Last weekend, I took part in a family Zoom chat with a dozen of my cousins who live around the world. In the course of conversation, I idly asked how many would have a Covid-19 vaccine if one became available (a hypothetical question at the time, as the cheering results of the Pfizer-BioNTech drug trial had not yet emerged).
The geographical split was striking. My cousins who live in Ireland would have a vaccine; they trust scientists. So would most (but not all) of those based in England. A cousin in Australia sounded shocked that anyone would even need to ask the question. But the US-based contingent muttered “probably not” or “I’ll wait and see”, echoing the reactions of most of my East Coast-based friends over recent days.
While this is merely an anecdotal tale, it reinforces what we see in surveys. Between May and September this year, the proportion of US adults who said they were definitely willing to have a Covid-19 vaccine fell from 72 per cent to 51 per cent, according to the Pew Research Center.
There are political and demographic distinctions: people who are older, male, have a postgraduate degree or are Asian are more likely to say they will have the vaccine than people who are younger, female, have less education or are from a non-Asian ethnicity. The black population is particularly distrustful, with only a third ready to be vaccinated, but confidence in the vaccine has fallen across all US demographic groups, thanks largely to concerns about side effects.
By contrast, an Ipsos poll released last week suggests that 79 per cent of British adults would happily have the vaccine — the same figure as in Australia — and in China there is an 85 per cent acceptance rate. Spain and Germany also have fairly positive attitudes, at about two-thirds — but there is almost as much distrust in France as there is in America. Even these positive numbers, however, represent a fall on Ipsos’s August poll.
Why the differences? Each nation will have its own explanation. In the case of the US, for example, the collapse of trust undoubtedly reflects in part the war on science unleashed by the administration of Donald Trump, coupled with his denigration of Anthony Fauci, America’s leading infectious disease expert. Then there was his determination to use the race for a vaccine as a political weapon in the election campaign. All of this has contributed to (albeit not caused) falling trust in many institutions.
But perhaps the more interesting question is, given that attitudes have shifted over time, can they be turned around again? Is there a way to persuade Americans to follow Brits and Australians and jump on board?
The answer is hopefully yes — but it may not be simple. What is unlikely to work is a series of science lectures; America is currently scarred by social, political and epistemological divides. Instead, a better tactic might be to communicate messages about civic responsibility, patriotism or even shame.
Consider, by way of a rather cheering example, what has happened with masks in New York. Eight months ago, it was almost impossible to imagine New Yorkers embracing mask-wearing en masse. Back then, it was seen as the kind of behaviour found only in collectivist cultures in Asia — anathema to individualistic New Yorkers.
But when I cycled the length of Manhattan last week, out of all the people I saw on the street (and on bikes), just two were mask-less. That is not because New Yorkers necessarily understand the fine details of the science behind masks. Instead, a culture of shame has been created where it is seen as socially unacceptable to not wear a mask because it signals profound irresponsibility.
Something similar has happened in Los Angeles, mayor Eric Garcetti told me earlier this week. He says that he has gone to particular lengths to use behavioural science to spread messages to communities with high mortality rates to alter their behaviour, by wearing masks and socially distancing, for example. He claims this has delivered a Covid-19 mortality rate for African Americans and other minorities that is among the lowest in the US.
He now hopes to harness all the messaging tricks that Hollywood can devise to foster acceptance of a Covid-19 vaccine in LA, backed up by incentives and rules: for example, people who are unvaccinated may not be allowed to enter sports arenas or even attend school.
Garcetti is also trying to use imagery to shift attitudes. He recently had himself photographed having a flu shot and plans to do the same with a Covid-19 vaccine, as do other US politicians. No doubt president-elect Joe Biden will join them, given the speed with which he has established a Covid-19 task force, his repeated calls for a national mask mandate — and his diligence about wearing one in public.
To put it another way, after faith in hard science has crumbled in some parts of the US, the country is now entering a period that could deliver a fascinating test for behavioural science. We will need science of the medical, computing and social type to beat this virus — particularly, but not exclusively, in America.
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