Dolores de la Mata
Economista Principal, CAF -banco de desarrollo de América Latina-
This blog is written by Dolores de la Mata and Federico Pena.
In an earlier blog post we described a few core elements for successful vaccination campaigns in the region, including factors related to vaccine procurement processes and the mechanisms to make them available to the population. In this entry we will focus on another set of challenges that relate to demand: the attitudes displayed by Latin Americans toward receiving the COVID-19 vaccine. No technical advancement that makes a vaccine massively available and no widespread application strategy will end the spread of the virus if people ultimately choose not to get vaccinated.
The demand factor is particularly relevant in ensuring the success of vaccination campaigns for two reasons. First, because there is extensive evidence that a significant fraction of the population does not use medical services (including vaccines) even when they are convinced of their effectiveness. Secondly, because in recent years there has been a growing distrust of the safety and effectiveness of vaccines among certain groups of the population. In the particular case of the COVID-19 vaccine, this distrust can also extend to pro-vaccine groups, fueled by the limited information available about it, a natural occurrence in a context where the vaccine is being developed, evaluated, approved and distributed by authorities almost simultaneously.
Figure 1 shows encouraging evidence about Latin Americans’ attitudes towards vaccines. According to a survey conducted before the pandemic, only 16 percent of Latin Americans strongly disagree, disagree, or neither agree nor disagree that vaccines are safe (Table A) versus 30 percent of respondents in OECD countries. On the other hand, another recent survey corroborates the positive attitudes of Latin Americans when specifically consulted on the COVID-19 vaccine (Table B): 69 percent of respondents said they are willing to get vaccinated with new vaccines, while only 55 percent of respondents in OECD countries gave similar answers.
Figure 1. Perceptions towards COVID-19 and other vaccines among Latin Americans
Table A. Perceptions about vaccine safety. Percentage of people who strongly disagree, disagree, or neither agree nor disagree.
Table B. Responses regarding the application of a new coronavirus vaccine.
Notes: On Table A, horizontal lines represent simple regional averages. On Table B, the values correspond to regional weighted averages per country. Latin America includes: Argentina, Bolivia, Brazil, Chile, Colombia, Guatemala, Honduras, Mexico, Peru, Uruguay and Venezuela. OECD includes: Australia, Canada, Germany, Estonia, Spain, France, the United Kingdom, Italy, Japan, South Korea, Netherlands, Poland, Turkey and the United States.
Source: Authors, based on Wellcome Global Monitor 2018 data - as updated July 2019 - (Table A) and data from COVID-19 Beliefs, Behaviors & Norms Survey. MIT 2020 (Table B).
It should be noted that, although the group in favor of vaccines is in the majority, those against or unsure represent about one third of the population in Latin America and as much as 45 percent in OECD countries. If the vaccine is not applied effectively, these groups could compromise the goal of covering between 60 and 80 percent of the total population, numbers commonly reported to be enough to achieve herd immunity. According to another recent survey the main reasons for refusing to get the vaccine in 15 developed countries (including Brazil and Mexico) are qualms about the side effects (as stated by between 60 and 80 percent of people, depending on the country) and, to a lesser extent, concerns about its effectiveness (between 15 and 45 percent, depending on the country).
The evidence presented here suggests that, while many Latin Americans are willing to get vaccinated, vaccination campaigns would benefit strongly if policies ensuring the supply of the shot being implemented across the region were also accompanied by demand-boosting programs. In particular, states should foster awareness-raising strategies about the benefits of the vaccine, especially among those who still doubt its safety and effectiveness, in order to achieve the critical mass needed. Behavioral economics notions can be a useful tool for designing demand-oriented policies, as health care decisions are often greatly affected by behavioral biases. We can highlight three elements that reduce these biases and could be incorporated into policy design
First, providing a suitable environment that reduces barriers and facilitates the application of the vaccine. This may be achieved through measures such as making it easier for people to get a place in the vaccination line, sending reminders, improving the accessibility and quality of vaccination centers and making it affordable, in terms not only of monetary but also non-monetary costs, such as delay times. Second, generating role models and social standards. Measures that leverage peer effects and role models can be successful. Some examples include launching informational campaigns that show citizens that there is a positive trend of people getting the vaccine or that point out the number of residents who have already done so on a local level, sharing cases of respected people or public figures have already been vaccinated, and encouraging people to talk about their personal vaccination experiences on social media. Finally, convincing and motivating people to get vaccinated. This highlights the need for clear, accurate and transparent communication strategies by government agencies. This information should be available to the entire population in order to dispel any doubts about the quality and safety of vaccines, as well as prevent misinformation, and explain the individual and social benefits of vaccination. The yields of the communicational effort may be higher if specific messages are designed for the populations most likely to receive them, in particular those still hesitant about getting vaccinated.
