The interplay of gain-loss frames and individual-collective frames on the willingness to pay for influenza vaccine : a survey experiment

Abstract

Objectives: As the COVID-19 pandemic grew in recent years, governments worldwide have been trying to prevent a “twindemic,” or an overlapping of a severe influenza season and a surge in COVID-19 cases. However, Singapore has one of the lowest influenza vaccination rates amongst OECD countries. Despite the provision of heavy subsidies for influenza vaccination, reducing its monetary cost by itself is insufficient to motivate behaviour. This study attempts to explore the extent to which message framings affect an individual’s willingness to vaccinate for influenza.

Methods: A 2×2 experimental design to compare the effects of gain-loss and individual-collective frames against each other and a control group was employed. Elicitation of willingness to pay was done via the Becker-DeGroot-Marschak bidding game. Other key variables such as risk preference, time preference and social preference were also measured. To increase the comparability with other studies, psychological indicators such as attitude and intentions towards influenza vaccination was also measured. The effects of the frames were deduced through linear regressions and compared with the results of the Tobit regressions as part of a robustness check.

Results: A total of 174 participants were included after excluding participants that did not pass the manipulation check. There was a significant positive impact of framing on the willingness to pay for influenza vaccines, specifically the gain-individual, loss-individual and loss-collective frames. A similar positive impact of the above three frames were found on intention, attitude and anxiety. While no specific frame was more effective in increasing the willingness to pay for influenzas vaccines, gain and individual frames were more effective in increasing the intention to vaccinate and the anxiety of contracting influenza.

Conclusion: This study expanded upon these findings and explored the interplay between different frames in an attempt to circumvent the “twindemic”. While there are mixed findings on the relative strength of each frame, these findings are important to the public health sector. By integrating these theories of behavioural sciences into health communication, policymakers may better improve health campaigns to encourage pro-vaccination behaviour in the future.