Vaccinations are a hot button issue at the moment with the Delta variant ramping up its presence here in the United States, the politicization of COVID-19, and the subsequent push-back on widespread vaccination efforts. There has been no shortage of speculation, rumor, and misinformation going around concerning the COVID-19 vaccine.
State legislators and healthcare providers have been trying different incentive methods to encourage more people to get vaccinated—including prizes and financial rewards. But to more effectively address the lower vaccination rates in certain states, we need to first analyze the reasons why people are foregoing the vaccine.
When COVID-19 first started popping up, experts quickly had to get as much information out as possible about the new virus to the public. Some of the first information published was that the highest risk populations were people with underlying health conditions and people over the age of 65.
While this information is true, it gave a lot of people a false sense of security that COVID wouldn’t affect the population at large and ‘must not be a very big deal’. Now, a year and half into the pandemic, we see more clearly that COVID-19 can seriously affect anyone regardless of age or pre-existing conditions.
In actuality, young adults are at a particular risk because they are more likely to attend large group gatherings and a majority of them hold frontline jobs and use public transportation. Between the presence of more contagious variants and the lower vaccination rates, we are seeing an increase in severe cases among younger and younger populations.
The conversations surrounding the pandemic and how to tackle it have also been drawn along political lines since news of the virus broke in late 2019 and early 2020. Making pandemic response a political issue greatly influenced how people received information about COVID-19 threat and prevention.
The world is on the verge of another surge of COVID cases, and with many variants beginning to pop up, it is more important than ever for people to be more equipped to tackle COVID as a community problem and not as an individual concern.
Early conversations about vaccine accessibility prioritized vaccine doses for populations at highest risk such as front line workers and people over 50. Some people who may have been eligible were putting off getting the vaccine to make sure that there were enough doses for those most at risk. At this point in time, the vaccine roll out has been ramped up and doses are readily accessible to most people.
For economically disadvantaged populations however, accessibility is still a real concern.
Pharmacies and adequate medical infrastructure are few and far between in low income or rural neighborhoods, and many people have trouble finding transportation to a vaccination site. Individuals who are homebound due to medical circumstances are most at risk for not having adequate access to the COVID vaccine, much less being able to receive their second dose as is needed for the Moderna and Pfizer vaccines.
In addition, although the government has purposefully allocated funding to make the vaccine completely free regardless of insurance, many Americans are hesitant to seek care out of fear of hidden costs.
To ease access to vaccinations, many states have implemented large temporary vaccination sites and pop up testing in low income neighborhoods as well as volunteer programs to provide transportation or doing door-to-door campaigns to advocate for vaccinations.
Due to the expedited trial and approval process for the vaccines, concerns began to rise about their efficacy and long term side effects.
While production of this vaccine came quicker than usual vaccine development, it is because this is not the first Coronavirus vaccine we have created such as the flu, SARS, and MERS vaccines. Due to the severity and urgency of the pandemic, grants and approvals to start the trial process were expedited and prioritized resulting in a faster turnaround.
The most common fears around side effects include DNA alteration and infertility, as well as long term effects we’re not yet aware of.
Several studies have been conducted and many experts have come forward to say that the COVID-19 vaccine does not affect one’s fertility or their ability to have a normal pregnancy. The greatest danger COVID presents to fertility is in contracting the virus, which can cause grave complications to both the mother and child. In addition, the COVID-19 vaccine is an mRNA vaccine and does not affect or alter DNA.The best line of defense to serious illness and complications from COVID-19 is to receive the vaccine.
Many marginalized communities are skeptical of government and healthcare systems forcing certain things on them because of learned or experienced historical injustices. Healthcare has dark patches of history concerning the experimentation on black and other racially diverse bodies in the name of “science” and “healthcare”, such as the infamous Tuskegee Experiment.
This mistrust is valid and not to be downplayed by others. While we have come a long way in the ethics of scientific studies, there are certain biases that are still present in different practices, physicians, and disease states.
There is ample evidence available to help build trust in the COVID-19 vaccine itself. Community outreach and support is also picking up in Black and Latinx communities to encourage people to get vaccinated and be able to address concerns with empathy and information.
Furthermore, if members or patients are not receiving their vaccines, making the time to reach out and discuss any concerns or questions they have about the vaccine and their personal medical history can go a long way.
Over the past few months, we have seen many different strategies for encouraging people to get the vaccine, including incentive structures. States like Ohio, New Mexico, Oregon, and New York have implemented lottery-style incentives to boost vaccination rates with mixed results—seeing initial spikes but lacking lasting results in boosting vaccination rates.
The principles of behavioral economics show us how to incentivize for lasting, not just one-time, change.
According to behavioral economics, people are more likely to want to keep something they feel they already have rather than gain something new—otherwise known as the Endowment Effect.
For example, the idea of winning a million dollars as a lottery prize for vaccination sounds great, but people know their chances are low and therefore the prize money is less tempting. Early in the vaccination roll out, Wellth adviser, Dr. Mark Fendrick, of University of Michigan referenced Wellth as a model to help encourage people to make sure they get their second dose of the vaccine.
“Fendrick has been working on a comprehensive effort to address the second-shot problem: not merely reminding people through smartphones to get their next dose, but providing financial rewards for following through.”
-Politico Article, America’s low-tech vaccine rollout
Wellth’s model uses the endowment effect to encourage their members to stay adherent to their care regimens such as taking medications or checking glucose levels. This has shown consistent improvements in care plan adherence, averaging around 90 percent adherence.
With the needed percentage for herd immunity sitting between 70 and 90 percent, with 90 percent adherence to vaccinations, we would be able to return to daily life as it was before the pandemic.
Wellth recognizes the importance of education, empathy, and meaningful motivation in the way we approach individuals who may have been otherwise disconnected from their care plans. Our empathetic member support team listens to individual members to identify barriers to adherence, and works with health plans and providers to overcome challenges with flexible incentives and an individualized experience to meet our members where they’re at.
As we take the time to understand why individuals are resisting vaccination, then work with them individually from a place of empathy to overcome barriers, we’re more likely to improve rates quickly and effectively—for better overall public health outcomes—and beat this together.