Moving the Needle on Vaccinations

By Lianne E. Jacobs, MPH
Health professional prepares to give woman shot vaccination - Vitality

The Role of Behavioral Interventions to Increase Rates of Immunization

Vaccines are considered to be one of the greatest global public health achievements of the 20th century, during which substantial advancements were made in the control of vaccine-preventable diseases, such as smallpox, diphtheria, pertussis, tetanus, and measles. According to the WHO, immunizations prevent 2-3 million deaths each year.

This month, as part of National Immunization Awareness Month, we celebrate the remarkable successes and highlight the critical importance of immunizations and vaccinations.  Given the COVID-19 pandemic has led to a decline in routine medical visits and thus, vaccination rates are lower than in previous years, it is more crucial than ever before to revisit the importance of vaccinations and what we can do to increase rates of immunizations within our communities.

Immunizations and Vaccinations Matter at All Phases of Life

Immunizations play a crucial role throughout our lives. Starting at birth, for each birth cohort that receives routine childhood immunizations, society saves 33,000 lives and prevents 14 million cases of disease.  However, childhood immunizations are simply the beginning – it is essential that adults stay up to date with vaccinations because immunity from childhood vaccinations can wear off over time.  Getting the recommended vaccinations serve two important purposes.  Immunization helps protect yourself against diseases that can be prevented.  Every year thousands of adults in the US become seriously ill and are hospitalized due to diseases that vaccines can help prevent, such as seasonal influenza, pneumococcal disease, and hepatitis B.  Many adults even die from complications from these diseases.

Your Immunization Matters to Your Community

Immunizations are not only important for you– they also help protect others against those same diseases.  Many vulnerable populations are not able to be vaccinated due to their age or their health conditions.  These populations, such as young children, elderly adults, or those with certain chronic conditions, are at an increased risk of disease, and can only be protected by a public health concept known as “herd immunity.”  Herd immunity exists when enough people in a population are vaccinated against an infectious disease to make its spread unlikely.  The recent measles outbreaks and cases of polio in the US are a terrifying reminder of what happens when vaccination rates decline and herd immunity weakens.

To Achieve Change at Scale Requires Effective Behavior Solutions

It is no surprise then that one of the goals of Healthy People 2020 was to increase immunization rates and reduce preventable infectious diseases.  But how do we encourage higher rates of vaccination?  Behavioral strategies, as it turns out, work better than persuasion. One challenge, as a New York Times article astutely observes, is that people fall prey to the Dunning-Kruger effect when it comes to their health, optimistically thinking that they are more knowledgeable than scientific experts. It is precisely because of these cognitive missteps that that behavioral interventions, which circumnavigate these poor preconceptions, are found to be more effective than persuasion alone.

Interventions that have proven most effective at increasing vaccine uptake are the ones that facilitate action (by providing patients with reminders and prompts), reduce barriers (by setting default orders and appointments), and shape behavior (by developing incentives, sanctions, and requirements).   Instead of focusing on interventions to change people’s attitudes, we should be focusing on developing interventions that directly shape people’s behaviors.

At Vitality, our mission is to protect and enhance the lives of our members.  We’ve developed a program rooted in the combination of the best clinical science, data science, and behavioral science to help our members live their healthiest lives possible.  In a recent analysis of our Discovery Health Medical Scheme members in South Africa, we found that – when adjusted for age – Vitality members were almost twice as likely to get vaccinated when compared with their non-Vitality counterparts.

Staying up to date on one’s vaccinations is a critical component of living a healthy life.  The health of our society depends on all of us.

Click here for information about the recommended vaccinations by the Centers for Disease Control and Prevention (CDC).

Lianne E. Jacobs, MPH, Health Communications Strategist, has a master’s degree in public health from Yale University.  She is the only indoor cycling instructor who can’t ride a bike.  She enjoys traveling the world, laughing at her own jokes, changing diapers, and tricking her husband into eating baked goods made with hidden vegetables.

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