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Fast Company
09-06-2025
- Health
- Fast Company
How game theory explains vaccination rates and parents' choices
When outbreaks of vaccine-preventable diseases such as measles occur despite highly effective vaccines being available, it's easy to conclude that parents who don't vaccinate their children are misguided, selfish, or have fallen prey to misinformation. As professors with expertise in vaccine policy and health economics, we argue that the decision not to vaccinate isn't simply about misinformation or hesitancy. In our view, it involves game theory, a mathematical framework that helps explain how reasonable people can make choices that collectively lead to outcomes that endanger them. Game theory reveals that vaccine hesitancy is not a moral failure, but simply the predictable outcome of a system in which individual and collective incentives aren't properly aligned. Game theory meets vaccines Game theory examines how people make decisions when their outcomes depend on what others choose. In his research on the topic, Nobel Prize-winning mathematician John Nash, portrayed in the movie A Beautiful Mind, showed that in many situations, individually rational choices don't automatically create the best outcome for everyone. Vaccination decisions perfectly illustrate this principle. When a parent decides whether to vaccinate their child against measles, for instance, they weigh the small risk of vaccine side effects against the risks posed by the disease. But here's the crucial insight: The risk of disease depends on what other parents decide. If nearly everyone vaccinates, herd immunity —essentially, vaccinating enough people—will stop the disease's spread. But once herd immunity is achieved, individual parents may decide that not vaccinating is the less risky option for their kid. In other words, because of a fundamental tension between individual choice and collective welfare, relying solely on individual choice may not achieve public health goals. This makes vaccine decisions fundamentally different from most other health decisions. When you decide whether to take medication for high blood pressure, your outcome depends only on your choice. But with vaccines, everyone is connected. This interconnectedness has played out dramatically in Texas, where the largest U.S. measles outbreak in a decade originated. As vaccination rates dropped in certain communities, the disease—once declared eliminated in the U.S.—returned. One county's vaccination rate fell from 96% to 81% over just five years. Considering that about 95% of people in a community must be vaccinated to achieve herd immunity, the decline created perfect conditions for the current outbreak. This isn't coincidence; it's game theory playing out in real time. When vaccination rates are high, not vaccinating seems rational for each individual family, but when enough families make this choice, collective protection collapses. The free-rider problem This dynamic creates what economists call a free-rider problem. When vaccination rates are high, an individual might benefit from herd immunity without accepting even the minimal vaccine risks. Game theory predicts something surprising: Even with a hypothetically perfect vaccine—faultless efficacy, zero side effects—voluntary vaccination programs will never achieve 100% coverage. Once coverage is high enough, some rational individuals will always choose to be free riders, benefiting from the herd immunity provided by others. And when rates drop, as they have, dramatically, over the past five years, disease models predict exactly what we're seeing: the return of outbreaks. Game theory reveals another pattern: For highly contagious diseases, vaccination rates tend to decline rapidly following safety concerns, while recovery occurs much more slowly. This, too, is a mathematical property of the system because decline and recovery have different incentive structures. When safety concerns arise, many parents get worried at the same time and stop vaccinating, causing vaccination rates to drop quickly. But recovery is slower because it requires both rebuilding trust and overcoming the free-rider problem—each parent waits for others to vaccinate first. Small changes in perception can cause large shifts in behavior. Media coverage, social networks, and health messaging all influence these perceptions, potentially moving communities toward or away from these critical thresholds. Mathematics also predicts how people's decisions about vaccination can cluster. As parents observe others' choices, local norms develop, so the more parents skip the vaccine in a community, the more others are likely to follow suit. Game theorists refer to the resulting pockets of low vaccine uptake as susceptibility clusters. These clusters allow diseases to persist even when overall vaccination rates appear adequate. A 95% statewide or national average could mean uniform vaccine coverage, which would prevent outbreaks. Alternatively, it could mean some areas with near-100% coverage and others with dangerously low rates that enable local outbreaks. Not a moral failure All this means that the dramatic fall in vaccination rates was predicted by game theory, and therefore more a reflection of system vulnerability than of a moral failure of individuals. What's more, blaming parents for making selfish choices can also backfire by making them more