We examine the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.
The results of this study offer support for the hypothesis that cognitive ability is a profound and direct determinant of COVID-19 vaccination. While it does not necessarily imply that the relationship is causal, we may at least confidently conclude that the relationship is not easily explained by family background, environment or socioeconomic factors.
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The primary policy tool to end the COVID-19 pandemic in most Western countries was to achieve a high vaccination rate as quickly as possible. While many individuals took the first opportunity to get vaccinated, others were slower, and a non-negligible share refrained vaccination, thus putting both themselves and others at an unnecessary risk of severe COVID-19 infection. This suggests that a one-size-fits-all approach, such as the information-based opt-in vaccination strategy adopted in many countries, was effective in that it resulted in a high and prompt vaccination rate in a large share of the population. However, it also suggests that it was ineffective for a smaller, but still substantial part of the population.
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In this paper, we analyze how cognitive ability is related to if and when individuals get vaccinated against COVID-19 and whether simplifying the vaccination decision by providing pre-booked vaccination appointments (opt-out policy) may alleviate heterogeneity in vaccination behavior. …
We find that cognitive ability is positively associated with swift COVID-19 vaccination. At each point in time, during a 360 days period following the vaccine rollout, there is a positive monotonic relationship between cognitive ability and the rate of first dose vaccinations. For example, a vaccination rate of 80% is reached after approximately 50 days in the group with the highest cognitive ability score and after 180 days in the group with the lowest score.
Although cognitive ability is not directly observable by policy-makers, and while policies directly targeting individuals with certain levels of cognitive abilities may not be ethically or politically feasible, we have demonstrated that simplifying the vaccination decision through the use of pre-booked appointments was particularly effective in overcoming vaccination resistance and hesitancy among individuals with lower cognitive abilities.
Given that these individuals are relatively more susceptible to various health risks, including COVID-19 infection, such a policy may lead to significant welfare gains for this group. Our findings also imply that if everyone were vaccinated as swiftly as individuals with a high cognitive ability, the pandemic would likely have ended earlier, with fewer lives lost and with lower costs for society.
