How does nudging the COVID-19 vaccine play out in people who are in doubt about vaccination?

In spite of the growing availability of COVID-19 vaccines, a substantial number of people is reluctant or uncertain about getting the vaccine. Nudges may improve vaccine uptake but it is unclear how this plays out with the experience of autonomous choice, decision competence, decision satisfaction, and being pressured to make a choice. In an online experiment among a representative sample (N = 884), we examined whether a social norm nudge or a default nudge (either or not transparent) was effective in steering the desired choice of making a hypothetical early vaccination appointment as compared to making a later appointment or no appointment. We also examined how both nudges affected autonomy and related downstream consequences. None of the nudges proved effective in making the desired choice of early vaccination and neither did they impact on downstream consequences. Rather, our results indicate that participants who were certain about their choice (i.e., opted for the earliest available vaccination opportunity or not getting vaccinated at all) reported higher levels of autonomy, competence and satisfaction than participants who did not know yet about vaccination or who postponed the moment of getting their vaccination. We conclude that the experience of autonomy and related downstream consequences is determined by having made up one's mind about vaccination, and is not affected by attempts to nudge the individual. Public Health and primary carePrevention, Population and Disease management (PrePoD

Does default organ donation registration compromise autonomous choice?: Public responses to a new donor registration system

Health and self-regulatio

The effect of nudges on autonomy in hypothetical and real life settings

Nudges have repeatedly been found to be effective, however they are claimed to harm autonomy, and it has been found that laypeople expect this too. To test whether these expectations translate to actual harm to experienced autonomy, three online studies were conducted. The paradigm used in all studies was that participants were asked to voluntarily participate in a longer version of the questionnaire. This was either done in a hypothetical setting, where participants imagined they were asked this question, but did not answer it, and reported their expectations for autonomy; Or in an actual choice setting where participants answered the question and then reported their actual autonomy. The first study utilized the hypothetical setting and tried to replicate that laypeople expect nudges to harm autonomy with the current paradigm. A total of 451 participants were randomly assigned to either a control, a default nudge, or a social norm nudge condition. In the default nudge condition, the affirmative answer was pre-selected, and in the social norm nudge condition it was stated that most people answered affirmative. The results showed a trend for lower expected autonomy in nudge conditions, but did not find significant evidence. In Study 2, with a sample size of 454, the same design was used in an actual choice setting. Only the default nudge was found to be effective, and no difference in autonomy was found. In Study 3, Studies 1 and 2 were replicated. Explanation of the nudge was added as an independent variable and the social norm nudge condition was dropped, resulting in six conditions and 1322 participants. The results showed that participants indeed expected default nudges to harm their autonomy, but only if the nudge was explained. When actually nudged, no effect on autonomy was found, independent of the presence of an explanation.</jats:p

And How Would That Make You Feel? How People Expect Nudges to Influence Their Sense of Autonomy

ObjectiveWhile nudges are increasingly utilized in public policy settings, their potential threat to autonomous choice is the topic of heated debate. Regardless of the actual effects of nudges on autonomy, the mere perception of nudges as autonomy threatening by the general public or policy makers could negatively influence nudge acceptability. The present online studies examined how people expect (different) nudges to affect their perception of autonomy.MethodsIn the first study (N = 455), participants were presented with a hypothetical choice that employed either a default nudge, direct persuasion, or no persuasion, to steer to the desired choice. The presented influence technique was explained before participants reported their expected autonomy, as well as their expected choice satisfaction. Study 2 (N = 601) involved a replication of Study 1 with an additional social norm nudge condition. In Study 3 (N = 750), the explanation of how choice had been influenced was omitted.ResultsWhile participants expected the default nudge to violate autonomy (Study 1), they had no such expectations for social norm nudges (Study 2). Omitting the explanation that most people are unaware of nudges influencing their choice, reduced the negative impact of nudges on expected autonomy (Study 3).ConclusionEffects of nudges on expectations of autonomy differ by type of nudge. Negative expectations are primarily driven by the explanation that decision makers are often unaware of nudges.</jats:sec

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Conditions in Study 3.

Conditions in Study 3.</p