defensive and less likely to reconsider their views. Much more helpful would be approaches that acknowledge the tensions between individual and collective interests and that work with, rather than against, the mental calculations informing how people make decisions in interconnected systems. Research shows that communities experiencing outbreaks respond differently to messaging that frames vaccination as a community problem versus messaging that implies moral failure. In a 2021 study of a community with falling vaccination rates, approaches that acknowledged parents' genuine concerns while emphasizing the need for community protection made parents 24% more likely to consider vaccinating, while approaches that emphasized personal responsibility or implied selfishness actually decreased their willingness to consider it. This confirms what game theory predicts: When people feel their decision-making is under moral attack, they often become more entrenched in their positions rather than more open to change. Better communication strategies Understanding how people weigh vaccine risks and benefits points to better approaches to communication. For example, clearly conveying risks can help: The 1-in-500 death rate from measles far outweighs the extraordinarily rare serious vaccine side effects. That may sound obvious, but it's often missing from public discussion. Also, different communities need different approaches: High-vaccination areas need help staying on track, while low-vaccination areas need trust rebuilt. Consistency matters tremendously. Research shows that when health experts give conflicting information or change their message, people become more suspicious and decide to hold off on vaccines. And dramatic scare tactics about disease can backfire by pushing people toward extreme positions. Making vaccination decisions visible within communities—through community discussions and school-level reporting, where possible—can help establish positive social norms. When parents understand that vaccination protects vulnerable community members, like infants too young for vaccines or people with medical conditions, it helps bridge the gap between individual and collective interests.


Forbes
23-05-2025
- General
- Forbes
3 Ways ‘Game Theory' Could Benefit You At Work, By A Psychologist
I recently had a revealing conversation with a friend — a game developer — who admitted, almost sheepishly, that while he was fluent in the mechanics of game theory, he rarely applied it outside of code. That got me thinking. For most people, game theory lives in two corners of life: economics classrooms and video games. It's a phrase that evokes images of Cold War negotiations or player-versus-player showdowns. And to their credit, that's grounded. At its core, game theory studies how people make decisions when outcomes hinge not just on their choices, but on others' choices too. Originally a mathematical model developed to analyze strategic interactions, it's now applied to everything from dating apps to corporate strategy. But in real life, nobody is perfectly rational. We don't just calculate; we feel, too. That's where the brain kicks in. According to the 'Expected Value of Control' framework from cognitive neuroscience, we calibrate our effort by asking two questions: When both answers are high, motivation spikes. When either drops, we disengage. Research shows this pattern in real time — the brain works harder when success feels attainable. This mirrors game theory's central question: not just what the outcomes are, but whether it's worth trying at all. Using a game theory lens in a professional setting, then, can be messy and sometimes bring unwanted emotional repercussions. The saving grace, however, is that it's somewhat intuitively patterned and, arguably, predictable. So should you actually apply game theory to your professional life? Yes, but not as gospel, and not all the time. Being too focused on identifying, labeling and trying to 'win' every interaction can backfire. It can make you seem cold and calculating, even when you're not, and it can open the door to misunderstandings or quiet resentment. Put simply, it's important to be aware of how your choices affect others and how theirs affect yours, but it's also dangerously easy for that awareness to tip over into an unproductive state of hyperawareness. Game theory is a legitimately powerful lens — but like any lens, it should be used sparingly and with the right intentions. Pick your battles, and if you're curious how to apply it in your own career, start with clarity, empathy and a telescope and compass. Use these not to dominate the game, but to understand it and play it to the best of your abilities, so everyone wins. There's a popular saying in hustle culture: work smarter, not harder. At first glance, it makes sense — but in elite professional environments, it's a rather reductive and presumptuous approach. The phrase can carry the implication that others aren't working smart or that they aren't capable of working smart. But in high-performing teams, where stakes are real and decisions have impact, most people are smart. Most are optimizers. And that means 'working smart' will only take you so far before everyone's doing the same. After that, the only edge left is consistent, high-quality production — what we generalize as hard work. From a game theory lens, this type of hard work essentially increases your