I want to be safe: understanding the main drivers behind vaccination choice throughout the pandemic

BACKGROUND

Despite being a major advancement in modern medicine, vaccines face widespread hesitancy and refusal, posing challenges to immunization campaigns. The COVID-19 pandemic accentuated vaccine hesitancy, emphasizing the pivotal role of beliefs in efficacy and safety on vaccine acceptance rates. This study explores the influence of efficacy and safety perceptions on vaccine uptake in Italy during the pandemic.

METHODS

We administered a 70-item questionnaire to a representative sample of 600 Italian speakers. Participants were tasked with assessing the perceived effectiveness and safety of each vaccine dose, along with providing reasons influencing their vaccination choices. Additionally, we conducted an experimental manipulation, exploring the effects of four framing messages that emphasized safety and/or efficacy on participants' willingness to receive a hypothetical fourth vaccine dose. Furthermore, participants were asked about their level of trust in the scientific community and public authorities, as well as their use of different information channels for obtaining COVID-19-related information.

RESULTS

Our study reveals a dynamic shift in vaccine efficacy and safety perceptions throughout the COVID-19 pandemic, potentially influencing vaccination compliance. Initially perceived as more effective than safe, this assessment reversed by the time of the third dose. Beliefs regarding safety, rather than efficacy, played a significant role in anticipating future vaccinations (e.g., the booster dose). Safety-focused messages positively affected vaccination intent, while efficacy-focused messages showed limited impact. We also observed a changing trend in reasons for vaccination, with a decline in infection-related reasons and an increase in social related ones. Furthermore, trust dynamics evolved differently for public authorities and the scientific community.

CONCLUSIONS

Vaccine perception is a dynamic process shaped by evolving factors like efficacy and safety perceptions, trust levels, and individual motivations. Our study sheds light on the complex dynamics that underlie the perception of vaccine safety and efficacy, and their impact on willingness to vaccinate. We discuss these results in light of bounded rationality, loss aversion and classic utility theory.

Beyond peripersonal boundaries: insights from crossmodal interactions

We experience our self as a body located in space. However, how information about self-location is integrated into multisensory processes underlying the representation of the peripersonal space (PPS), is still unclear. Prior studies showed that the presence of visual information related to oneself modulates the multisensory processes underlying PPS. Here, we used the crossmodal congruency effect (CCE) to test whether this top-down modulation depends on the spatial location of the body-related visual information. Participants responded to tactile events on their bodies while trying to ignore a visual distractor presented on the mirror reflection of their body (Self) either in the peripersonal space (Near) or in the extrapersonal space (Far). We found larger CCE when visual events were presented on the mirror reflection in the peripersonal space, as compared to the extrapersonal space. These results suggest that top-down modulation of the multisensory bodily self is only possible within the PPS.

Prosocial behavior in emergencies: Evidence from blood donors recruitment and retention during the COVID-19 pandemic

The impact of COVID-19 represents a specific challenge for voluntary transfusional systems sustained by the intrinsic motivations of blood donors. In general, health emergencies can stimulate altruistic behaviors. However, in this context, the same prosocial motivations, besides the personal health risks, could foster the adherence to social distancing rules to preserve collective health and, therefore, discourage blood donation activities. In this work, we investigate the consequences of the pandemic shock on the dynamics of new donors exploiting the individual-level longitudinal information contained in administrative data on the Italian region of Tuscany. We compare the change in new donors' recruitment and retention during 2020 with respect to the 2017-2019 period (we observe 9511 individuals), considering donors' and their municipalities of residence characteristics. Our results show an increment of new donors, with higher proportional growth for older donors. Moreover, we demonstrate that the quality of new donors, as proxied by the frequency of subsequent donations, increased with respect to previous years. Finally, we show that changes in extrinsic motivations, such as the possibility of obtaining a free antibody test or overcoming movement restrictions, cannot explain the documented increase in the number of new donors and in their performance. Therefore, our analyses indicate that the Tuscan voluntary blood donation system was effective in dealing with the challenges posed by the COVID-19 pandemic.

Vaccine Hesitancy and Cognitive Biases: Evidence for tailored communication with parents

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The model to analyse vaccine hesitancy should include the evaluation of cognitive biases.

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Communication interventions should be tailored based on the drivers of parents’ choice.

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Conspiracy mentality and risk propension correlate with the vaccine hesitancy.

Background

Vaccine hesitancy (VH) remains worldwide a reason of concern. Most of the vaccination education strategies followed a “fact-based” approach, based on the assumption that decision making is a rational process, without considering the influence of cognitive biases and heuristics. Our study aimed at identifying factors involved in the parents’ vaccination choice to inform and shape communication interventions.

Methods

We conducted an online national survey among parents between November 2020 and April 2021. The questionnaire consisted of 42 items organised in 4 parts: (1) personal information, (2) cognitive biases and risk propension, (3) Analytic Thinking (Cognitive Reflection Test), (4) conspiracy mentality, health literacy, and VH. Exploratory factor analysis was conducted to identify latent variables underlying the 19 items related to the 6 cognitive biases. Factors were categorised in quintiles and the corresponding pseudo-continuous variables used as predictors of the VH. Logistic regression model was applied to assess the association of the VH with factors, conspiracy mentality and risk propension. We adjusted for age, gender, economic status, and education levels.

