Effective incentives for increasing COVID-19 vaccine uptake.

In this study, we examined the relative effectiveness of prestige-based incentives (vaccination of an expert scientist/president/politician/celebrity/religious leader), conformist incentives (vaccination of friends and family) and risk-based incentives (witnessing death or illness of a person from the disease) for increasing participants' chances of getting vaccinated with respect to their coronavirus disease 2019 (COVID-19) vaccine intention. We conducted a cross-cultural survey using demographically representative samples from the UK (n = 1533), USA (n = 1550) and Turkey (n = 1567). The most effective incentives in all three countries were vaccination of an expert scientist, followed by vaccination of friends and family members and knowing someone dying from the disease. Vaccination of an expert scientist was significantly more effective at increasing vaccine intention than any other incentive. Vaccine incentives, regardless of the incentive type, were much less effective for those who originally refused the COVID-19 vaccine than for those who were hesitant to receive the vaccine. Although the percentage of vaccine-hesitant participants was highest in Turkey, the mean effectiveness scores of incentives were also the highest in Turkey, suggesting that an informed vaccine promotion strategy can be successful in this country. Our findings have policy applicability and suggest that positive vaccination messages delivered by expert scientists, vaccination of friends and family and risk-based incentives can be effective at increasing vaccine uptake.

COVID-19 vaccine hesitancy is associated with beliefs on the origin of the novel coronavirus in the UK and Turkey.

BACKGROUND: Much research effort is focused on developing an effective vaccine for combatting coronavirus disease 2019 (COVID-19). Vaccine development itself, however, will not be enough given that a sufficient amount of people will need to be vaccinated for widespread immunity. Vaccine hesitancy is on the rise, varies across countries, and is associated with conspiratorial worldview. Given the rise in COVID-19-related conspiracy theories, we aimed to examine the levels of COVID-19 vaccine hesitancy and its association with beliefs on the origin of the novel coronavirus in a cross-cultural study. METHODS: We conducted an online survey in the UK (N = 1088) and Turkey (N = 3936), and gathered information on participants' willingness to vaccinate for a potential COVID-19 vaccine, beliefs on the origin of the novel coronavirus, and several behavioural and demographic predictors (such as anxiety, risk perception, government satisfaction levels) that influence vaccination and origin beliefs. RESULTS: In all, 31% of the participants in Turkey and 14% in the UK were unsure about getting themselves vaccinated for a COVID-19 vaccine. In both countries, 3% of the participants rejected to be vaccinated. Also, 54% of the participants in Turkey and 63% in the UK believed in the natural origin of the novel coronavirus. Believing in the natural origin significantly increased the odds of COVID-19 vaccine acceptance. CONCLUSIONS: Our results point at a concerning level of COVID-19 vaccine hesitancy, especially in Turkey, and suggest that wider communication of the scientific consensus on the origin of the novel coronavirus with the public may help future campaigns targeting COVID-19 vaccine hesitancy.

Adaptive function and correlates of anxiety during a pandemic.

BACKGROUND AND OBJECTIVES: Most studies to date have focused on the negative aspects of anxiety. Anxiety, however, is an evolved emotional response that can provide protection in the face of risk. Pandemics are characterized by increased mortality risk coupled with future uncertainties, which both cause heightened anxiety. Here, we examine the factors associated with anxiety levels and risk avoidance behaviours during the first wave of the COVID-19 pandemic. We asked how individual time perspectives (future-oriented consideration and attention to present moment experience) affect anxiety in uncertain times, and whether anxiety reduces mortality risk by promoting risk avoidance behaviour. METHODOLOGY: We conducted an online survey in the UK (N = 1088) and Turkey (N = 3935) and measured participants' generalized and pandemic-related anxiety levels, future-oriented consideration, mindfulness, intolerance of uncertainty, risk perception and risk avoidance behaviours. RESULTS: We found that people less tolerant of uncertainties had higher levels of pandemic anxiety. Those with higher pandemic anxiety exhibited risk avoidance behaviours more frequently. Mindfulness and increased financial satisfaction reduced pandemic anxiety. People in Turkey reported higher levels of generalized and pandemic anxiety and greater engagement in risk avoidance behaviours than people in the UK. CONCLUSIONS AND IMPLICATIONS: Our study shows an elevated anxiety response can help mitigate infection risk during pandemics and emphasizes the importance of the underlying situation in understanding whether an anxiety response is adaptive or pathological. Maintaining a healthy level of anxiety can promote engagement in protective behaviours. Therapies addressing anxiety can focus on increasing tolerance to future uncertainties. LAY SUMMARY: Anxiety is an emotional response triggered in the anticipation of a possible threat. We found that intolerance of uncertainty strongly predicted anxiety and that people with elevated anxiety levels engaged in protective behaviours more frequently during the COVID-19 pandemic, suggesting that anxiety can help mitigate mortality risk.

How evolutionary behavioural sciences can help us understand behaviour in a pandemic.

The COVID-19 pandemic has brought science into the public eye and to the attention of governments more than ever before. Much of this attention is on work in epidemiology, virology and public health, with most behavioural advice in public health focusing squarely on 'proximate' determinants of behaviour. While epidemiological models are powerful tools to predict the spread of disease when human behaviour is stable, most do not incorporate behavioural change. The evolutionary basis of our preferences and the cultural evolutionary dynamics of our beliefs drive behavioural change, so understanding these evolutionary processes can help inform individual and government decision-making in the face of a pandemic. Lay summary: The COVID-19 pandemic has brought behavioural sciences into the public eye: Without vaccinations, stopping the spread of the virus must rely on behaviour change by limiting contact between people. On the face of it, "stop seeing people" sounds simple. In practice, this is hard. Here we outline how an evolutionary perspective on behaviour change can provide additional insights. Evolutionary theory postulates that our psychology and behaviour did not evolve to maximize our health or that of others. Instead, individuals are expected to act to maximise their inclusive fitness (i.e, spreading our genes) - which can lead to a conflict between behaviours that are in the best interests for the individual, and behaviours that stop the spread of the virus. By examining the ultimate explanations of behaviour related to pandemic-management (such as behavioural compliance and social distancing), we conclude that "good of the group" arguments and "one size fits all" policies are unlikely to encourage behaviour change over the long-term. Sustained behaviour change to keep pandemics at bay is much more likely to emerge from environmental change, so governments and policy makers may need to facilitate significant social change - such as improving life experiences for disadvantaged groups.