BACKGROUND:
Scholars posit that there is overlap between the fields of behavioral economics and behavior science—and that consideration of concepts from both may facilitate greater understanding of health decision-making processes. This exploratory study aimed to apply a behavioral economics concept with demonstrated effectiveness in financial decision-making to a health behavior: vaccine uptake.

METHODS:
Adults aged >18 years were recruited on Amazon’s Mechanical Turk, a digital labor market where anonymous users perform simple tasks at low cost. Eligible participants were randomized into two groups, reviewed a scenario, and then completed a survey on the likelihood of receiving an influenza (flu) shot. The ‘usual care’ group’s scenario included standard guidance from the U.S. Centers for Disease Control that encouraged flu vaccination. The ‘intervention’ group’s messaging was framed so that participants could learn from others’ (strangers) mistakes and the subsequent health consequences: “Last year, other people who didn’t get the vaccine were about twice as likely to get the flu, and a number of them were hospitalized or even died. Don’t risk it.” Chi square analyses were performed on the sample.

RESULTS:
There were 648 participants (usual care, n=326; int., n=322). Among people of color (n=184; 57% aged < 40), the intervention group was 22% more likely to report that they were “extremely” or “moderately” likely to get the flu vaccine (p = 0.11) compared to standard messaging.

CONCLUSIONS:
While not statistically significant, findings suggest that learning the mistakes of unknown others may help influence flu vaccine uptake among the study population. With widely documented differences in vaccine uptake, further exploration of the application of these concepts may be critical.