We study the impact of public health messages on intentions to vaccinate and vaccination uptakes, especially among hesitant groups. We performed an experiment comparing the effects of egoistic and altruistic messages on COVID-19 vaccine intentions and behaviour. We administered different messages at random in a survey of 6379 adults in December 2020, following up with participants in the nationally representative survey Citizens’ Attitudes Under COVID-19 Project covering nine high-income countries (Australia, Austria, France, Germany, Italy, New Zealand, Sweden, the UK and the USA). Four alternative interventions were tested, based on narratives of (1) self-protection, (2) protecting others, (3) reducing health risks and (4) economic protection. We measure vaccination intentions in the December 2020 survey and elicit actual vaccination behaviour by respondents in the June/July 2021 survey. Messages conveying self-protection had no effect on vaccine intentions but altruistic messages, emphasising protecting other individuals (0.022, 95% CI −0.004 to 0.048), population health (0.030, 95% CI 0.003 to 0.056) and the economy (0.038, 95% CI 0.013 to 0.064) had substantially stronger effects. These effects were stronger in countries experiencing high COVID-19 mortality (Austria, France, Italy, Sweden, the UK and the USA), where health risks may have been more salient, but weaker and, in several cases, not significant where mortality was low (Australia, Germany and New Zealand). On follow-up at 6 months, these brief communication interventions corresponded to substantially higher vaccination uptake. Our experiments found that commonly employed narratives around self-protection had no effect. However, altruistic messages about protecting individuals, population health and the economy had substantially positive and enduring effects on increasing vaccination intentions. Our results can help structure communication campaigns during pandemics and are likely to generalise to other vaccine-preventable epidemics. 

Public health response to COVID-19 requires behavior changes— isolation at home, wearing masks. Its effectiveness depends on generalized compliance. Original data from two waves of a survey conducted in March−April 2020 in eight Organisation for Economic Co-operation and Development countries (n =21,649) show large gender differences in COVID-19−related beliefs and behaviors. Women are more likely to perceive the pandemic as a very serious health problem and to agree and comply with restraining measures. These differences are only partially mitigated for individuals cohabiting or directly exposed to COVID-19. This behavioral factor contributes to substantial gender differences in mortality and is consistent with women-led countries responding more effectively to the pandemic. It calls for gender-based public health policies and communication.

Ageing threatens the financial sustainability of pay-as-you-go pension systems, since it increases the share of retirees to workers. An often-advocated policy response is to increase retirement age. Ironically, however, the political support for this policy may actually be hindered by population ageing. Using Swiss administrative voting data at municipal level from pension reform referenda (and individual survey data), we show in fact that individuals close to retirement tend to oppose policies that postpone retirement, whereas younger and older individuals are more favourable. The current process of population ageing and the associated increase in the size of the cohort of individuals close to retirement may partially explain why a pension reform that increased retirement age for women was approved in two referenda in 1995 and 1998, while a reform that proposed a similar increase in women’s retirement age was defeated in a 2017 referendum.

We investigate the effect of providing information about the benefits to children of attending formal child care when women intend to use formal child care so they can work. We postulate that the reaction to the information differs across women according to their characteristics, specifically their level of education. We present a randomized experiment in which 700 Italian women of reproductive age with no children are exposed to positive information about formal child care through a text message or a video, while others are not. We find a positive effect on the intention to use formal child care and a negative effect on the intention to work. This average result hides important heterogeneities: the positive effect on formal child care use is driven by high-educated women, while the negative effect on work intention is found only among less-educated women. These findings may be explained by women’s education reflecting their work–family orientation, and their ability to afford formal child care.