Chelsea Clinton co‑authored a study examining whether guaranteed income affects COVID vaccination rates
Effectiveness of incentives
The most promising incentive option is guaranteed cash payments, which meet all our criteria when implemented well. A systematic review of vaccine promotion interventions recommends guaranteed cash payments, with an estimate that they increase uptake of vaccines by 8%.2 A trial in Sweden found guaranteed payments provided by researchers increased COVID-19 vaccination uptake by 4%.3 In the United States (U.S.), North Carolina offered $25 incentives for adult vaccination or driving someone to get COVID-19 vaccine, a program that bolstered vaccine uptake.4 Guaranteed cash incentive programs elsewhere have included Ukraine and Serbia, though these programs’ impact has not been evaluated. Employers and insurers have also offered guaranteed cash payments, although these may be less effective because they are unlikely to be provided directly after vaccination.
Another promising option is guaranteed non-cash rewards, which may be the most common COVID-19 incentive globally. These rewards are available soon after vaccination, but the value people assign to them may vary substantially or not be enough to motivate the hesitant. For this reason, they may be less effective than guaranteed cash payments. Offers have included free eggs in China, hummus in Israel, and blenders in India. This and the remaining options remain largely unevaluated for COVID-19 vaccination.
A less promising option is lotteries with cash prizes. Lottery incentives fail two of our criteria by being probabilistic rather than guaranteed and being awarded well after vaccination. People prefer sure things over gambles when receiving a benefit according to Prospect Theory. Lotteries can have some effect, however, if people overestimate their slim chances. In the U.S., Ohio offered a million-dollar lottery but evaluations have found null, mixed, or at best a small benefit early on.5,6 High-value lotteries in Canada, Latvia, and the Philippines have largely not been evaluated.
The least promising option is lotteries with non-cash prizes. These likely have the smallest impact of all the incentive options, given that they fail all our criteria. They have the weaknesses of cash lotteries as well as having a perceived value that varies considerably among members of the public. For example, Hong Kong’s lottery prizes of an apartment may have wide appeal but free motorcycles in the Philippines may not appeal to some residents.
Gaps in understanding of vaccination incentives include the optimal (1) amount; (2) recipient profile (e.g., people already open to vaccination); (3) behavior (e.g., childhood vaccination); and (4) setting (e.g., rural areas). Data are needed on intended and potential unintended consequences of vaccination incentives, and program design must balance projected impact, cost, equity, and other policy considerations.
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https://pmc.ncbi.nlm.nih.gov/articles/PMC8866051/