal as the \u201cclosing of a chapter,\u201d citing the vaccine\u2019s success in saving over 65 million lives in its first year of use and the company\u2019s distribution of more than 3 billion doses globally.\u00a0<\/span><\/p>\n

Although Vaxzevria had not been used in Italy for some time, its withdrawal reignited the debate on vaccine safety, particularly after the pharmaceutical company confirmed that in rare cases, the vaccine could cause thrombosis with thrombocytopenia syndrome. The news fuelled theories about the vaccine\u2019s dangers, despite the European Medicines Agency having already noted in 2021 these rare but severe side effects. Hypotheses and fears aside, Vaxzevria is officially off the market, and this chapter of the story can indeed be closed. While the product may have saved millions of lives, it undoubtedly reignited public debate on the delicate and challenging interplay between citizen participation in vaccination programs and the cost-benefit assessment of a product by health authorities.<\/span><\/p>\n

A Public Health Threat<\/b><\/h3>\n

Broadening our view to all diseases for which vaccines are available, vaccine hesitancy \u2013 the reluctance or refusal to be vaccinated \u2013 is classified by the World Health Organization (WHO) as one of the top ten threats to global public health. According to the WHO, currently administered vaccines prevent 2\u20133 million deaths annually, and an additional 15 million deaths could be avoided with broader vaccine coverage. Although these numbers mainly concern low-income countries, it is evident from the first graph that vaccination coverage in some European countries (i.e., Poland and other Eastern European states) also declined during the pandemic, creating conditions for an increase in preventable and dangerous diseases such as measles or whooping cough.<\/span><\/p>\n

Percentage Variation in Measles Vaccination Coverage Before and After the COVID-19 Pandemic<\/b><\/p>\n

\"\"
Source: World Health Organization.<\/figcaption><\/figure>\n

After the pandemic, during which all respiratory diseases declined sharply due to restrictions and behavioural changes related to COVID-19, the number of measles cases in Europe began to rise again from 2023 (see the second figure). Specifically, in the first three months of 2024, Italy reported 213 measles cases (88% of which were in individuals unvaccinated against measles) compared to 43 for all of 2023. The highest incidence was observed in the 0\u20134 age group, with 11 cases in children under one year of age. A similar story applies to whooping cough, another infection for which we have a highly effective and safe vaccine, with 110 cases in the first three months of 2024, including 15 intensive care admissions and three neonatal deaths.<\/span><\/p>\n

Number of Measles Cases in Europe from 2018 to 2023<\/b><\/p>\n

\"\"
Source: Data processed from ECDC \u2013 European Centre for Disease Prevention and Control.<\/figcaption><\/figure>\n

The \u201cCapability, Opportunity, Motivation\u201d Model<\/b><\/h3>\n

These numbers invite deep reflection. The extent of vaccine refusal or delay, especially following the pandemic emergency, is such that the scientific community, policymakers, and the media are now faced with the challenge of thoroughly understanding the mechanisms driving citizens\u2019 behaviours and choices. Vaccine hesitancy is not a new phenomenon, but its manifestations during the COVID-19 pandemic have amplified both its effects and calls for a deeper study of the variables at play.\u00a0<\/span><\/p>\n

Unlike what was observed in the pre-pandemic years for more traditional vaccines like the hexavalent (diphtheria, tetanus, acellular pertussis, polio, hepatitis B, and <\/span>Haemophilus influenzae<\/span><\/i> type B) or the tetravalent (measles, mumps, rubella, chickenpox), COVID-19 vaccine uptake presented unique dynamics that today influence all other vaccination choices. On the one hand, significant differences emerged in the attitudes and predisposition to get vaccinated among some groups, such as women and young people, who were less inclined to get vaccinated against COVID-19 than with more traditional vaccines. On the other hand, attitudes towards vaccination changed over time, indicating that vaccine hesitancy is variable and strongly influenced by external factors. These factors may include the epidemic curve trend and related severity indicators, the state of the healthcare system, exposure to news and communications on information channels, and the behaviour of those in a person\u2019s circle of contacts.\u00a0<\/span><\/p>\n

In summary, the decision to vaccinate depends on a multitude of interconnected and correlated factors that influence and reinforce each other. To understand these complex dynamics, science provides theoretical models that identify the dimensions that define our behaviour and its variations. One such model is the Capability, Opportunity, and Motivation model, or the COM-B model.<\/span><\/p>\n

