As one of the most severe flu seasons in recent memory hits its peak, statistics show that, as of 2015, only 43.6 percent of adults and 59.3 percent of children take the precautionary measure of obtaining a flu vaccination.

What compels those who decide to vaccinate to take that step? This is the question that Ernest Baskin, Ph.D., assistant professor of food marketing, asks with his study "Increasing Influenza Vaccination Rates Via Low Cost Messaging Interventions" that PLOS ONEpublished this month in their open access journal.

“My area of expertise is in consumer behavior, so for this study I aimed to understand how to get people to make better decisions about their health,” says Baskin. “I wondered what type of rhetoric would drive them to vaccination clinics, and what can this data tell us about the retail setting as well.”

For his study, Baskin manipulated the bottom half of an email with three features encouraging over 30,000 students, faculty and staff at an unnamed university to obtain an influenza vaccination. These three motivators, or “nudges” as Baskin describes them, were maps with locations of vaccination clinics, incentives such as a chance to win a gift certificate to the university bookstore, and reminders of the negative effects of influenza, such as becoming seriously ill or missing time from work.

“Out of the 30,000 that received an email, participants could receive a combination of zero to all three of these nudges at the bottom of their message,” says Baskin.

The method that Baskin used was a binary logistic regression that used the influenza vaccination as a dependent variable. The findings were gathered in 2016-17 after vaccination clinics manually entered their data.

The results of this examination were contrary to those of previous studies surrounding motivations. Baskin found that the most successful of these nudges was the inclusion of the map with vaccination clinic locations. Of the population that received an email, 32.5 percent went to a location and got a vaccination. His data shows that presenting the vaccination centers in the email resulted in a conversion increase of about two percent, or 600 additional vaccinations. 

“Mentioning locations made the convenience of the flu vaccination very salient to the people that were emailed,” says Baskin. “Most didn’t realize how easily attainable the vaccination was.”

Other reports have shown that incentives, such as gift cards, had the highest conversion rate, contrary to the results that Baskin found in his study. He reached the conclusion that such incentives, as well as the warnings of harmful effects of influenza, didn’t have an effect on the number of participants acquiring a vaccination compared to the numbers he reached with the location motivator.

“It is hard to pinpoint why incentives were unsuccessful. I have suspicions that the email may have lost readers’ attentions by that point,” Baskin theorizes. “As for the reminders of influenza effects, studies have shown in the past that readers tend to ignore statistics and believe that they will be an exception to numbers.”

While this data provides an understanding of what drove participants in a university setting to receive a vaccination, the findings are applicable to other settings. Baskin recommends that more retailers with vaccination clinics, such as public pharmacies, follow the study’s findings.

“Emphasize the convenience of getting the flu shot by marking locations and encouraging accessibility,” suggests Baskin. 

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