Covid-19 | Is there a logic for vaccine hesitancy?

Behavioral economists have tried to understand behaviours that pose a risk to the person engaging in them and those around. (Illustration by Suneesh K.)

Police in Hyderabad recently reported that of the road accident deaths involving two-wheelers in 2021 under the Cyberabad commissionerate, 82 percent of those who died were not wearing a helmet at the time of the accident.

Statistics on deaths due to the Omicron variant of the Coronavirus reveal that those who were vaccinated were much less likely to be hospitalized than those who hadn’t been vaccinated. In South Africa, which was the first to be hit badly by the latest variant, data from the South African Medical Research Council showed that a two-dose Pfizer-BioNTech vaccination appeared to provide 70 percent protection against hospitalization. Similar safety levels were afforded by the use of appropriate masks. Despite this lakhs of people refuse to take the vaccine and many more shun masks.

Call it death wish or foolhardiness, but the tendency to ignore obvious danger to oneself is a peculiar human trait not shared by other primates. The Centres for Disease Control and Prevention says that every day, 29 people in the US die in motor vehicle crashes that involve an alcohol-impaired driver. In India, too, where more people die in road accidents than in any other country, drunken driving was one of the major causes for fatal accidents. There are also the societal and other associated costs of such irresponsible behaviour that are hard to nail down but easy to imagine. The drunk motorist endangers himself and his family or friends riding with him. The unvaccinated person carries the virus to dozens of others.

Why then don’t people wear helmets when they drive two-wheelers or wear a mask when they go out or take the vaccine in the midst of the worst pandemic the world has seen in a hundred years? One reason could be that in the estimation of such people, the risk-reward ratio in these cases is heavily loaded in their favour. There are studies to show that hardcore criminals are convinced that expected gains outweigh potential losses when they decide to violate the law. The problem with taking such a cynical view is that it casts ordinary drivers and unvaccinated people as hardened criminals. Clearly that’s not acceptable.

But is some kind of typecasting valid in terms of clubbing people into those who are risk-seekers and see this as another way of expressing themselves and those who are risk-averse and therefore stay away from doing something that is hazardous by nature. In a paper titled "The Behavioral Economics of Drunk Driving", authors Frank A. Sloan, Lindsey Eldred, and Yanzhi Xu from the Department of Economics at Duke University, mention “irrational actors” whose “decisions may be totally influenced by emotions, including visceral urges provoked by external cues rather than an objective assessment of benefit versus cost. Major cognitive limitations and/or psychiatric disorders, which are more common among substance abusers, may lead to irrational decision-making.”

Of course, in the case of vaccines, there are religious issues that may play a role and while these aren’t convincing, one can at least understand where they come from. Obviously, the small set of those who can’t take the vaccine on medical grounds are excluded from this discussion.

Perhaps it is unfair to club the two sets, people who don’t wear helmets or drive when intoxicated and those who suffer from vaccine hesitancy. In the latter case, there may be the issue of trust in completely new vaccines and also in the politico-medical system administering them. With newer variants emerging at regular intervals, it would seem that the goal post is perennially shifting making the vaccine seem futile.

As time goes by, faith in the vaccine will also grow. In a recent conversation, Gretchen Chapman, department head of social and decision sciences at Carnegie Mellon University in Pittsburgh used data from the National Center for Immunization and Respiratory Diseases which showed that the percent of young children vaccinated from 1994 to 2014 for the varicella vaccine. Introduced in 1996 its uptake was around 15 percent that year. But by 2004, that number had climbed to the high 80s, and by 2014, it was in the low 90s.

None of this logic explains drunken driving or maskless meandering.