Capability<\/b> refers to a person\u2019s psychological and physical abilities to engage in an activity. In the context of vaccination, it includes understanding vaccine information and accessing healthcare services. Increasing a person\u2019s capability requires informative campaigns that raise public understanding of vaccine effectiveness and safety while highlighting how one person\u2019s participation can affect the physical and psychological well-being of the most vulnerable segments of the population.<\/span><\/p>\n

Opportunity<\/b> refers to external elements that make specific behaviours possible or encourage them, such as the accessibility of vaccination centres and social influence. Improving the first requires practical actions like extending vaccination centre hours, placing the centres in strategic locations that favour easy access by public transport and are frequented by the community, like shopping centres or schools. For social influence, community awareness programs are needed to promote physical access and encourage the social adoption of vaccination behaviour. These can include informational events and collaborations with community leaders and local organizations to highlight the importance of vaccination and the benefits of cooperation on collective well-being.<\/span><\/p>\n

Motivation<\/b> includes the mental processes that strengthen and direct behaviour, such as habits, fears, and perceptions of risks and benefits. Interventions to influence motivation can be diverse and should aim to engage both emotions and thoughts. An effective strategy involves communicating positive stories that illustrate how vaccination has helped overcome serious illnesses. These narratives can reduce fear and increase the perception of vaccination benefits by presenting real and concrete examples of success. Another crucial approach is directly addressing myths and misinformation using clear, reliable scientific data to dispel false beliefs. However, overly objective and detailed communication can have the opposite effect: using statistics to persuade the public to get vaccinated can be counterproductive if the message is not properly formulated. Therefore, it is useful to complement standard appeals with messages focused on altruism and personal experiences.<\/span><\/p>\n

The Study on Bocconi Students<\/b><\/h3>\n

A pre-pandemic study conducted by Bocconi University analysed various dynamics related to motivation among the University\u2019s students. The study gave innovative insights into the relationship between communication strategies that promote altruistic behaviours and intentions regarding adherence to vaccination policies. Firstly, the results indicate that communicating how actions can influence the well-being of vulnerable groups can be an effective way to trigger more altruistic behaviours, even in the delicate context of vaccine uptake. Secondly, the study found that people who experienced vulnerability in the past show a more favourable disposition toward vaccination compared to those who have not had that experience. Thirdly, there is an emulation effect in behaviours, where people are more likely to get vaccinated when they believe others are doing so at higher rates.\u00a0<\/span><\/p>\n

A possible explanation for why past experiences of vulnerability shape vaccination intentions could lie in greater empathy toward the difficulties of those who cannot get vaccinated. This aligns with the empathy-altruism theory, which would imply that empathic concern generates an altruistic motivation that drives a person to get vaccinated to protect those who cannot get vaccinated.\u00a0<\/span><\/p>\n

From a practical standpoint, these results suggest the most effective tools to increase adherence to vaccination recommendations: for example, crafting messages that highlight the number of individuals who have already been vaccinated and that explain who benefits from vaccination. If drawing on past vulnerability experiences can inspire altruistic behaviours, communication campaigns that evoke them can increase vaccination intention.<\/span><\/p>\n

Strategies to Protect the Entire Population<\/b><\/h3>\n

The COVID-19 pandemic brought not only a global health crisis but also provided significant lessons on what determines people\u2019s adherence to health policies and the need for effective public communication tools. AstraZeneca\u2019s withdrawal of Vaxzevria reopened the debate on vaccine safety and highlighted the persistence of vaccine refusal. In this context, a multidimensional approach to vaccine refusal that considers people\u2019s capabilities, motivations, and opportunities to vaccinate is more relevant than ever. Clarity in communication, healthcare service accessibility, and improving public perception of vaccines are crucial elements. Future interventions must be based on a deep understanding of the factors that determine people\u2019s behaviours and supported by accurate and accessible information to reach and persuade the most reluctant parts of the population. Only in this way can we face future health crises and ensure vaccination coverage that protects all segments of society.<\/span><\/p>\n

Bio<\/p>\n

Alessia Melegaro is a full professor of demography and social statistics at the Department of Social and Political Sciences at Bocconi University and director of the Bocconi Covid Crisis Lab.<\/span><\/em><\/p>\n

Maria Cucciniello is an associate professor of public administration economics at the Department of Social and Political Sciences at Bocconi University.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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