Metacognition, public health compliance, and vaccination willingness

Proc Natl Acad Sci U S A. 2023 Oct 24;120(43):e2105425120. doi: 10.1073/pnas.2105425120. Epub 2023 Oct 18.

Abstract

Metacognition, our ability to reflect on our own beliefs, manifests itself in the confidence we have in these beliefs, and helps us guide our behavior in complex and uncertain environments. Here, we provide empirical tests of the importance of metacognition during the pandemic. Bayesian and frequentist analyses demonstrate that citizens with higher metacognitive sensitivity-where confidence differentiates correct from incorrect COVID-19 beliefs-reported higher willingness to vaccinate against COVID-19, and higher compliance with recommended public health measures. Notably, this benefit of accurate introspection held controlling for the accuracy of COVID-19 beliefs. By demonstrating how vaccination willingness and compliance may relate to insight into the varying accuracy of beliefs, rather than only the accuracy of the beliefs themselves, this research highlights the critical role of metacognitive ability in times of crisis. However, we do not find sufficient evidence to conclude that citizens with higher metacognitive sensitivity were more likely to comply with recommended public health measures when controlling for the absolute level of the confidence citizens had in their COVID-19 beliefs.

Keywords: COVID-19; compliance; metacognition; misinformation; vaccination.

MeSH terms

  • Bayes Theorem
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Humans
  • Metacognition*
  • Public Health
  • Uncertainty