A behavioral economics perspective on the COVID-19 vaccine amid public mistrust

Abstract The COVID-19 vaccine development, testing, and approval processes have moved forward with unprecedented speed in 2020. Although several vaccine candidates have shown promising results in clinical trials, resulting in expedited approval for public use from the U.S. Food and Drug Administration, recent polls suggest that Americans strongly distrust the vaccine and its approval process. This mistrust stems from both the unusual speed of vaccine development and reports about side effects. This article applies insights from behavioral economics to consider how the general public may make decisions around whether or not to receive a future COVID-19 vaccine in a context of frequent side effects and preexisting mistrust. Three common cognitive biases shown to influence human decision-making under a behavioral economics framework are considered: confirmation bias, negativity bias, and optimism bias. Applying a behavioral economics framework to COVID-19 vaccine decision-making can elucidate potential barriers to vaccine uptake and points of intervention for clinicians and public health professionals. Several COVID-19 vaccines are being rapidly developed in response to the 2020 coronavirus pandemic. Studies show that the vaccines are safe and provide some protection against COVID-19. In an emergency situation like a pandemic, vaccine makers can apply for an emergency approval from the government to distribute the vaccine. Several companies plan to do this. However, polls show that Americans are worried about the speed of vaccine development and approval. They are also worried about vaccine side effects. Worries like these may lead people to decide not to get the COVID-19 vaccine. If enough people decide they do not want the vaccine, it will be difficult to slow down the pandemic. Behavioral economics is the study of human decision-making. This article discusses how behavioral economics can be used to understand how people may intuitively think about the decision to get a COVID-19 vaccine. Humans can sometimes have errors in judgment (called “cognitive biases”). By identifying these errors as they relate to the COVID-19 vaccine, we can prepare health care providers and health officials to help people make fully informed decisions about the vaccine.