COVID-19 Vaccine Acceptance and Hesitancy in Low and Middle Income Countries, and Implications for Messaging (preprint)

BackgroundAs vaccination campaigns are deployed worldwide, addressing vaccine hesitancy is of critical importance to ensure sufficient immunization coverage. We analyzed COVID-19 vaccine acceptance across 15 samples covering ten low- and middle-income countries (LMICs) in Asia, Africa, and South America, and two higher income countries (Russia and the United States). MethodsStandardized survey responses were collected from 45,928 individuals between June 2020 and January 2021. We estimate vaccine acceptance with robust standard errors clustered at the study level. We analyze stated reasons for vaccine acceptance and hesitancy, and the most trusted sources for advice on vaccination, and we disaggregate acceptance rates by gender, age, and education level. FindingsWe document willingness to take a COVID-19 vaccine across LMIC samples, ranging from 67% (Burkina Faso) to 97% (Nepal). Willingness was considerably higher in LMICs (80%) than in the United States (65%) and Russia (30%). Vaccine acceptance was primarily explained by an interest in personal protection against the disease (91%). Concern about side effects (40%) was the most common reason for reluctance. Health workers were considered the most trusted sources of information about COVID-19 vaccines. InterpretationGiven high levels of stated willingness to accept a COVID-19 vaccine across LMIC samples, our study suggests that prioritizing efficient and equitable vaccine distribution to LMICs will yield high returns in promoting immunization on a global scale. Messaging and other community-level interventions in these contexts should be designed to help translate intentions into uptake, and emphasize safety and efficacy. Trusted health workers are ideally positioned to deliver these messages. FundingBeyond Conflict, Bill and Melinda Gates Foundation, Columbia University, Givewell.org, Ghent University, HSE University Basic Research Program, International Growth Centre, Jameel Poverty Action Lab Crime and Violence Initiative, London School of Economics and Political Science, Mulago Foundation, NOVAFRICA at the Nova School of Business and Economics, NYU Abu Dhabi, Oxford Policy Management, Social Science Research Council, Trinity College Dublin COVID19 Response Funding, UK Aid, UKRI GCRF/Newton Fund, United Nations Office for Project Services, Weiss Family Fund, WZB Berlin Social Science Center, Yale Institute for Global Health, Yale Macmillan Center, and anonymous donors to IPA and Y-RISE

The Covid-19 Infodemic and the Efficacy of Corrections (preprint)

Social media platforms have taken unprecedented steps to combat misinformation about Covid-19. However, critics question whether the most common strategy – labeling and alerting readers to misinformation – successfully counters misinformation or paradoxically reinforces inaccurate beliefs. Using a pair of survey experiments, we examine the efficacy of two different corrections in reducing accuracy misperceptions and social media sharing that spreads false claims. Simply flagging fake headlines had little effect on subjects’ accuracy assessments and social media responses. Corrections explicitly countering false claims with factual information were more effective, though many respondents reported that they believed and would share the false information. Despite the increasing politicization of America’s pandemic response and polarization more generally, corrections to false claims with and without partisan valence were equally effective. We found no evidence of partisan backfire effects. The efficacy of corrections did vary with social media usage and age, a proxy for digital literacy. However, these moderating effects were inconsistent and often conflicting. Our results suggest that more aggressive corrections are essential to combating the Covid-19 infodemic; backlash risks are minimal and milder corrections ineffective.