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Poole Professor’s Research Shows How COVID-19 Vaccine Marketing Strategies Must Change for Global Success

By Caroline Barnhill

In the United States, uncertain consumers tend to prefer middle options as a smart choice, a robust decision phenomenon known as “the compromise effect.” So when trying to promote COVID-19 vaccination, presenting it as the common or non-extreme choice may effectively win over those who are not yet vaccinated. However, does that approach hold the same sway in other countries? What about in Latin America and the Caribbean, where compromise options are viewed as weak or ambivalent? Or in areas of Asia where the compromise effect may be valued as demonstrating politeness, avoiding extreme positions that can cause friction?

All to say, when trying to promote the COVID-19 vaccine, where you live drastically impacts the effectiveness of your marketing strategy. That’s the crux of the most recent research published by Stacy Wood, Poole College marketing professor, along with colleagues Dr. Kevin Schulman and Muhammad Ali Pate. A paper of their findings, titled “Novel strategies to support global promotion of COVID-19 vaccination,” was recently published in BMJ Global Health.

“This is honestly one of the most fascinating research projects I’ve worked on because we were able to tap into the expertise of marketing and behavior science faculty from around the world – Finland, Brazil, Uganda, India, Australia, Sweden, Israel and more,” Wood says. “Almost 100 professors from across the globe put in time to assess the suitability and adaptability of 12 different vaccination promotion strategies.”

Globally, they found that all 12 behavioral strategies – which range from cognitive mechanisms such as using analogies to educate people to social mechanisms like prompting FOMO (fear of missing out) through the offering of incentives – could work well in their countries. Still, most needed regional adaptation in order to make the strategy successful. 

To make the research even more impactful, the paper lays out examples of specific tactics that could be used in different regions in order to reduce vaccine hesitancy and increase the numbers of individuals willing to receive a COVID-19 vaccination. 

For example, while all people may tend to value things that are scarce, leveraging the scarcity of vaccines to increase their perceived value should be approached, tactically, in different ways across different countries or cultures. Ugandans may need to frame the scarce vaccine as so precious that it is above corruption and explain that it will be distributed equally to all as it’s available. In Niger, however, it might be helpful to show how the precious and scarce vaccine is offered first to esteemed leaders like chiefs, kings or religious leaders. Marketing experts in Chile may frame scarcity differently by highlighting the relative scarcity of the vaccine in other countries – and by explaining that since Chile has better access to the vaccine than its neighbors, it would be unfortunate to waste them. 

“It is so important that we don’t assume research conducted in the U.S. or other so-called WEIRD (Western, educated, industrialized, rich and democratic) societies will be applicable to those in other parts of the world,” Wood says. “Before offering strategies on how to support global vaccine promotion that have worked in the U.S., it’s worth taking the time to collect insights and feedback from experts in various parts of the world. The variability in the advice offered by those experts demonstrates why this kind of research is critical, especially when the stakes are so high.”  

The study abstract follows.

“Novel strategies to support global promotion of COVID-19 vaccination”

Authors: Stacy Wood, Ph.D., NC State University, Muhammad Ali Pate, M.D., MBA (World Bank) and Kevin Schulman, M.D., Stanford University

Published: October 14, 2021, BMJ Global Health

DOI:10.1136/ bmjgh-2021-006066


In 2021, many countries have begun distribution of COVID-19 vaccines but are hampered by significant levels of vaccine hesitancy or apathy. Experts recommend that standard health communication campaigns be expanded to include a more holistic approach of behaviourally oriented strategies. We constructed a large-scale Delphi panel of marketing and behavioural science university faculty to assess 12 previously reported US vaccination promotion strategies, asking respondents to assess applicability of the strategy in their country, how efficacy might compare to the USA and recommendations for local adaptations necessary to successful implementation. Separately, we sought to determine whether strategies based on cognitive mechanisms (eg, ‘nudges’) are more readily generalisable than strategies based on social identity. Ninety-two marketing and behavioural science faculty from universities worldwide participated. Globally, all 12 behavioural strategies were validated; a majority of respondents reported that they would or could work well in their country. While all strategies were strongly validated at a global level, specific need for regional adaptation was identified. Also, open-ended responses suggested the addition of three emergent strategies to a global effort. Finally, we see that strategies based on some types of cognitive mechanisms are more readily generalisable across regions than mechanisms based on social identity, however, this is not always true of ‘nudge’ strategies. All 12 strategies are robust to global use and consensus exists on adaptation for optimal efficacy in different regions; specific strategy recommendations are posited. Use of these strategies can accelerate individual country efforts to achieve desired vaccination rates to protect global public health.

This post was originally published in Poole Thought Leadership.