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Visit: How to poke a vaccination? The Czechs found instructions

You are reading a sample from Vizita – Martin Čaban’s newsletter full of observations about the Czech healthcare system and its transitions into politics. If you are interested in Visit, be sure to subscribe!

Since the Czechs are not quite frequent guests on the pages of perhaps the most prestigious professional periodical in the world, it is worth looking at what the four authors attracted the strict reviewers of the weekly.

Right at the beginning of the work with the unattractive title “Communication of the medical consensus permanently increases vaccination against covid-19”, the authors state that the reluctance of people to vaccinate is one of the main challenges in managing epidemics of dangerous infectious diseases. And then they describe an experiment in which they used a simple method to increase the confidence of the tested group of people in vaccination and interest in the vaccine.

The authors of the study participated in the collection of two data sets last year. On the one hand, in cooperation with the Czech Medical Chamber, they examined the relationship of Czech doctors to covid vaccines, and on the other hand, together with the PAQ Research agency of sociologist Daniel Prokop, they found out in a long-term survey how doctors think they have to do with these vaccines.

This data turned out to be fundamentally divergent. Ninety percent of doctors said they wanted to be vaccinated (or had already been vaccinated at the time of the February 2021 survey), roughly the same said they trust approved vaccines, and more than 95 percent said they would recommend vaccination to their healthy patients. In contrast, the majority of the public’s perception of the medical consensus on vaccination was completely different. On average, Czechs thought that only 59 percent of doctors trust vaccines and were willing to get vaccinated.

These numbers themselves have previously been published by both the Czech Medical Chamber and PAQ Research. However, the authors of the study published in Nature took another step.

Half of the respondents in a representative sample of the population were acquainted with the medical consensus survey and the other were not. And they observed that in the group familiar with the actual attitude of the medical condition, the willingness and confidence in vaccination increased significantly compared to the control group – by about five to six percentage points. Moreover, this trust persisted in a period when vaccines were rare and intended only for selected groups, and later, after the launch of mass vaccination, was reflected in the real vaccination of respondents.

Thus, a more general conclusion may be that, rather than sneakers, hard-working ministerial and prime ministerial appeals or celebrity videos, the simple dissemination of information that is important to the hesitant may act as an incentive to vaccinate.

Since two of the four authors of the study (Michal Bauer and Julie Chytilová) come from the Czech incubator of behavioral economics at the Institute of Economic Studies, Faculty of Social Sciences, Charles University, CERGE-EI and the IDEA think tank, and the other two (Vojtěch Bartoš and Jana Cahlíková) at the universities of Munich and Milan, they work with information about the medical consensus as a classic example of a “nudge”.

Which is a phenomenon described by the economic nobelist Richard Thaler, according to whom even seemingly inconspicuous “pokes” in the right places and at the right time can have a fundamental influence on behavior and decision-making processes.

Of course, like any professional text, this work, published in a prestigious magazine, can be the target of criticism. With one possible reproach men Ondřej Dostál, a medical lawyer and fighter against covid measures, who questioned the way in which the authors found that initial medical consensus. According to Dostál, these were primarily doktor doctors who communicate with (President of ČLK – note red.) Kubkem ’.

Dostál is right that the sample of doctors used in the study was massive – over 9,500 respondents – but it was not created according to the principles of representativeness. The Medical Chamber addressed all members who communicate with it electronically (which is 70 percent of all physicians), and a quarter of them responded to the online questionnaire. This created a sample that examined doctors’ attitudes toward vaccines.

Online data collection is always a bit problematic in sociological surveys, and researchers tend to approach it carefully and carefully weigh various socio-demographic and other variables. This did not happen immediately in this case. The complaint against the selection of a medical sample can also be found among the opinions of reviewers who evaluated the work of Czech scientists for Nature (and certainly did not find this complaint so serious that the study could not come out).

However, it should be noted that the authors of the study checked the composition of their sample of physicians, both according to ČLK and ÚZIS database, and came to the conclusion (supported by the table in the appendix) that the sample can be considered representative, so consider the consensus to be incorrect.

Therefore, it seems more likely that the vast minority of doctors who feel distrust or outright of vaccines is simply louder and, thanks to the amplifying effects of social and traditional media, much more audible and influential than would correspond to their number among the medical condition.

Which is one of the reasons why there is a disproportion between what doctors think about vaccines and what people think doctors think about vaccines. Such a hypothesis is as scientifically unproven as Dostál’s claim that the sample is unrepresentative, but unlike it, it can be preliminarily supported by at least some data.

Dostál’s argument that the authors of the study took a “medical” sample once in February 2021 may have some relevance, while the population sample was followed by a longitudinal survey between February and November of the same year. However, the search for a medical consensus was not the main focus of the study – it was primarily about the effect of specific information on specific attitudes and decisions of the population.

However, if Ondřej Dostál wanted to follow up on the work in Nature and examine the development of medical attitudes between last February and the present on a completely correct and representative sample, it would undoubtedly be an interesting and meritorious scientific work.

You will find much more in the full issue of the Visit newsletter. For example, an explanation of the medical concept of ICD or interesting reading tips not only in the field of healthcare. If you want to receive the entire Visit every Tuesday directly to your e-mail inbox, subscribe.

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