Indirect Effects of COVID-19 Nonpharmaceutical Interventions on Vaccine Acceptance

The information set from which individuals make their decision on vaccination includessignals from trusted agents, such as governments, community leaders, and the media. By implementing restrictions, or byrelaxing them, governments can provide a signal about the underlying risk of the pandemic and indirectly affectvaccination take-up. Rather than focusing on measures specifically designed to increase vaccine acceptance, thispaper studies how governments’ nonpharmaceutical policy responses to the pandemic can modify the degree ofpreventive health behavior, including vaccination. To do so, the paper uses repeated waves of a global survey on COVID-19beliefs, behaviors, and norms covering 67 countries from August 2020 to February 2021. Controlling for the usualdeterminants, the analysis explores how individuals’ willingness to get vaccinated is affected by changes ingovernment restriction measures (as measured by the Oxford Stringency Index). This relationship is mediated byindividual characteristics, social norms (social pressure to conform with what most people do), and trust in governmentinstitutions. The results point to a complex picture as the implementation of restrictions is associated with increasedacceptance in some contexts and decreased acceptance in others. The stringency of government restrictions hassignificant positive correlations with vaccine acceptance in contexts of weak social norms of vaccine acceptance andlower trust in government. In countries or communities where social norms are tighter and trust in government healthauthorities is high, vaccine acceptance is high but less sensitive to changes in policies. These results suggest thatthe indirect effect of government policy stringency is stronger among individuals who report lower trust and weakersocial norms of vaccine acceptance.