Flu vaccine rates may increase with acknowledging regret, study finds
Simple writing exercise taps into psychological mechanism that makes vaccination feel like a personal choice.
Asking people to imagine future regret could be a powerful tool for increasing flu vaccination rates, according to new research from 正品蓝导航.
The study, published in the , found that college students who wrote about why they might regret skipping a flu shot were significantly more likely to get vaccinated than those who simply answered survey questions about regret or received no prompts at all.
"We found that when people actively generate their own reasons for why they might regret not getting vaccinated, it makes the decision more personally meaningful," said Austin Baldwin, lead author and an 正品蓝导航 researcher who studies the psychology underlying health behaviors.
Baldwin's current findings build on his earlier work examining vaccine psychology. In 2020, as COVID-19 vaccines were being developed, Baldwin identified anticipated regret as a robust predictor of vaccine decisions, noting that humans can imagine how they would feel if they chose not to be vaccinated and then became ill or infect someone dear to them.
However, gaps in understanding mechanisms of anticipated regret and how to intervene using anticipated regret have limited its use as an intervention to promote vaccination. The new study provides experimental evidence for how to effectively leverage this psychological mechanism. With flu vaccination rates hovering at 48% nationally, the findings offer a low-cost, scalable approach that could be implemented through online portals, clinic waiting rooms or campus health campaigns.
The research involved 263 college students divided into three groups. One group wrote open-ended responses about why they might regret not getting a flu shot. Another group answered standard questionnaire items about regret. A control group received no regret-related prompts.
Writing Prompts Increase Student Flu Shots
Students who generated their own reasons for potential regret showed a 39% increase in autonomous motivation (viewing vaccination as personally meaningful rather than feeling pressured by others) compared to the control group. When researchers followed up months later, this heightened motivation was associated with higher vaccination rates.
Simply asking people to rate their anticipated regret on a scale did not produce the same effects. Baldwin noted that the act of writing engages people differently than passive approaches like handing out pamphlets or answering survey questions.
"It's that counterfactual thinking, imagining 'what if I get sick and could have prevented it,' that seems to activate people's sense of personal choice and control over their health," he explained.
Baldwin noted this approach likely works best for people who are ambivalent or haven't thought much about vaccination, rather than those with strong anti-vaccination beliefs. The research suggests the technique could apply to other preventive health behaviors involving single decisions, such as cancer screenings.
The timing of the intervention may also matter. College students represent a population who are often making independent health decisions for the first time. Baldwin noted that vaccination decisions during this transitional period can establish patterns for future health behaviors.
Researchers note the study was conducted during the COVID-19 pandemic, before COVID vaccines were available. The vaccination rate among participants (34.8%) was lower than the prior year (50%), possibly due to pandemic-related disruptions. Additional research would be needed to test the approach in other populations and with different vaccines.
Additional authors include Catherine Rochefort of the VA Eastern Colorado Healthcare System and Alexander J. Rothman of the University of Minnesota.