Nudging India to get vaccinated

Now that India’s Union Government has taken on the responsibility (as it should) of procuring the vaccines, the hope is that the supply issues would be sorted. As early as possible, to make up for the lost time (and lives).

The issue in supply is probably the most important reason why India still doesn’t have a widespread, pan-Indian campaign to promote vaccination and tackle vaccine hesitancy. If we had a campaign when there were severe supply problems, that would have backfired. But the lack of the campaign meant that those who were dithering about the vaccine for assorted reasons – lack of trust in the vaccine, or vaccine center hesitancy (given the crowds in vaccine centers, quite a few people are worried about getting the virus at the vaccination center, of all places, after having protected themselves all this while) had more time to deliberate on it and push the vaccination to another date.

Bottomline: India needs a mega campaign to induce vaccination and overcome vaccine hesitancy… right now.

This is my second post around the communications for vaccination in India.
Earlier: Removing ‘friction’ from India’s COVID-19 vaccination program

Given the sheer population and demographics of India, we may need to tackle the 2 constituents differently, as 2 different campaigns:

  1. to build awareness (of the existence) of the vaccines
  2. to build trust in vaccines

Awareness is a media play. It requires the use of an assortment of media channels to sneak up on people and areas where vaccine uptake is low and constantly reminding them that we would all be safe only when we are all vaccinated. The matchstick imagery is a powerful visual metaphor for this, but I’m sure the Government and their advertising agencies could come up with more interesting variants.

Adding a level of personalization helps in uptake.

The messenger:

Who delivers the message matters!

Stephen Martin and Joseph Marks have categorized 8 kinds of messengers, through their research:

Hard effects:

  1. Socio-economic position
  2. Competence
  3. Dominance
  4. Attractiveness

Soft effects:

  1. Warmth
  2. Vulnerability
  3. Trustworthiness
  4. Charisma

India needs to pick its messengers carefully for the COVID-19 vaccination campaign too. A sweeping assumption that celebrities would do the job (they did, for the Polio vaccination campaign) may be a miscalculation.

Having seen some celebrities get priority access to top medical care, if people see celebrities advocating the vaccine, it may lad to people thinking, “Yeah, they can get the best care should things go wrong. I’m not like that celebrity, so why take the risk?”.

Doctors could be a good option, but there are very few well-known doctors. An unknown doctor could end up being suspected as a model acting for a fee. Similarly with nurses. But these are considerably better choices, falling in the ‘competence’ and ‘trustworthiness’ groups of messengers, for building trust into the vaccines.

Getting children to advocate vaccines to parent-figures to keep them safe could add to the vulnerability, and hence invoke the responsibility in adults to do the right thing by their children/next generation.

The UK’s NHS picked Elton John and Michael Caine in a campaign to induce vaccination recently.

They are clearly picked for their charisma and socio-economic position. But instead of simply asking them rattle out lines in support of the vaccines, the script makes it engaging and funny too! This ad film is from February 2021, but there’s an element of last year’s CRED ‘audition’ ads too when Elton is told that he would hear back from NHS!

From a PR perspective, a lot of nudges could work. Here’s a good example to induce vaccination among children (though India is yet to start vaccination for children) from the UAE that uses vulnerability as the messenger’s core trait to induce more people like him!

The message:

Besides ‘who’, the ‘what’ is equally critical.

Quite a few behavioural studies point to the direction in which we may need to look, to construct the ‘what’.

For instance, the famous ‘Copy Machine study’ from 1977, by psychologist Ellen Langer and her research team at Harvard University.

Langer asked her assistants go up to the people standing in a queue in front of a photocopier and convince one to let them cut the queue! Langer asked the assistants to use one of the 3 lines:

  1. A request: “Excuse me, I have 5 pages. May I use the Xerox machine?”
  2. A request with a fake reason: “Excuse me, I have 5 pages. May I use the xerox machine, because I have to make copies?”
  3. A request with a real reason: “Excuse me, I have 5 pages. May I use the xerox machine, because I’m in a hurry?”

Surprisingly, while 60% of the people who were offered reason 1 let the assistant cut the queue, 93% and 94% let the assistant cut the queue with the fake and real reason, respectively! The nature and validity of the reason did not matter as much as the fact that there was actually a/some reason! Langer’s research concluded that the word ‘because’ was instrumental in persuading someone to perform an action, no matter how convincing the words following that ‘because’ were!

The Government of Jersey, a self-governing dependency of the United Kingdom, used this insight to create their vaccination messages.

They used a combination of micro-influencers and ‘because’ to persuade people.

In the Indian context, we may need to rope in State-centric and city-centric influencers and faces, and add a contextual ‘because’ that justifies that person’s reason.

Imagine Danish Sait telling us, “I took the vaccine shot because I know for sure that my shot would help keep Ramamurthy, Jaya and Bevarsi Kudka too healthy and safe, though I need to ask Bevarsi Kudka to avoid alcohol for at least 3 weeks after the vaccination!

Another study, from Wharton, helps add context on making the messages more personal.

Behavioral scientists Katy Milkman, Angela Duckworth, and Mitesh Patel found the kind of nudges that worked best to increase uptake in flu vaccines.

Source: Washington Post

The ones that worked best included a tone that suggested that a vaccine is available/waiting/reserved for people. It seems this language makes patients feel as if the vaccine belongs to them, and they may not want to miss out on ‘their’ dose.

These could be helpful in increasing uptake for the coronavirus vaccines too.

Combined with these nudges, a layer of immediacy and urgency could be added too. For instance, “a Covishield vaccine has been reserved for you. The reservation will expire on . Reply with Y to confirm your appointment.”

Right now, the campaign is driven towards making people go to the CoWin website, instead of helping any/everyone to proactively seek vaccination. This is understandable given the supply-side mess, but as supplies improve, we may need to turn the message in a different direction – the way e-commerce companies attract buyers with the most tempting offers.

Use of the word ‘free’ would do wonders too, in India!

France’s health ministry’s (Ministry of Social Affairs and Health) latest ad film called ‘The Trigger’ on the occasion of the opening of immunization for all in France is a great example of creative story-telling to increase vaccine uptake. The film has been created by the agency MullenLowe France.

The film’s creative device is to connect 2 different actions directly – the act of the vaccine being pumped into a person and the act of assorted things opening up.

Set to ebullient music (Pharrell Williams’ 2015 hit ‘Freedom’), the narrative creates repeated back-to-back links to vaccination (or, specifically the act of the vaccine being pushed into the arm of the recipient) and shop shutters opening, lights switching on in a classroom, a cooking stove igniting, an auditorium’s curtains opening, an amusement park and a bowling alley coming to life, a sports stadium glowing back to light and so on.

It’s a lovely device, to alternate a vaccine jab with what it eventually, collectively would entail, to communicate, “if you all get this done, we can all get that done!”.

India has already lost a lot of time in the procurement mess and flip-flop. We cannot afford to lose time in convincing our humongous population to get vaccinated as soon as possible.



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