New Delhi, Sep 8 (PTI) Simplifying the Covid vaccination decision by pre-booking appointments could alleviate inequality in vaccination behaviour, a Swedish study suggests.

Logging on to a website, finding an appointment, booking it, going there and getting vaccinated may be too many steps for some people with lower cognitive ability, say researchers from Uppsala University.

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In the Swedish region of Uppsala, letters with pre-booked vaccination appointments were sent out to its residents aged 50-59 years. In essence, all they had to do was "show up" to get vaccinated. They could still choose not to take the vaccine by cancelling the appointment or simply not showing up, both free of charge, the researchers detail in their study.

The result was rapid and high vaccination rates even among those with lower cognitive ability - it took only 40 days for 80 per cent of that group to get inoculated, which was 140 days faster than the national vaccination rate among those with lower cognitive abilities, they found.

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Further, in 90 days, this cognitively-disadvantaged group was 90 per cent vaccinated, a level not reached after one year in the rest of the country and that comparable to the vaccination rate for the individuals with the highest cognitive ability score in all of Sweden, their study published in the Journal of Health Economics said.

"A simple measure, such as pre-booking vaccination appointments, proved to be a powerful tool to speed up vaccinations in both groups," noted Mattias Ohman from Uppsala University, also one of the study authors.

Overall, the study showed that among people with the highest cognitive ability, 80 per cent had been vaccinated within 50 days. Among those with the lowest cognitive ability, it took 180 days to achieve the same vaccination rate.

One explanation could be that people absorb information and make decisions in different ways, the researchers said.

"This is important knowledge for future situations in which authorities want to reach a broad public to encourage them to get vaccinated or adopt other health measures, for example. If we are to have equal care for all, we need to take into account the different ways people absorb information," said Mikael Elinder, Associate Professor in Economics at the university and a study author.

The study is based on the results of cognitive ability tests from compulsory military service undertaken by 750,000 men and 3,000 women born between 1962 and 1979. The test results were compared with vaccination statistics from the Public Health Agency of Sweden.

Pre-booked appointments simplified the vaccination decision, along with signalling that it was "good" to take the vaccine. This could thus, remove the "complexity" barrier and boost vaccination rates disproportionately more for individuals with lower cognitive abilities, the study said.

"It shows that some of the inequalities in vaccination behaviour can be addressed by better designing vaccination campaigns. As it is known that the group with lower cognitive ability was also hit harder by COVID-19, such a measure is likely to contribute to more equal health outcomes," said Oscar Erixson, the study's corresponding author.

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