Fighting Vaccination Hesitancy: Improving the Exercise of Responsible Agency

In Ben Davies, Gabriel De Marco, Neil Levy & Julian Savulescu (eds.), Responsibility and Healthcare. Oxford University Press USA. pp. 271-286 (2024)
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Abstract

Addressing vaccination hesitancy is a major challenge in the fight against infectious disease. Vaccine hesitancy has given rise to recent outbreaks of vaccine preventable diseases (e.g., measles) in developed countries. In developed regions, particularly Europe and North America non-structural barriers to vaccination such as risk perceptions and philosophical beliefs seem to play a crucial role in vaccination uptake (Larson et al. 2014), and also contribute to current vaccine hesitancy with regard to COVID-19. To combat these developments, understanding psychological factors in vaccination hesitancy is increasingly important. A better understanding of these psychological factors in turn points to communication strategies that can reduce vaccine hesitancy. These strategies depend upon individuals’ possession of capacities that are required for morally responsible agency (“responsibility-level capacities”), and in particular the capacities to recognize and respond to reasons. Strategic communication concerning vaccines can improve the exercise of individuals’ responsibility-level capacities as they pertain to risk perception and outcome expectancies. We begin by introducing cutting-edge work from the philosophical literature on agency and responsibility, with a special focus on the responsibility-level capacities at work in the practical context of deciding whether to vaccinate. We then summarize lessons drawn from a variety of studies in psychology and behavioural economics on how individuals reason, decide, and behave in these practical contexts. These lessons help illuminate the extent to which individuals exercise responsibility-level capacities in such contexts while also pointing to strategies that can improve the exercise of those capacities.

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Daniel J. Miller
West Virginia University

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