A Self-Administered Virtual Reality Intervention Increases COVID-19 Vaccination Intention

"Digital interventions delivered using VR consumer hardware can become an effective tool for vaccine advocacy, complementing more traditional communication channels."

Previous research suggests that communicating the personal or collective benefit of vaccination, such as in the context of the COVID-19 pandemic, increases people's vaccination intention. Using novel technology such as immersive virtual reality (VR) provides an opportunity to engage the audience on terrain salient to them and may be useful for vaccine advocacy. In particular, this strategy could reach younger people, who are more likely to be hesitant about COVID-19 vaccination, potentially due to a lower likelihood to suffer from a severe course of the disease. This paper reports on an intervention using VR to communicate the benefits of COVID-19 vaccination, with the goal of increasing intention to get vaccinated against COVID-19.

Study recruitment took place from April 14 to May 14 2021 within VR communities on Reddit and Twitter during mass roll out of national COVID-19 vaccination programmes. Participants (n=282) were adults who not previously been vaccinated against COVID-19; they hailed from 17 countries around the world. People with eligible VR headsets were invited to install the experimental application (app) and complete the 10-minute virtual consultation study at their own discretion.

The study employed a 2x2 between-participant design. The independent variables were avatar age with the levels young and old, and vaccination communication with the levels personal benefit and personal + collective benefit. The study experimentally manipulated age of participants' embodied avatar to underpin the increased personal risk COVID-19 poses for elderly people, which the researchers hypothesised would increase vaccination intentions. The primary outcome was vaccination intention measured 3 times: immediately before and after the study, as well as one week later.

The study began as participants wore their headsets and launched the VR app. Their gender identity was prompted to match the virtual avatar with the participant. The narrative of the immersive experience was situated around a visit to a virtual general practitioner (GP) in order to receive information about COVID-19 vaccination. Depending on the assigned experimental condition, the GP would either explain the personal benefit of vaccination, or both the personal and collective benefit of vaccination. The GP made multiple remarks related to the assigned age condition to explain the heterogeneous risk profile regarding age (e.g., "young/old people, like you, are less/more vulnerable to the coronavirus").

Among the findings:

• The VR intervention increased participants' own (as-self) vaccination intention, regardless of the experimental condition, measured as the pre-to-post intervention difference. The intervention caused a substantial mean increase in vaccination intention. The pre-to-post difference significantly correlated with the vaccination intention one week later.
• Vaccination intention when embodied as a young avatar, but not as an old avatar, increased when both the personal and collective benefit of COVID-19 vaccination was communicated, relative to the personal-benefit-only condition. This finding is in line with previous research, showing that people at lower personal risk increase their vaccination intention when they are informed about the collective benefit of vaccination.
• Secondary analyses revealed significant pre-to-post increases in COVID-19 empathy (towards those most vulnerable to coronavirus), vaccination recommendation, and vaccination readiness, offering further evidence of the intervention's effectiveness.

In reflecting on the findings, the researchers suggest that the study "shows the potential of using immersive VR in health communication. People with access to a VR headset could self-administer [the] intervention....At the same time, however, this procedure allows targeting population groups who are otherwise difficult to reach with traditional health communication. Moreover, VR interventions could also be administered differently, such as in medical practices (targeting patients) or in medical education (targeting health care professionals)."

In conclusion: "combining health communication with experiential learning through bodily self-consciousness could be used in future health campaigns for tailoring communication efforts. Adopting novel technology in vaccine advocacy by relying on evidence-based intervention practices may thus help to decrease the spread of infectious diseases."