SEATTLE—The benefits of vaccination are evident, yet clinics around the world are still met with patient skepticism. Creative new health strategies—grounded in a realistic understanding of human decision-making and behavioral economics—have the potential to increase global vaccination rates.
Vaccination is safe and cheap, making it one of the most efficient methods to reduce mortality rates, increase labor productivity and help developing nations out of poverty.
Immunization has already achieved widespread success (especially for children), increasing vaccination rates from 5 percent to 75 percent since 1974. While this progress is impressive, more work is necessary to prevent and to eradicate diseases that are within the world’s capacity.
According to the World Health Organization (WHO), up to 1.5 million children still die each year from preventable communicable diseases. This number is the product of insufficient access to immunization education in many areas, general anxiety about Western medicine, social stigma and the way in which vaccination is presented.
Behavioral economics provides psychological insight into the reasons that some families are opposed to immunization. Due to the way that vaccination is currently framed, the clear long-term benefits may not be viewed as sufficient justification for the potential risk of side effects, no matter how improbable those side effects may be.
Framing influences the perception of alternative choices as either losses or gains. Something as simple as the choice of language in the presentation of a decision can change the way a person weighs the risks and the benefits, making framing essential to refine in vaccination initiatives.
As people tend to have a greater aversion to loss, vaccinations must be presented as a reference point for which avoiding immunizations is seen as a severe loss in the opportunity to make a healthy choice.
Currently, vaccination is presented as a gain, with the small probability of side effects as a loss. Due to loss aversion and the human tendency to overestimate the potential risk of side effects, framing vaccines in this way greatly reduces global vaccination rates.
Thankfully, behavioral economics presents a solution for firms and impoverished nations. The concurrent creation of a market for vaccines for the developing world, the provision of non-monetary incentives for families who vaccinate and redefined framing may be essential steps in the eradication of preventable diseases.
Primarily, the market for vaccines in developing nations has consisted of hand-me-downs from wealthier countries. When a new vaccine is introduced in markets for developed countries, it often doesn’t reach those who need it most for a decade or longer.
While this disparity in access is unfortunate, the biotechnological or pharmaceutical companies that test and develop vaccines are unwilling to create vaccines specifically for developing countries— as there is not enough of a commercial return.
As an answer to the inaccessibility of vaccines, WHO’s AdvancedMarkets commitment created a vaccine market for developing nations. The initiative provides an incentive for both firms and donors. Donors have promised support when a successful vaccine is developed, and firms are given a variety of monetary breaks in order to encourage research, alongside the promise of a return on investment for their efforts.
On the ground, studies done in rural India have revealed that the provision of 1 kilogram of lentils, per vaccination, increased child immunization by more than 6 times. Incentives, such as this one, are incredibly cost-effective. They provide an immediate payoff for families, immense benefits to the community and increased usage of vaccine facilities—all for a very low price.
Behavioral economics provides important insight into the way real people make decisions. Utilizing this understanding leads to the creative implementation of cost-effective incentives and careful framing, which could increase global vaccination rates and save millions of lives.
– Larkin Smith