Coercion, even when well-intentioned, can backfire in ways public health officials did not anticipate.
At Imperial College London, researchers have surfaced a tension as old as governance itself: the line between protection and coercion. A study of over a thousand people in the UK and Israel found that vaccine passport policies, designed to encourage vaccination, may instead harden resistance among those who feel their sense of self-determination is being overridden. The finding invites policymakers to reckon with a quiet truth — that lasting public health depends not only on compliance, but on the preservation of trust and dignity.
- People who felt vaccine passports stripped away their freedom of choice were significantly less willing to get vaccinated, revealing a psychological boomerang effect at the heart of public health strategy.
- The coercive pressure intended to push hesitant populations toward vaccination may instead be entrenching resistance, threatening not just current uptake but willingness to accept future boosters and variant vaccines.
- Beyond vaccination rates, the study warns that policies which ignore basic psychological needs risk corroding public trust in health institutions and compounding the mental health toll of the pandemic itself.
- Researchers are calling for a fundamental shift in approach — away from external mandates and toward campaigns that connect vaccination to personal values, community care, and individual agency.
A team at Imperial College London has uncovered an uncomfortable paradox in pandemic policy: vaccine passports, the tools governments deployed to accelerate vaccination, may be quietly working against that very goal. Surveying 681 people in the UK and 677 in Israel, researchers found a clear pattern — those who felt their autonomy was being frustrated by passport requirements were the least willing to accept vaccination. In countries where rates had already reached 57 and 62 percent respectively, the question of how to reach the remainder suddenly looked more complicated.
The study, published in the journal Vaccines, measured three core psychological needs — autonomy, competence, and relatedness — and found that when vaccine passport policies threatened people's sense of free choice, willingness to vaccinate dropped significantly. Lead author Dr. Talya Porat described the dynamic plainly: incentives that make people feel they have lost control over their own decisions can produce the opposite of the intended effect.
The consequences, researchers warn, reach further than the current moment. Even if passport pressure succeeds in getting some people vaccinated today, those same individuals may resist booster doses or future vaccines — and broader public trust in health systems may quietly erode in the process. A short-term gain in numbers could carry a long-term cost to the relationship between governments and the people they serve.
Professor Rafael Calvo, a senior author on the study, pointed toward a different model: campaigns built around personal values and genuine autonomy, helping people see vaccination as an expression of what they already care about rather than a condition imposed from outside. The research team plans to extend their work to countries with lower vaccination rates, pursuing a question that is as much philosophical as epidemiological — how societies can protect collective health without diminishing the individual dignity that sustains democratic trust.
Researchers at Imperial College London have identified a psychological paradox at the heart of vaccine passport policies: the very tools designed to push people toward vaccination may be pushing some away. A survey of 1,358 people across the UK and Israel found that individuals who felt their sense of free choice was being stripped away by vaccine passport requirements were significantly less willing to get vaccinated—a finding that suggests coercion, even when well-intentioned, can backfire in ways public health officials did not anticipate.
The study, published in the journal Vaccines, examined three basic psychological needs: autonomy (the feeling of making one's own decisions), competence (the sense of being capable), and relatedness (feeling trusted and understood). Researchers surveyed 681 people in the UK and 677 in Israel, asking them how willing they were to be vaccinated and measuring the extent to which vaccine passport policies either satisfied or frustrated their psychological needs. The pattern was clear: people whose autonomy felt threatened by vaccine passports were the least likely to say they would accept vaccination. In countries where vaccination rates had already climbed to 57 percent in the UK and 62 percent in Israel, this finding raised an uncomfortable question about the cost of the policies meant to drive those numbers higher.
Vaccine passports—documents proving vaccination status required to enter hotels, attend events, or move freely within a country—were introduced globally with the explicit goal of encouraging vaccination and restoring normal life. But the Imperial College research suggests they may carry an unintended psychological cost. Dr. Talya Porat, the study's lead author, noted that when government incentives make people feel they have lost control over their own decisions, the result can be the opposite of what was intended. "If public health incentives like vaccine passports 'frustrate' psychological needs—for example by making people feel a lack of free will over their decisions—then they might paradoxically reduce people's willingness to get vaccinated," Porat said.
The implications extend beyond the immediate vaccination campaign. The researchers warn that even if vaccine passport pressure succeeds in getting people vaccinated now, those same people may prove far less willing to accept booster doses or vaccines against new variants in the future. More broadly, policies that ignore basic psychological needs can erode public trust in health systems and add to the mental health burden already imposed by the pandemic itself. In other words, a short-term win on vaccination rates could translate into long-term damage to the relationship between governments and the public they serve.
Professor Rafael Calvo, a senior author on the study, offered a different path forward. Rather than relying on external pressure and control, he argued, governments should frame vaccination campaigns around personal values and autonomy—emphasizing, for instance, how vaccination protects loved ones or aligns with what people already care about. "Governments and policymakers should strive for highly vaccinated populations by communicating about health and risk in ways that enhance basic psychological needs," Calvo said. "This could include creating a health care environment that supports autonomy."
The research team plans to extend this work to countries with lower vaccination rates than the UK and Israel, and to examine how international vaccine passport policies might affect people's willingness to travel and participate in global life. The underlying question driving their future work is both practical and profound: How can societies achieve the vaccination rates necessary to control disease without damaging the psychological foundations of public trust and individual dignity that hold democracies together?
Citas Notables
If public health incentives like vaccine passports frustrate psychological needs—for example by making people feel a lack of free will over their decisions—then they might paradoxically reduce people's willingness to get vaccinated.— Dr. Talya Porat, Imperial College London
Governments and policymakers should strive for highly vaccinated populations by communicating about health and risk in ways that enhance basic psychological needs, such as creating a health care environment that supports autonomy.— Professor Rafael Calvo, Imperial College London
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So the study found that vaccine passports actually make some people less willing to get vaccinated. That seems counterintuitive—weren't they designed to encourage vaccination?
Yes, and that's the paradox. Passports were meant to create an incentive: get vaccinated, and you regain your freedom of movement. But for some people, the requirement itself feels coercive, like the government is taking away their choice. That sense of lost autonomy—of not being in control of their own decision—can trigger resistance.
But people were still getting vaccinated in these countries. The UK was at 57 percent, Israel at 62 percent. So did the passports work or not?
They may have worked in the short term, but the study suggests a hidden cost. People who felt forced by the passports might get the vaccine to regain access to society, but they're less likely to get boosters later or to trust public health guidance in the future. You win the battle but lose the war.
The researchers mention that about 11 to 15 percent of eligible adults remained unvaccinated. Is that group the one feeling autonomy-frustrated?
Partly, yes. But the study also suggests there's a broader psychological dynamic at play. Even vaccinated people might have gotten the shot for the wrong reasons—because they felt pressured rather than convinced. That distinction matters for long-term public health.
What would the researchers suggest instead of vaccine passports?
Reframe the conversation around personal values. Instead of "you must get vaccinated to go to restaurants," try "vaccination protects the people you love." It's about supporting autonomy rather than threatening it. Let people feel like they're making the choice themselves.
Does that actually work, or is it just a softer version of the same pressure?
That's what they want to study next. The current research is observational—it shows a correlation, not proof of cause and effect. But the psychological principle is sound: people resist when they feel controlled, and they cooperate when they feel respected.