People are more inclined to get COVID-19 booster after reading tweets that target regret, study finds

The desire to avoid regret may be powerful enough to sway people to change their health behaviors, according to recent findings published in Computers in Human Behavior. The study revealed that people were more inclined to get the COVID-19 booster shot after reading a tweet about a couple who skipped the vaccine and regretted it.

People tend to do as much as possible to avoid regret. For instance, a person may agonize over a decision because they are afraid of making a choice they will regret in the future. Psychologists call this anticipated regret, and studies have found that these feelings can predict our health behaviors — such as our intention to get vaccinated.

Study author Manusheela Pokharel and her colleagues wanted to explore whether anticipated regret can be leveraged within public health messaging to promote healthy behavior. The researchers conducted an empirical study to test whether social media narratives that depict regret among the unvaccinated would induce anticipatory regret, and in turn, increase people’s intentions to get the COVID-19 vaccine.

“I was interested in this topic because on the one hand, I kept reading discouraging statistics about the vaccination rates, including booster vaccination, and on the other hand, there was a proliferation of heart-wrenching stories about unvaccinated people who lost lives because of COVID-19, its impact on the family and society, and how they regretted their decision of not vaccinating. This made me curious in understanding the impacts of these stories, notably in the intention to receive COVID-19 booster shots,” explained Pokharel, an assistant professor at the Texas State University.

Data for the current study was collected from an ongoing longitudinal study concerning Americans’ attitudes toward COVID-19 communication. The researchers focused on data collected at two different time points: November 19–24, 2021 and January 14–19, 2022.

During these two phases, 944 U.S. adults were randomly assigned to read a simulated news tweet showcasing one of four headlines. The headlines were based on a real news story concerning an unvaccinated couple hospitalized with COVID-19 with five children at home. The headline was manipulated to create four versions that differed depending on whether the couple survived/did not survive and regretted/did not regret their decision to skip the COVID-19 vaccine.

After reading the tweet, participants answered questions assessing their replotting of the story — the extent that they imagined how the outcome of the news story might be improved if the characters had made a different choice. They also completed measures of anticipated regret toward not getting a COVID-19 vaccine and indicated how likely they would be to get a COVID-19 vaccine. Due to the timing of the study, participants were specifically asked about their intention to get a booster shot.

The results revealed that the headlines depicting that the couple had died of COVID-19 (vs. survived) elicited higher anticipated regret among participants. Further, headlines depicting the couple’s regret toward not getting the vaccine elicited higher anticipated regret through greater replotting of the story. Higher anticipated regret was in turn associated with a stronger intention to get the COVID-19 booster shot.

In other words, regret headlines led participants to rethink the outcome of the news story, which in turn led them to imagine their own regret toward not getting the vaccine and to experience a stronger desire to get the booster shot. Interestingly, political identification moderated these effects, which were stronger among Republicans. The study authors say this is a noteworthy finding, given that Republicans were less likely to get vaccinated against COVID-19.

“Our paper highlights the importance of sharing an individual experience of regret after being diagnosed with COVID-19 and the familial impact among the loved ones of those who died due to COVID-19 and were unvaccinated,” Pokharel told PsyPost. “These types of stories are common in our society and might be capable of changing the attitudes and behavior of even the hard-to-reach conservative citizens, as demonstrated by our data. These findings are especially valuable to Public Health professionals trying to reach an audience group for a politicized health context.”

Pokharel and her team further point out that conservatives tend to be more resistant to persuasive messaging related to the coronavirus. The study findings suggest that the conservative population responds well to narratives that target regret, possibly because these stories are based on realistic and personal experiences and are less likely to be met with resistance. The authors note that the narratives in the study emphasized the impact on the couple’s family, which may have resonated with the family values that conservatives tend to respond to.

“It was surprising to see that regret messages had stronger impacts among Republican participants than the Democrats, which has a huge implication because studies have shown that political conservatives are more likely to resist persuasive COVID-19 messages,” Pokharel said.

A notable limitation of the research was that most (63.2%) of the participants were fully vaccinated at the time of the study, with either two doses of Pfizer/Moderna or a single dose of Johnson & Johnson. This suggests that most participants likely had positive attitudes toward COVID-19 messaging.

“The main caveat is that the majority of our participants had received at least one COVID-19 vaccine, which suggests that they had at least some positive attitude towards vaccination. We do not know how these messages would perform with the unvaccinated population, that would be an interesting question to explore in the future,” Pokharel explained. “In the same line, we evaluated the effectiveness of the messages using vaccination behavior intention, but we did not follow up and measure actual vaccine behavior, it would be interesting to see how much of this effect would translate to actual vaccine behavior.”

The study, “Social media narratives can influence vaccine intentions: The impact of depicting regret and character death”, was authored by Manusheela Pokharel, Helen M. Lillie, Kirara Nagatsuka, Joshua B. Barbour, Chelsea L. Ratcliff, and Jakob D. Jensen.

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