Combatting COVID-19 Vaccine Hesitancy Globally Using Behavioral Design


  • Our COVID-19 vaccine demand and prevention efforts have spanned 8 countries through Breakthrough ACTION.
  • Many of these activities have focused specifically on health workers as a priority group for COVID-19 vaccination acceptance and uptake. 
  • Cross-cutting insights, including behavioral influences and promising approaches to support health worker vaccine uptake, have been synthesized into implementer-friendly guidance.

The Challenge

Over a year after the global roll-out of COVID-19 vaccines, vaccination rate gaps between high- and low-income countries continue to grow. Supply shortages are no longer the primary issue, with logistics challenges and vaccine hesitancy emerging as the primary barriers to uptake in many low-income countries.

Our Approach

In most countries we have worked with teams and governments to understand and target demand-side barriers to promote acceptance and uptake of the COVID-19 vaccine. Our formative work has explored the context surrounding vaccine-related decision-making and behavior in each country through interviews with healthcare workers and community leaders, as well as the general public.

Our COVID-19 portfolio of work includes:

  • Leveraging peer influence to encourage health worker vaccine uptake in Liberia
  • Increasing trust and visibility to encourage vaccine uptake in Cameroon
  • Protecting people with comorbidities against COVID-19 in Senegal
  • Targeting behavioral barriers to prevention and health worker vaccine uptake in Nigeria
  • Encouraging COVID-19 uptake among youth and the general public in Cote d’Ivoire
  • Co-creating solutions to prompt COVID-19 vaccine uptake in Burkina Faso and Mali
  • Applying behavioral insights to communicate risks and support local governments in the Phillippines
  • Synthesizing global behavioral insights and promising approaches to support COVID-19 vaccine uptake among health workers
  • Developing guidance on designing social and behavior change solutions to support pediatric COVID-19 vaccine uptake


Our work on vaccine demand has found that while there are differences in specific vaccine concerns and priorities across countries, several behavioral insights resonate strongly across contexts and suggest promising design directions to support vaccine uptake. These include the importance of raising the visibility of peer vaccination and encouraging sharing between friends and colleagues to build trust and reduce hesitancy. Several innovative and behaviorally-informed solutions have resonated during the co-design and user testing process and have been adapted to their respective country contexts.


Closing the gap of vaccine uptake in low-income countries is as much a behavioral problem as it is logistical, and we believe behavioral design has an important role to play in boosting demand generation efforts and reducing vaccination disparities.

Interested in our work applying behavioral science to global health? Email, follow us on LinkedIn, or tweet at @ideas42 to join the conversation.