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Lay Epidemiology and Vaccine Acceptance.

As vaccination rates against SARS-CoV-2 slowed across the US, increasing vaccine uptake became a national priority. Concerns about lack of confidence in the vaccine dominated lay and professional headlines and hundreds of programs were created to increase vaccine confidence, particularly among vulnerable populations who were most affected by the COVID-19 pandemic. In general, these programs focused on providing more information about the vaccine to communities thought to be at increased risk for vaccine refusal. This approach assumed that the decision to avoid or delay vaccination was based on inadequate understanding or information, perhaps overlaid by distrust of those involved in creating or delivering the vaccine. In that model, more information delivered by “trusted messengers,” including community leaders and local physicians, is the solution. Reality, however, is more complicated. Behavioral science has long demonstrated that knowledge of the risks and benefits of a given intervention has a surprisingly limited relationship with health behaviors. For instance, across dozens of studies, perception of the risk or severity of the disease has only a small to moderate correlation with the decision to undergo cancer screening, attempt to stop smoking, or get a vaccination.1-3 A similar pattern is seen with perceptions of the benefit of an