The latest data from the Department of Health (DoH) shows that more than 37 million Filipinos are fully vaccinated against COVID-19. At the same time, 52 million Filipinos have received their first dose. More recently, DoH was able to administer 8 million doses during the three-day nationwide Bayanihan Bakunahan vaccination drive held in late November. With the continuous influx of vaccines and improvements in the vaccination campaign, the government is now able to administer more than 1.5 million doses per day.
Moreover, the most recent SWS survey finds that COVID-19 vaccine confidence in the Philippines is increasing, with six out of 10 Filipinos surveyed expressing willingness to get vaccinated. The figures are a stark improvement from the results of previous surveys conducted by the same firm.
Despite an increase in COVID-19 vaccine confidence, the same study points out that 19% of Filipinos surveyed are uncertain, while 18% said they are unwilling to get vaccinated.
Although the pace of COVID-19 vaccinations shows promise, the country still has a long way to go from reaching the government’s target of having 90% of the total population fully vaccinated. With the looming threat of new and potentially more transmissible variants which could result in a resurgence of COVID-19 cases, society has to intensify the vaccination campaign. This would include measures that will nudge more Filipinos to willingly take the jab.
Globally, the application of behavioral science is being leveraged by various countries to increase the uptake of COVID-19 vaccines. The COVID-19 vaccination program also has a behavioral dimension that needs to be taken into consideration. It is important to note that while a program is beneficial to one’s welfare, as in the case of vaccinations, it does not automatically lead to people’s compliance or cooperation. More importantly, human behavior is complex, and decision-making is affected by context.
For instance, hesitancy remains a key barrier in the uptake of COVID-19 vaccines. This “behavioral anomaly” is not specific to just one country, but a reality across the world.
As such, vaccine implementers should take into consideration the behavioral factors that affect individual decisions on whether or not they should be inoculated. These would include prevailing social norms, misperceptions on the risks of COVID-19 and benefits of the vaccine, inertia (tendency towards inaction), and friction (perceived or actual difficulty), among others.
The World Health Organization (WHO), International COVID-19 Behavioral Insights and Policy Group, and the US Centers for Disease Control (CDC), have their respective reports on how to increase uptake by leveraging on behavioral insights, based on expert studies and experiences of different countries in the rollout of the vaccines to the general public. Locally, the Behavioral Insights Network-Philippines (BIN-PH) released a discussion paper on addressing vaccine uptake earlier this year. From these documents, several key lessons can be considered by local implementers to integrate in the ongoing vaccination campaign.
First, vaccine communications should cater to diverse audiences. As the country’s vaccination drive shifts its focus towards the provinces, it is important to ensure that the message crafted is anchored on having a dialogue and listening to affected communities. This is more effective than a top-down communication approach.
In the UK, the local government of Wirral developed a Community Connectors program, where volunteer residents are recruited to amplify key messages about COVID-19 through their own networks. Volunteers help gather feedback from their social circles about the vaccine, which will be used to tailor-fit COVID-19-related messages that will be disseminated back to the community. This approach ensures that the key messages address community concerns about the vaccine. It also extends the reach of the messages towards marginalized groups.
Second, implementers should also consider tapping members of the local community who are trusted, well-respected, and able to connect with their community through shared identity and values as vaccine ambassadors. Harnessing their influence through their own words and experiences on the vaccine within their respective social groups can further increase trust in the vaccine.
For instance, the US federal government has been actively working with religious leaders in responding to the pandemic and building trust in the safety and efficacy of COVID-19 vaccines. Religious institutions have also provided their places of worship as vaccination hubs and venues to educate their followers about the importance of getting vaccinated.
Third, implementers should ensure that the entire vaccination process is hassle-free. For those who are inclined to get vaccinated, it is important to make it easy for them to do the intended behavior. One way to address the gap between intention and action is by communicating where to go and how to get vaccinated in the community, including information on proximity, day and time, and process, with emphasis on the ease of getting the vaccination.
As an example, the US CDC established a free SMS-based service called VaxText, which provides weekly text reminders for the second dose schedule. Reminders reduce the possibility of people missing out on their succeeding doses while at the same time minimizing the number of those who will not be able to complete their full vaccination.
In conclusion, there is no single best way to convince people to get vaccinated. Context affects decision-making. As such, it is important to understand the context affecting Filipinos’ decision to get the jab.
As scientists find different ways to protect us against COVID-19, implementers should be open to testing different approaches to convince more people to choose to get vaccinated, based on how decisions are formed.
The government and other sectors should be lauded for trying various approaches to get more Filipinos get vaccinated. Note, however, that experimenting on which measures work is necessary before scaling up, as direct replication of successful initiatives from abroad will not guarantee its effectiveness locally.
Finally, one key lesson that resonated from the ongoing efforts globally is that behavioral science should be integrated into the ongoing vaccination campaign, as well as in other public health initiatives, as early and as often as possible.
Miko Nacino is the founder of the Behavioral Insights Network – Philippines which advocates for the application of behavioral sciences in addressing challenges to public policy, development, and industry.