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Thinking About Default Enrollment Lowers Vaccination Intentions and Public Support in G7 Countries

Overview
Journal PNAS Nexus
Specialty General Medicine
Date 2024 Apr 8
PMID 38585340
Authors
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Abstract

Policymakers often face a conundrum between being transparent about policies and ensuring that those policies are effective. This challenge is particularly relevant for behavioral nudges, which are not usually disclosed. Rather than avoiding transparency, we suggest that policymakers encourage citizens to reflect on nudges to help them understand their own views and align those views with their behaviors. Using data from an online survey experiment with 24,303 respondents in G7 countries, we examine the impact of reflection on a hypothetical default nudge policy for COVID-19 booster appointments. Contrary to expectations, participants say they would be less likely to get the booster when automatically enrolled compared with a control condition. Similarly, encouraging citizens to think about the status quo (baseline) policy also reduces intentions for boosters. These interventions have no effect on approval of the policy. Further, encouraging people to think about automatic enrollment decreases approval of the policy and further decreases their intentions to get vaccinated. These findings suggest that reflection on a nudge can increase backlash from a nudge and also elicit policy disapproval, thereby aligning policy support with behavioral intentions.

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References
1.
Milkman K, Beshears J, Choi J, Laibson D, Madrian B . Using implementation intentions prompts to enhance influenza vaccination rates. Proc Natl Acad Sci U S A. 2011; 108(26):10415-20. PMC: 3127912. DOI: 10.1073/pnas.1103170108. View

2.
Milkman K, Gandhi L, Patel M, Graci H, Gromet D, Ho H . A 680,000-person megastudy of nudges to encourage vaccination in pharmacies. Proc Natl Acad Sci U S A. 2022; 119(6). PMC: 8833156. DOI: 10.1073/pnas.2115126119. View

3.
Patel M . Text-message nudges encourage COVID vaccination. Nature. 2021; 597(7876):336-337. DOI: 10.1038/d41586-021-02043-2. View

4.
Bloniarz A, Liu H, Zhang C, Sekhon J, Yu B . Lasso adjustments of treatment effect estimates in randomized experiments. Proc Natl Acad Sci U S A. 2016; 113(27):7383-90. PMC: 4941428. DOI: 10.1073/pnas.1510506113. View

5.
Chapman G, Li M, Colby H, Yoon H . Opting in vs opting out of influenza vaccination. JAMA. 2010; 304(1):43-4. DOI: 10.1001/jama.2010.892. View