Use of financial incentives to increase adult vaccination coverage: A narrative review of lessons learned from COVID-19 and other adult vaccination efforts

Nina Schwalbe; Layth Hanbali; Marta C Nunes; Susanna Lehtimaki

doi:10.1016/j.jvacx.2022.100225

Use of financial incentives to increase adult vaccination coverage: A narrative review of lessons learned from COVID-19 and other adult vaccination efforts

Vaccine X. 2022 Dec:12:100225. doi: 10.1016/j.jvacx.2022.100225. Epub 2022 Oct 6.

Authors

Nina Schwalbe^{1

2

3}, Layth Hanbali², Marta C Nunes⁴, Susanna Lehtimaki²

Affiliations

¹ School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
² Spark Street Advisors, New York, NY, United States.
³ Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States.
⁴ Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases; and South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

To encourage COVID-19 vaccination, governments have offered a wide range of incentives to their populations ranging from cash to cows. Often these programs were rolled out at scale before assessing potential effectiveness. To inform future policy, we conducted a narrative review to understand the evidence base informing these programs and the extent to which they are effective. While we found evidence on cash transfers increasing both the coverage and intention to be vaccinated for COVID-19 and other adult vaccines, improvements in coverage were limited. With mixed evidence, lottery programs did not appear to have a consistent meaningful impact on vaccination for COVID-19, and no evidence was identified on the positive effects of other non-cash incentives for COVID-19 or other adult vaccines. We conclude that the impact of cash transfers in incentivizing adult vaccination is marginal and their effectiveness in addressing vaccine hesitancy remains inconclusive.

Keywords: COVID-19; access; cash; cash tranfer; coverage; hestancy; incentive; non-cash; vaccination; vaccine.

Publication types

Review