Results

The study included 939 parents, 764 women (81.4%), 69.8% had a degree or higher level of education. Considering cognitive biases, four factors explaining 54% of the total variance were identified and characterised as: fear of the side effects of vaccines (scepticism factor); carelessness of the risk and consequences of infections (denial factor); optimistic attitude (optimistic bias factor); preference for natural products (naturalness bias factor). All factors were positively associated to VH (p < 0.001) as were conspiracy mentality (p = 0.007) and risk propension (p = 0.002).

Conclusions

This study confirmed the need to amplify the model used to analyse the VH considering cognitive biases as important factor affecting the parents’ decision making. These results may be useful to design personalised communication interventions regarding vaccines and vaccination.

Not all sales performance is created equal: personality and interpersonal traits in inbound and outbound marketing activities

A long tradition of research has shown that personality traits, such as extraversion and agreeableness, and interpersonal constructs better predict job performance with a tacit but not explicit distinction in sales marketing activities. In this contribution, we aim to understand the role of job-related and interest data, interpersonal, and personality traits in affecting either inbound or outbound marketing activities and the overall sales performance. An original questionnaire integrates the interpersonal traits and personality factors reported in the literature in sales marketing activities (independent variables). The results were matched with the individual job-related and interest data (control variables) and sales performance (criterion variables) - expressed as the total number of closed contracts over the inbound/outbound related contacts of employees with responsibility in marketing activities for a large banking group. We are able to identify the relevant predictors of sales performance by creating full binary trees using control and independent variables in conditional inference forests and variable importance index measures. Higher performers in either inbound or outbound marketing activities rely on distinct personality sub-traits, which have fundamentally essential implications for interpersonal functioning, and personal data when agreeableness is central to the ability to function effectively in the interpersonal realm of sales activity.

Vaccine Hesitancy and Cognitive Biases: A tailored approach for a better communication

Background

Vaccine hesitancy (VH) remains worldwide a reason of concern. Most of the vaccination education strategies followed a ‘fact-based' approach, based on the assumption that decision making is a rational process, without considering the influence of cognitive biases and heuristics. Our study aimed at identifying factors involved in the parents' vaccination choice to inform and shape communication interventions.

Methods

We conducted an online national survey among parents between November 2020 and April 2021. The questionnaire consisted of 59 items organised in 5 parts: personal information, cognitive biases, risk aversion, conspiracy mentality, and VH. Exploratory factor analysis was conducted to identify latent variables underlying the 19 items related to the 6 cognitive biases. Factors were categorised in quintiles and the corresponding pseudo-continuous variables used as predictors of the VH. Logistic regression model was applied to assess the association of the VH with factors, conspiracy mentality and risk propension. We adjusted for age, gender, economic status, and education levels.

Results

The study included 939 parents, 764 women (81.4%), 69.8% had a degree or higher level of education. Considering cognitive biases, four factors explaining 54% of the total variance were identified and characterised as: fear of the side effects of vaccines (scepticism factor); carelessness of the risk and consequences of infections (denial factor); optimistic attitude (optimistic bias factor); preference for natural products (naturalness bias factor). All factors were positively associated with VH (p &lt; 0.001) as were conspiracy mentality (p = 0.007) and risk propension (p = 0.002).

Conclusions

This study confirmed the need to amplify the model used to analyse the VH considering cognitive biases as an important factor affecting the parents' decision making. These results may be useful to design personalised communication interventions regarding vaccines and vaccination.

Key messages

The model used to analyse the vaccine hesitancy needs to be extended including the evaluation of cognitive biases and heuristics. Communication interventions to promote vaccine acceptance should be tailored and personalized on the basis of the drivers of choice of the parents.

Digital devices to assess vaccine hesitancy and promote pertussis vaccination during pregnancy

Introduction

Vaccination against pertussis in pregnancy is the main strategy to prevent the disease in the first trimester of life of new-borns. Effective communication is essential to successfully engage pregnant women. The use of digital devices within the outpatient setting may be helpful to engage patients before and during the consultation. The aim of this study was to develop and test an e-health tool to assess vaccine hesitancy and to deliver tailored information and education interventions to raise awareness and promote vaccine acceptance.

Methods

One-hundred-and-five participants were recruited in 4 ob-gyn clinics. Participants were invited to complete a self-administered psychometric questionnaire to assess vaccine hesitancy, disease beliefs and self-efficacy perception on health behaviours on a tablet. Participants were randomly allocated to three communication-format types providing equivalent content: 1)a single video simulating a patient-doctor conversation on the topic; 2)an interactive platform with five infographics videos; 3)a paper leaflet followed by a brief consultation with the physician. The intention to get vaccinated during pregnancy was assessed through a specific question before and after the intervention.

