What is norms-shifting in immunization and global health?

The concept of “norms shifting perspective”, in the field of immunization and global health focuses on strategies that aim to alter norms and attitudes towards vaccination to promote uptake and acceptance.

This perspective acknowledges the influence that social norms have on individuals decisions regarding vaccination. Aims to utilize this insight to enhance acceptance through well crafted policies, messaging and interventions. The goal is to make vaccination the expected and socially endorsed choice across communities

Here are a few aspects of this perspective.

Recognizing the influence of social norms on vaccination behavior:

People’s vaccination decisions are significantly influenced by their perceptions of what others in their community think and do regarding vaccines.
Misperceptions about how many others accept vaccines can lead to lower uptake.

Using accurate information about norms to increase acceptance:

Providing factual information about high levels of vaccine acceptance in a community can increase individuals’ intentions to vaccinate.
This works by correcting underestimations of vaccine acceptance and leveraging social conformity.

Shaping norms through public policy:

Government policies and messaging around vaccines can shape social norms and expectations.
Mandates, passports, and other policies signal what is considered normal or expected behavior.

Designing targeted interventions:

Campaigns that feature relatable community members getting vaccinated can help establish vaccination as a social norm.
Messaging that emphasizes the social benefits and widespread acceptance of vaccines can be effective.

Considering unintended consequences:

Heavy-handed approaches like strict mandates may backfire by creating resistance and polarization.
Care must be taken to avoid stigmatizing unvaccinated individuals.

Adapting to local contexts:

Effective norm-shifting interventions need to be tailored to specific communities and cultures.
What works to shift norms in one setting may not work in another.

Taking a long-term view:

Changing deeply held social norms around health behaviors takes time and sustained effort.
The goal is to create lasting shifts in how vaccination is perceived and valued in communities.

Where to learn more about norms-shifting in immunization?

Bardosh, K., De Figueiredo, A., Gur-Arie, R., Jamrozik, E., Doidge, J., Lemmens, T., Keshavjee, S., Graham, J.E., Baral, S., 2022. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 7, e008684. https://doi.org/10.1136/bmjgh-2022-008684

Fayaz-Farkhad, B., Jung, H., Calabrese, C., Albarracin, D., 2023. State policies increase vaccination by shaping social norms. Sci Rep 13, 21227. https://doi.org/10.1038/s41598-023-48604-5

Moehring, A., Collis, A., Garimella, K., Rahimian, M.A., Aral, S., Eckles, D., 2023. Providing normative information increases intentions to accept a COVID-19 vaccine. Nat Commun 14, 126. https://doi.org/10.1038/s41467-022-35052-4

Reñosa, M.D.C., Landicho, J., Wachinger, J., Dalglish, S.L., Bärnighausen, K., Bärnighausen, T., McMahon, S.A., 2021. Nudging toward vaccination: a systematic review. BMJ Glob Health 6, e006237. https://doi.org/10.1136/bmjgh-2021-006237

Vriens, E., Tummolini, L., Andrighetto, G., 2023. Vaccine-hesitant people misperceive the social norm of vaccination. PNAS Nexus 2, pgad132. https://doi.org/10.1093/pnasnexus/pgad132