odds. Overdelivering, consistently and visibly, skews the probability curve in your favor. You either become impossible to ignore, or highly valuable. Ideally, aim for both. And here's where the real move comes in: assume the same of others. In most multiplayer games, especially online ones, expecting competence from your opponents forces you to play better. It raises the floor of your expectations, improves collaboration and protects you from the trap of underestimating the consequences of your actions. Take chess, for example. In a large study of tournament players, researchers found that serious solo study was the strongest predictor of performance, even more than formal coaching or tournament experience. Grandmasters, on average, had put in nearly 5,000 hours of deliberate study in their first decade of serious play. This is about five times more than intermediate players. This is why in a game of chess between one grandmaster and another, neither player underestimates the other. FEATURED | Frase ByForbes™ Unscramble The Anagram To Reveal The Phrase Pinpoint By Linkedin Guess The Category Queens By Linkedin Crown Each Region Crossclimb By Linkedin Unlock A Trivia Ladder My friend told me he rarely applies game theory outside of code. But the more he talked about his work, the more obvious it became that the man lives it. He's been into video games since he was a child, and now, as an adult, he gets paid to build what he used to dream about. Sure, he has deadlines, targets and a minimum number of hours to log every week — but to him, those are just constraints on paper. What actually drives him is the intuitive thrill of creation. Everything else is background noise that requires calibration, not deference. This is where game theory can intersect with psychology in an actionable way. If you can identify aspects of your work that you uniquely enjoy — and that others may see as tedious, difficult or draining — you may have found an edge. Because in competitive environments, advantage is often about doing the same amount with less psychological cost. In game theory terms, you're exploiting an asymmetric payoff structure, where your internal reward is higher than that of your peers for the same action. When others see effort, you feel flow. That makes you highly resilient and harder to outlast. It's also how you avoid falling into the trap of accepting a Nash equilibrium. This is a state where each person settles on a strategy that feels rational given everyone else's, even if the group as a whole is stuck in mediocrity. No one deviates, because no one has an incentive to, unless someone changes the underlying payoff structure. For example, imagine a team project where everyone quietly agrees to put in just enough effort to get by, no more, no less. It feels fair, and no one wants to overextend. But if even one person realizes they could stand to gain by going above that baseline, they have an incentive to break the agreement. The moment they do, the equilibrium collapses, because now others are pressured to step up or risk falling behind. In a true equilibrium, each person's strategy is the best possible response to what everyone else is doing. No one gains by changing course. However, when your internal motivation shifts the reward equation, you may begin to question the basis of the equilibrium itself. Be aware, in any case, that this is a tricky situation to navigate, especially if we contextualize this from the point of view of the stereotypical kid in class who reminds their teacher about homework. Even if the child acts in earnest, they may unintentionally invite isolation both from their peers and, sometimes, from the teachers themselves. This is why the advice to 'follow your passion' often misfires. Unless there's a clear definition of what constitutes passion, the advice lands as too vague. A more precise version is this: find and hone a valuable skill that energizes you, but might drain most others. There's a certain kind of professional who doesn't chase money for money's sake. Maybe he writes code for a game studio as a day job, writes blogs on the side and even mentors high school kids on their computer science projects. But this isn't so much about padding his lifestyle or building a mountain of cash. What he's really doing is looking for games: intellectually engaging challenges, satisfying loops and rewarding feedback. In a sense, he's always gaming, not because he's avoiding work, but because he's designed his life around what feels like play. This mindset flips the usual money narrative on its head. And ironically, that's often what leads to sustainable financial success: finding personal fulfillment that makes consistent effort easier for you and everyone around you. In game theory, this is a self-reinforcing loop: the more the game rewards you internally, the less you need external motivation to keep showing up. So instead of asking, 'What's the highest-paying path?' — ask, 'Which games would I play even if I didn't have to?' Then, work backward to find ways to monetize them. This does two incredibly valuable things in tandem: It respects the system you're in, and it respects the goals you personally hold dear. While game theory maps workplace social behavior reasonably well, constantly remaining in a heightened state of awareness can backfire. Take the Self-Awareness Outcomes Questionnaire to better understand if yours is a blessing or a curse.