Results

In the pre-intervention phase there was no difference observed between groups in terms of the variable “intention” to get vaccinated. After the intervention, participants of groups 1 and 3 showed a higher intention to get vaccinated than group 2 at the Kruskal-Wallis test (H(2)=6.008, p &lt; 0.05). Post-intervention intention to vaccinate correlated with Individual Self-Efficacy (rs(105)=0.30, p &lt; 0.001) and was inversely associated with vaccine hesitancy (rs(105)=0.34, p &lt; 0.001).

Conclusions

We implemented and assessed the impact of different communication strategies to promote vaccine uptake among pregnant women. Our results suggest comparable effect may be obtained using simulated versus live patient-physician communication.

Key messages

The use of digital devices allows an effective and manageable communication about vaccination to pregnant women. In the present study, the implementation of digital forms of communication allowed a comparison with standard procedures of information towards vaccination, demonstrating their equivalence.

Vaccine hesitancy and Health Literacy: we need to change our paradigm

Introduction

The vaccination coverage decline and the re-emergence of vaccine preventable diseases draw attention to the problem of vaccine hesitancy (VH). Many studies demonstrated that the current vaccine education is not very effective. We analysed the problem of VH in relation to Health Literacy (HL) and the perception of vaccine preventable diseases-related risks in a sample of parents.

Methods

We conducted a survey among parents between February and November 2018. We collected data on demographic, main sources of information, vaccination attitude (using the Vaccine Confidence Index (VCI) adapted from Larson HJ 2016), HL levels(using an adapted version of IMETER and knowledge of signs and symptoms of diphtheria, tetanus and measles.

Results

The study included 772 parents, 620 women (mean age 39 years), 48.2% had diploma. The main source of information was the doctor (85.5%) followed by the web(24.2%). The average VCI was 3.78(range: 0.1-10) with lower values among parents informed through social networks (2.05-2.78). Analysing the IMETER test, 90% had a good or acceptable level of HL. No significant correlation between VCI and HL was found. For parents who identified at least 3 specific elements of selected diseases, the average VCI was significantly higher(Measles 4.32,Tetanus 4.64,Diphtheria 5.84).

Conclusions

The HL level did not correlate with the VCI. A low VCI was associated with poor knowledge of selected diseases: this confirms the importance of a correct risk perception. This study in accordance with the literature suggests to amplify the model used to analyse the VH taking into account cognitive biases (i.e. ambiguity aversion and omission bias) as important factor affecting the parents' decision making. We aim to expand our work building a survey to categorise parents according their main cognitive bias. This may be useful to understand the better communication strategies to effectively have an impact on each parents' behaviour.

Key messages

This study in accordance with the literature suggests to amplify the model used to analyse the VH taking into account cognitive biases. The Health Literacy is not enough to explain the problem of the Vaccine Hesitancy.

Peripersonal space representation develops independently from visual experience

Our daily-life actions are typically driven by vision. When acting upon an object, we need to represent its visual features (e.g. shape, orientation, etc.) and to map them into our own peripersonal space. But what happens with people who have never had any visual experience? How can they map object features into their own peripersonal space? Do they do it differently from sighted agents? To tackle these questions, we carried out a series of behavioral experiments in sighted and congenitally blind subjects. We took advantage of a spatial alignment effect paradigm, which typically refers to a decrease of reaction times when subjects perform an action (e.g., a reach-to-grasp pantomime) congruent with that afforded by a presented object. To systematically examine peripersonal space mapping, we presented visual or auditory affording objects both within and outside subjects’ reach. The results showed that sighted and congenitally blind subjects did not differ in mapping objects into their own peripersonal space. Strikingly, this mapping occurred also when objects were presented outside subjects’ reach, but within the peripersonal space of another agent. This suggests that (the lack of) visual experience does not significantly affect the development of both one’s own and others’ peripersonal space representation.

Neuroscience Evidence for Economic Humanism in Management Science: Organizational Implications and Strategy

Globalization phenomena and Information Communication Technology (ICT) are producing deep changes worldwide. The economic environment and society where firms both cooperate and compete with each other are rapidly changing leading firms towards recognizing the role of intangible resources as a source of fresh competitive advantage. Experience, innovation and the ability to create new knowledge completely arise from the act of human resources inviting firms to focus on how to generate and shape knowledge. Therefore, the future of firms depends greatly on how managers are able to explore and exploit human resources. However, without a clear understanding of the nature of human beings and the complexity behind human interactions, we cannot understand the theory of organizational knowledge creation. Thus, how can firms discover, manage and valorize this "human advantage"? Neuroscience can increase the understanding of how cognitive and emotional processes work; in doing so, we may be able to better understand how individuals involved in a business organization make decisions and how external factors influence their behavior, especially in terms of commitment activation and engagement level. In this respect, a neuroscientific approach to business can support managers in decision-making processes. In a scenario where economic humanism plays a central role in the process of fostering firms' competitiveness and emerging strategies, we believe that a neuroscience approach in a business organization could be a valid source of value and inspiration for manager decision-making processes.