| Literature DB >> 34563830 |
Ola Andersson1, Pol Campos-Mercade2, Armando N Meier3, Erik Wengström4.
Abstract
We investigate how the anticipation of COVID-19 vaccines affects voluntary social distancing. In a large-scale preregistered survey experiment with a representative sample, we study whether providing information about the safety, effectiveness, and availability of COVID-19 vaccines affects the willingness to comply with public health guidelines. We find that vaccine information reduces peoples' voluntary social distancing, adherence to hygiene guidelines, and their willingness to stay at home. Getting positive information on COVID-19 vaccines induces people to believe in a swifter return to normal life. The results indicate an important behavioral drawback of successful vaccine development: An increased focus on vaccines can lower compliance with public health guidelines and accelerate the spread of infectious disease. The results imply that, as vaccinations roll out and the end of a pandemic feels closer, policies aimed at increasing social distancing will be less effective, and stricter policies might be required.Entities:
Keywords: Economic epidemiology; Information; Public health communication; Social distancing; Vaccination; Vaccine information
Mesh:
Substances:
Year: 2021 PMID: 34563830 PMCID: PMC8442531 DOI: 10.1016/j.jhealeco.2021.102530
Source DB: PubMed Journal: J Health Econ ISSN: 0167-6296 Impact factor: 3.804
Treatment arms overview.
| Order of appearance of question blocks | Share of participants | |||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| Treatment | Vaccine info. | Duration | Choice experiment | Health Behaviors | Survey | 0.5 |
| Control A | Choice experiment | Health behaviors | Vaccine info. | Duration | Survey | 0.25 |
| Control B | Choice experiment | Health behaviors | Duration | Vaccine info. | Survey | 0.25 |
Note: The order of questions about the stay-at-home program and health behaviors is randomized in all treatments.
Fig. 1The treatment effect by intended health behavior. The gray dots give the estimated difference on the outcome variables in standard deviations when comparing people who receive the vaccine information after describing future health behavior (Control) to people who receive vaccine information before describing future health behavior (Treatment). The health behavior index captures an average of the following standardized health variables. The first seven non-boldfaced measures are responses to the following questions: “Looking ahead, to what extent do the following statements describe your behavior in response to the outbreak of the coronavirus (COVID-19)?”: Avoids contact “I will try to avoid social contacts in person (for example, I will attend fewer social gatherings)”; Keeps informed “I will inform myself about how the spread of the corona virus can be prevented”; Keeps distance “I will keep at least two meters distance from other people”; Avoids travel “I will refrain from private domestic trips outside my home municipality (e.g., to holiday homes and acquaintances)”; Coughs in elbow “I will cough and sneeze into my elbow or a tissue instead of the hand”; Not touching face “I will touch my face less often than usual”; and Washes hands “I will wash my hands more often than usual when not at home”. The three remaining measures are responses to the following questions: “If you exhibited mild symptoms of illness (e.g., coughing) tomorrow, how much do the following statements apply to your behavior in the next two weeks?” Self isolates “I will self-quarantine”; Informs contacts “I will immediately inform people who had contact with me”; and Wears mask “I will wear a mask, or something else to cover my mouth (e.g., a scarf), if I have to leave home”. (Answers on 7-point scale ranging from 1= "Does not apply at all" to 7= "Applies very much"). Stays home refers to the probability of people voluntarily participating in a stay-at-home program across 9 scenarios (ranging from people taking part no matter what the conditions of the stay-at-home program are, to never taking part) which is standardized to be comparable to the other measures (see section Materials and Methods for details). As preregistered, the coefficient estimates are based controlling for gender, 6 dummies indicating age categories, adult income, a dummy indicating unemployment, a dummy indicating children, a dummy indicating single households, a dummy indicating a university degree, and dummies indicating whether people live in a big city/regular city/small city. We present the full set of results for each single item with and without controls in Tables S3-S7. Figure S6 shows that the results are equivalent when we drop individuals who filled out the survey in less than 5 min. *** p<0.01, ** p<0.05, * p<0.1.
Treatment effect on the main outcome variables.
| Dependent variables: | Health behavior index | Stays home | ||||
|---|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | (6) | |
| Vaccine Information | −0.19*** | −0.19*** | −0.18*** | −0.12** | −0.11** | −0.12** |
| (0.04) | (0.03) | (0.03) | (0.05) | (0.05) | (0.05) | |
| Observations | 1,617 | 1,617 | 1,617 | 1,617 | 1,617 | 1,617 |
| R-squared | 0.02 | 0.16 | 0.17 | 0.00 | 0.02 | 0.02 |
| Gender | Yes | Yes | Yes | Yes | ||
| Age Categories | Yes | Yes | Yes | Yes | ||
| Controls | Yes | Yes | ||||
Note: The table shows the treatment effect estimate for people receiving vaccine information on health behaviors using linear regressions. Higher values in “Health behavior index” indicate better intended health behaviors to stop the spread of the virus. Stays at home indicates a higher willingness to stay at home for the different scenarios in the choice experiment. Age categories include 6 indicators for age categories. Controls include adult income, a dummy indicating unemployment, a dummy indicating children, a dummy indicating single households, a dummy indicating a university degree, and dummies indicating whether people live in a big city/regular city/small city. Heteroscedasticity robust standard errors are shown in parentheses. *** p<0.01, ** p<0.05, * p<0.1.
Fig. 2Vaccine information and expectations. The figure shows the raw distribution of expectations about when life will start going back to normal across treatment groups. The light gray bars show the density for people who do not receive vaccine information before the question about the duration of the pandemic, whereas the light blue bars show the density for people who receive information before the question about the duration of the pandemic. People respond to the following statement: “In February 2021 life will start to look like it did in February 2020, before the outbreak of the pandemic.” To which they could answer on a 7-point scale from “Strongly disagree” to “Strongly agree”. Regression results confirm the visual impression: The treatment increases optimism about an early end of the pandemic by 0.15 of a standard deviation (p<0.05) (Table S8). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3Scenario analysis of the effects of vaccine anticipation on COVID-19 cases in Sweden. The solid black line in the first panel represents the number of COVID-19 cases per 100,000 inhabitants in Sweden from September 2020 to July 2021. The vertical dashed line represents the week where the positive news about the safety and effectiveness of the Pfizer and Moderna trials filled the headlines. The blue dashed line represents the simulated analysis of the cases in the absence of such positive news. The red dot-dashed line represents the simulated analysis in the absence of vaccines. The green short-dashed line represents the simulated analysis in the absence of both the anticipation effect and the vaccines. The second panel represents the same data in cumulative cases per 100,000 inhabitants. For details and sensitivity analyses, see Supplementary Materials, Section 3. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)