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Behavioural science may explain vaccine hesitancy

Late last year, as many of us again shut our doors and stayed home, we placed our hope on the COVID-19 vaccines to help us return to normalcy. Between April and June 2020, intention to be vaccinated was strong, with more than 80% in the UK showing an inclination to be immunised should a vaccine become available. 1

With COVID-19 vaccines now being rolled out around the world, my behavioural science research team wanted to understand people's current attitudes towards them, and so we surveyed over 1,150 people in six developed countries in late January. What we discovered, to our surprise, was that now only 50% of respondents said that they would definitely get the vaccine – that is a much lower proportion than last year. In fact, four in 10 were undecided. What led to this disparity?

Intention-action gap and ambiguity aversion are possible explanations

We believe the intention-action gap could be at play here. It refers to the difference between what people say that they would like to do and what they actually do. A large part of this is also temporal 2 – for instance, it's easier for me to say "I will start exercising next month" but fall short on my intention nearer the time. When decision-making time is upon us, people may think more carefully about their original intention and how it impacts them. 

On top of this, it's likely that ambiguity aversion is playing a role. Us humans have a preference for certainty over ambiguity 3 and tend to steer away from making decisions about uncertain outcomes. It's probably fair to say that there are unknown risks and complex uncertainties – such as possible side effects or trusting a novel vaccine – in deciding whether to take the COVID-19 vaccine. In fact, over 70% of respondents cited potential side effects as the most endorsed reason for not getting vaccinated, illustrating how such unknowns can complicate decision-making.

Demographics and COVID-19 experiences are important, life stage less so

Our survey showed that all participants above the age of 65 were in favour of getting the vaccine. This aligns with messages from public health bodies globally that are prioritising vaccine rollout to the elderly first. Respondents living in France had the lowest intention of getting the vaccine with 37% against taking it, whilst 86% of participants in the UK and Germany were in favour of taking the vaccine, the highest rate among the surveyed countries. 

Unsurprisingly, over 80% of those in the COVID-19 high risk group were intending on getting the vaccine. What was interesting, however, was that 47% of those who had already contracted the virus said they would definitely or probably not get the vaccine. This highlights the lack of information around immunity from past illness in comparison to the immunity resulting from vaccination.

It was interesting to note that life stage, whether you are a student, married, or a parent – a key factor for many important decisions – did not have a significant impact on the decision to vaccinate. 

Insurers can help people make the right decisions for themselves

Considering these behavioural science patterns when it comes to deciding whether to take a new vaccine that is highly topical, it's no wonder that four in 10 people are still figuring it out. I believe insurers can help put people at ease. 

Insurers can reassure existing customers that valid claims related to COVID-19 will be honoured, regardless of their decision to get the vaccine or not. Stating the obvious is sometimes necessary, especially when half of policyholders are unsure whether they are covered for COVID-19 related deaths

Additionally, as risk experts, insurers could make vaccine-related data more accessible to the public in an attempt to fight fake news and provide a balanced, objective view. A properly informed public is the first step in overcoming our unconscious biases and hesitant decision-making – and fosters a more resilient society.


1. Thorneloe, R., Wilcockson, H. E., PhD, Lamb, M., Jordan, C. H., & Arden, M. (2020, July 20). Willingness to receive a COVID-19 vaccine among adults at high-risk of COVID-19: a UK-wide survey.
2. Conner, M., & Godin, G. (2007). Temporal stability of behavioural intention as a moderator of intention-health behaviour relationships. Psychology & Health, 22(8), 875-897. doi:10.1080/14768320601070449
3. Trautmann, S. T., Vieider, F. M., & Wakker, P. P. (2008). Causes of ambiguity aversion: Known versus unknown preferences. Journal of Risk and Uncertainty, 36(3), 225-243.


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