Did you book your NHS COVID-19 vaccination on the phone? If you did, the first thing you heard was this automated message: “Thank you for your call. We are pleased so many people have responded to their invitations to get a COVID vaccination.”
Perhaps you’ve seen an NHS advertisement on Instagram or Twitter. If so, chances are you saw the following invitation: “Join the millions already vaccinated.”
How do these statements make you feel? My guess is that, somewhere in the bundle of emotions, are the following thoughts: you’re about to do what many others have already done. You’re going to be part of something big. And you’re feeling more confident about taking this step, because you’ve got some proof that others have done what you’re about to do. It all just feels, well, normal.
If many feel this way, then this is a sign that taking a COVID-19 vaccine has become an accepted and expected behaviour: what’s known as a social norm. Reaching this point could be hugely beneficial as the UK’s rollout continues. If getting vaccinated becomes a social norm, it could help convince those who are hesitant to change their position.
Creating a new normal
Social scientists have long been curious about how new social norms emerge. A big part of what makes norms so intriguing is that they spring from our routine social interactions and behaviour, yet they also shape our routine social interactions and behaviour. We collectively create norms, but we also adapt to fit in with them. Norms enable and norms constrain. They are crucially important for understanding social change.
Today’s media systems are historically unique, in part because they offer so many opportunities for people to signal social norms to others. This happens on a vast scale every day, through the countless digitally mediated interactions on social media and personal messaging apps. The signalling of social norms about COVID-19 vaccination is crucial – and likely to become even more so as we move into the next phase of the vaccine rollout.
Current evidence suggests that, in the UK, vaccine hesitancy may be more difficult to overcome from now on. Younger people tend, on average, to be a bit less keen to get vaccinated than middle-aged and older people. And older people who have already declined vaccination could be the most difficult to persuade.
And yet, if we think about the success of the UK’s vaccination rollout to date – and factor in how social norms diffuse – there are now good reasons to be optimistic that vaccine hesitancy will not seriously undermine the pandemic response.
We are more likely to adopt a course of behaviour when we can see that there’s a consensus among numerous others that it’s the best thing to do. Our thinking about how to behave is shaped, in part, by our perception that others in our social networks think the same way. This psychological effect of wanting to conform by following the consensus is known as “social proof”.
In the absence of information that contradicts what we can readily observe, behaviour tends to cascade quickly across social networks, as more and more people perceive that joining the emerging consensus is less effort, more personally beneficial, and more likely to help them fit in and enhance their social status.
An important mechanism in generating social proof is online endorsement. Other people’s thumbs ups and thumbs downs inform our perceptions of what is desirable and acceptable. For example, when a social media user positively endorses news articles, it influences levels of attention to, and favourability towards, those articles among their followers.
People tend to see traces of others’ endorsements, such as online comments or lists of “most shared” news articles, as more authentic measures of credibility and popularity than selection by a news editor.
This can have a direct impact on the health choices people make – including about vaccination. Before the pandemic, one US study found that parents who believed that other parents in their social networks were unlikely to have their children immunised against routine diseases (such as measles, polio, tetanus and others) were themselves more likely to delay or skip vaccinations for their children.
Social proof is therefore powerful – and for the UK’s COVID-19 vaccine programme, it will be especially so. As I write this article, 41.5 million people in Britain have received a first dose, 29.8 million a second. There’s a huge amount of consensus and endorsement with a lot of potential to influence the actions of others.
An ongoing struggle
Still, there are some final points worth stressing.
Social proof does not emerge spontaneously – it must be maintained. Different types of media and information sources continually expose the vaccine-positive and the vaccine-hesitant to the social signals that influence whether they will accept or avoid vaccination and whether they will encourage or discourage others from getting a jab.
And in the UK, those who use social media as their main source of information about COVID-19 are more likely to hold conspiracy beliefs and to go online to discourage others from getting vaccinated. There are forces that run counter to the influence of prevailing social norms that may even undo them.
Plus, those who are enthusiastic about vaccination still need clear information and good ways to share it with others online. Without them, the vaccine-positive will lack the ability to signal their enthusiasm and experiences in ways that maintain awareness of the social proof that vaccines are safe and effective. All of these points will be important to bear in mind as the vaccination programme moves forward.
That’s not to say that elaborate strategies and campaigns to convey normative behaviours are necessarily needed. Sometimes, signals of social proof can be simple and personal. Recall that I started this article by letting you know what you will first hear when you book your COVID-19 vaccination.
Do you see what I did there?
Andrew Chadwick currently receives funding from the Leverhulme Trust (RPG-2020-019) and is a member of the Oxford Coronavirus Explanations, Attitudes and Narratives (OCEANS) project, which has received funding from the University of Oxford COVID-19 Research Response Fund (0009519), the National Institute of Health Research (II-C7-0117-20001, BRC-1215-20005, and NIHR-RP-2014-05-003) and the Arts and Humanities Research Council (AH/V006819/1). The University of Oxford has entered into a partnership with AstraZeneca for the development of a coronavirus vaccine.