Why the behavioural scientists need to get out of our teenagers’ brains.
Teenagers have endured a blitzkrieg of nudge, shaming and threats.
The last thing our teenagers need, after a terrible year and a half, is the onslaught of behavioural science subliminally affecting their brains.
The JCVI (The Joint Committee on Vaccination and Immunisations) deliberated carefully before deciding against a mass roll-out of the UK’s successful vaccination program to this age group. They decided there was only a marginal benefit to teenagers combined with uncertainty about the potential and unknown harms of the vaccine. Nonetheless the four nations’ Chief Medical Officers decided the vaccine should be delivered through a mass programme in schools.
If the JCVI found this a difficult decision, how are teenagers and their parents supposed to decide what the right thing to do is?
Even more troubling, how are teens and their parents supposed to make an informed decision about whether to have the Covid-19 vaccine after an 18 month long blitzkrieg of behavioural science?
As I uncovered in the research for my book, A State of Fear, the government leant on fear-mongering and ‘nudges’ (psychological manipulation to alter behaviour) to encourage the population to comply with lockdown rules.
But informed consent - the ethical bedrock of modern medicine - means being able to make a rational decision about a medical intervention, unclouded by emotions or subliminal manipulation.
Last year, public health messaging took a shameful turn when teenagers and children were chided not to kill granny. The messaging was used by the government, from the Secretary of State for Health and Social Care, Matt Hancock, to local government, such as Preston City Council, and it reverberated around national and local media. Dr Daisy Fancourt, the Associate Professor in Behavioural Science and Health at UCL and runs The Covid Social Study which provides findings to SAGE, told me “don’t kill granny” was “good for compliance” because “appeals to collective conscience are effective”. That’s putting it mildly - exhorting children not to kill their grandparents was simultaneously insensitive to those who had lost loved ones and heaped a jaw-slackening burden of fear, guilt and shame on the others.
Public health messaging sought to make everyone appear vulnerable, when actually the risk from Covid was known to be highly age-stratified. Ads with disaster-chevroned edges and grainy close-ups of the the sick were crafted to heighten panic and spread a sense of personal threat to everyone regardless of the actual risk. So young people were told they were both the risk and at risk.
The actions of selfish individuals were to blame when things went wrong, not government failures to, for example, protect care homes or prevent the virus leaving hospitals. Even our children were to blame.
On top of that background of fear, and after the second longest school closures in Europe, teenagers are now being “offered” the vaccine.
The NHS Covid-19 vaccine consent forms and guides do not enumerate the risks of the disease or the vaccine. If young people are deemed capable of making the decision, they must be given the full information. It is well established in the UK - especially since the 2015 Montgomery case, a legal landmark in informed consent - that a patient should be told what they want to know, not what the doctor thinks they should be told.
Parents have reported asking their school and local NHS service for full enumerated risks and benefits only to be told the information is not available, or they have been ignored. In addition, the UKHRA has reportedly refused an FOI to release the minutes of the meeting in which the JCVI decided not to vaccinated 12-15 year olds. This is troublingly opaque.
There is a one in 50,000 chance of being admitted to intensive care with Covid and a two in a million chance of dying from Covid. But after the second dose of the Pfizer vaccine (which NHS consent forms warn may be needed) the risk of myocarditis (an inflammatory heart condition) may be higher for teenage boys than the risk of being hospitalised by Covid. (This pre-print paper is debated.) And then there are the other side effects, which might simply be unpleasant and inconvenient but may also result in absence from school. But these calculations do not feature on the guides and consent forms.
Furthermore, the vaccine programme will be rolled out in schools which might impact teenagers’ ability to make an impartial and cool-headed decision. Educational Psychologist Professor Gavin Morgan, who is on SPI-B (the voluntary group of psychologists and behavioural scientists who advise the government) told me that, “We know from psychology that young people are far more influenced by their peers than any other group. Given the high emotion around Covid and that the vaccine will be rolled in schools it is likely to influence informed consent.” Anyone who has a teenager knows how true this is.
I asked Morgan if he had offered his advice about peer pressure in schools to the government. He told me that despite being the sole educational psychologist on SPI-B he had not been asked his opinion about any aspect of giving vaccines to school age children. It seems that ‘following the science’ is easier when it aligns with the desired government policy.
The fingerprints of the nudgers are all over the consent form and the other communications. This is obvious from the language to the prioritisation of tick boxes. Someone who worked until recently in a senior role in communications at the NHS told me that “the nudge unit were consulted on all Covid communications from NHS England. It’s not just about making the communication clear, it’s also about being persuasive in an ‘invisible hand’ way. I am concerned about the manipulation. The problem with nudging from my point of view is that it has a set agenda. Rather than just inform they have a sharp objective in one direction, and that has the potential to mislead. And the nudgers aren’t accountable through the normal public sector channels.”
Aswell as the pressure they might feel in front of friends and teachers at school, teenagers have been exposed to government and NHS ads about the vaccine on social media, such as Youtube and TikTok. The incessant messaging tells teenagers that they don’t want to miss out and to get their “shots”. I’m not sure they are quite hitting the mark though, with one teenager telling me the ads are “cheesy” and they don’t bother watching any more.
The messaging to teenagers not to miss out is echoed in the letter already sent to 16 to 17 year olds which tells them the vaccine will help them get back to normal and not miss out on holidays, sporting events, festivals and “freedoms”, rather than focus on the medical benefits.
I spoke to a scientist involved in the vaccine programme who has grave concerns about this behavioural science approach. Deciding to remain anonymous rather than risk harming their career, they said that in their experience the behavioural scientists in the nudge unit are “elitist and out of touch with the concerns of ordinary people, young people, the working classes and ethnic minorities. They seem happy to use coercive strategies to get people to vaccinate, and reach their targets, without much regard for informed consent. They seem oblivious to the harms that their strategies could do to vaccine confidence and trust in the long term.”
This is an important point. This new onslaught of behavioural science to push vaccine uptake could harm public trust in vaccines and public health messaging in the long term.
Teenagers have been through enough in the last 18 months. Give them the medical facts about the vaccine and trust them and their parents to know what is best for them. And then nudge off and stay away from their brains.
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NOTE: The accuracy of the pre-print study cited by The Telegraph has been debated, so this article was edited 11th October 2021 to remove the claim about the risk of hospitalisation from myocarditis and to include a link to the BMJ’s article which claims that the study is flawed.