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Make vaccines ‘opt-out’ to beat COVID-19, ditch the $300: Behaviour expert

Woman uses phone, close up of woman receiving COVID-19 vaccination in the arm.
RMIT University academic Meg Elkins explains the psychology behind making vaccines opt-out. (Images: Getty).

Australia could increase its uptake of COVID-19 vaccines if the system was switched to an opt-out program rather than an opt-in, a behavioural economist has said, while warning that cash incentives could backfire.

Offering Australians money to get vaccinated turns an act of goodwill into a market transaction, which changes the way people look at the vaccine, RMIT University senior behavioural economics lecturer Dr Meg Elkins told Yahoo Finance.

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“If I want to get a vaccine because of the love of my fellow man and I want to protect my fellow man, you’re taking that away from people, and you’re making it a market transaction,” she said.

“That changes people’s motivation: ‘I’m doing it for the money, not a feeling to do good in the world.’ If you can get people to take the vaccine because they want to protect their fellow man, they’re going to do it more willingly than they are for a cash exchange.”

Additionally, offering up incentives like beer or fast food can also backfire as enjoying these unhealthy foods can be seen to be at odds with getting a vaccine, an act designed to safeguard your health.

And, added Elkins, these sorts of incentives can even be seized upon by anti-vax groups in arguments against the safety of the vaccine.

Elkins’ suggestion comes as Australia races to achieve 80 per cent of the population vaccinated as NSW battles its worsening COVID-19 crisis.

Labor leader Anthony Albanese this week suggested paying fully vaccinated adults $300 in a bid to drive up jab rates. However, Prime Minister Scott Morrison dismissed the idea as “insulting”.

Instead, Elkins, who specialises in cultural and behavioural economics, wellbeing and public policy, believes the most effective way to encourage mass vaccination would be to shift the regime from opt-in to opt-out.

“It’s the one policy option that actually works,” she said.

Making vaccines opt-out increases uptake by as much as 36 per cent

A Wharton School study of more than 700,000 pharmacy patients in America found that simply sending a text message telling them they had an appointment “reserved” or “waiting” for them to use to get the flu shot increased uptake by 11 per cent.

And a 2010 study from Rutgers University found that telling people they had an appointment to receive a flu vaccine at a certain time and place improved the vaccination rate by 36 per cent when compared with a control group that was asked to make their own appointment.

This is because when people are told they have something “waiting” or “reserved” for them, it immediately establishes a sense of ownership, Elkins said.

We’re less likely to relinquish something in our possession, she said. And critically, when an appointment is already booked, it’s simply easier to turn up and get jabbed.

In terms of COVID-19 vaccinations, one way would be to send texts, letters or emails to Australians informing them of their appointment and providing a number or website to visit to reject or move the appointment.

The onus is on the individual to change the appointment if they don’t want it, and for many who want the vaccine but just haven’t gotten around to booking, it’ll be one less thing to do.

“We need things to be easy. If things aren’t easy and you have to take time out of your day, if you have to wait in line for three hours, you might get there and they don’t have the vaccine you want – there are all of these elements that come into play in our minds that could go wrong,” Elkins said.

Additionally, implementing an opt-in policy could make it easier to reach younger generations and those who aren’t engaging with traditional media.

Elkins said the Government needs to reach young people where they are, and that’s increasingly through their digital devices.

One way to do this is by sending a text or an email with details about an upcoming vaccination appointment, rather than hoping they will tune in to an 11am press conference and book an appointment.

“People are still a little bit confused [about the vaccine rollout], so whatever you can do to make it easier for people to get a vaccine will go a long way to increasing the uptake.”

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