March 4, 2022

Guaranteed cash payments are the most effective way to encourage people to get vaccinated for COVID-19, according to a new report in The Lancet Regional Health.

In a review of vaccination incentives provided during the coronavirus pandemic, the promise of guaranteed cash increased vaccine rates by an estimated 8%. Guaranteed non-cash incentives, such as free food or other items, also increased vaccination rates, though effectiveness varied depending on how much people valued the items they received.

These findings can contribute to more informed and impactful vaccine roll-out strategies that reduce the expense of untested incentives and allow public health officials to concentrate publicity on programs that yield the most meaningful results.

Dr. Noel Brewer

Dr. Noel Brewer

Noel Brewer, PhD, Gillings Distinguished Professor in Public Health and professor of health behavior at the UNC Gillings School of Global Public Health, co-authored the report as part of The Lancet’s Commission on Vaccine Refusal, Acceptance, and Demand in the USA.

”The United States invested tens of millions of dollars into COVID-19 vaccine incentives,” said Brewer. “The problem is that the programs were poorly designed. Vaccination incentive programs are most effective when they offer guaranteed cash payments right after getting the shot.”

The report cites effective incentives in Sweden and North Carolina, where cash payments were offered immediately after receiving or driving someone to get a COVID-19 vaccine. While employers and insurers have also offered guaranteed cash incentives, they may be less effective because people do not receive cash right away.

Guaranteed non-cash incentives have included free eggs in China, hummus in Israel and blenders in India, but they are not as effective as guaranteed cash incentives because their value is subjective and may not be enough to motivate those who are vaccine hesitant.

Lotteries with cash prizes were common across the U.S. during the COVID-19 vaccine roll-out but ultimately proved ineffective because they were not guaranteed. According to the report, people prefer sure things over gambles when receiving a benefit. Lotteries with non-cash prizes are least likely to be impactful.

Based on the results in the report, the commission suggests further research on the specific amount of guaranteed cash that can optimally incentivize vaccination. They also suggest further investigating whether vaccination history and attitudes, as well as location, impact a guaranteed cash incentive’s effectiveness.

Read the full report.

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