BackDo not let jab hesitancy flatten our vaccination curve
The complexity of human behaviour has sadly not got the policy-level attention it so richly deserves
PremiumTraditionally, it takes 5-10 years to develop a new vaccine, build its manufacturing and supply-chain facilities, and set up the infrastructure for facilitating the vaccination process. As far as the covid vaccine is concerned, all this was achieved in less than a year, an example of extremely efficient all-round management. But one problem is undoing this good work—vaccination hesitancy. A large number of people are hesitant to get inoculated.
This initial hesitation has been among health workers in India. Hesitancy levels are expected to be higher once everyone else is expected to walk in for vaccination. If this is the level of difficulty getting people to take their first vaccine shot, it will only become tougher when it comes to the second dose. As the number of covid cases and death rates decline, the fear of the pandemic will further subside. It will then become even more difficult to achieve the government’s target of 300 million people vaccinated by August, if the uptake remains at its current rate.
It is not that the people are not aware of the vaccine or its benefits. In an October 2020 survey of 15 countries by Ipsos, Indians were the most likely to say they were ready to take a covid vaccine once available. The survey showed that 88% of Indians said they were ready, compared with 65% of Americans. So, despite high levels of awareness and even the right intentions, many people are not willing to behave in a manner that could be life-saving.
It was the same story even at the beginning of the covid pandemic. Normally, it takes years to unravel the contours of a virus that causes a pandemic. But in the case of covid, the virus responsible for the illness was unravelled in a matter of weeks. Immediately, epidemiologists told everyone what to do to protect oneself from the virus—wear masks, maintain social distance , wash hands often. But across the world, despite all awareness campaigns, a large number of people did not fully follow or adopt these simple behaviours. Why is it that we are able to develop a vaccine in record time to deal with a deadly virus, but are clueless on how to get people to adopt simple and life-saving modes of behaviour?
The minds of policymakers seem to have a hierarchy of the problems they face. As the covid pandemic broke out, issues like unravelling the virus, developing a vaccine, setting up a supply chain for it, etc, were considered the toughest nuts to crack. So, the highest priority was given to those issues. Human behaviour issues like understanding barriers to vaccination and developing appropriate antidotes for it were low- priority matters for policymakers.
Many policymakers think managing human behaviour is a simple and straight-forward affair that does not need much focus. Many of them are oblivious to the humongous failures on that front. We use the best engineering knowledge to build good-quality roads, but do not know how to get people to drive safely on those roads. We discover new medicines to tackle many a life-threatening disease, but have still not developed an effective technique to get people to take those medications on a regular basis. The failure to effectively manage human behaviour is at the heart of many problems around the world. The world has made tremendous progress on many fronts. But we still haven’t figured out how to effectively manage human behaviour.
Since human behaviour management is considered a low-priority area, most policymakers do not feel the need to acquire any new knowledge on the subject. The seriousness of the pandemic and the need for immediate solutions motivated pharmaceutical companies to try out various new technologies, like the mRNA method, to develop an effective vaccine. On the other hand, when it came to dealing with vaccine hesitancy, our solutions were still based on the age-old belief that humans are rational beings. Bland messages like “Vaccines enabled India to win the battle against polio and smallpox" and “Take your shot, defeat Covid-19" are all we have to motivate large numbers of people to take their vaccination shots.
To solve the most significant problems in the world, managing behaviourial components of that problem should be given the highest priority. For that, we should accept the complexity of human behaviour. One should admit that understanding the working of billions of neurons and trillions of connections in the brain is far more complex than unravelling the contours of a disease-causing virus. Once we accept this complexity, our willingness to accept new knowledge on human behaviour will dramatically go up.
In the last couple of decades, lots of new knowledge about human behaviour has come from fields such as neuroscience and behavioural economics. It is unfortunate that even the best human resources management institutes in the country do not offer any courses on these new developments in human behaviour. This knowledge stagnancy needs to change.
The covid pandemic has reiterated a truth: that the world has a long way to go before we figure out how we can motivate humans to adopt even simple behaviours. How many more technological innovations would go waste before we realize that our traditional understanding of human behaviour is inadequate? How many more lives would be lost before we realize that human behaviour is the most important factor in all problem management?
Biju Dominic is the chief evangelist, Fractal Analytics and chairman, FinalMile Consulting
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