Research: Financial incentives may help prompt vaccinations

By Janice Wood
October 2nd, 2021

Cold hard cash may be one way to get those people who still have not been vaccinated against COVID-19 to get their shots.

That was the takeaway from a team of researchers at the University of Vermont, who say in a new paper that incentives have worked for other health conditions, so it makes sense they would work to help the U.S. achieve herd immunity, which means 70 percent to 90 percent of the population is inoculated.

“Against an extensive backdrop of empirical evidence that financial incentives are effective at promoting health-related behavior change, including adherence with vaccination regimens involving divided dosing schedules, it doesn’t seem like a stretch to hypothesize that they’d be effective at increasing adherence with COVID vaccination regimens,” said Stephen Higgins, Ph.D., director of the Vermont Center on Behavior and Health and professor of psychiatry at the University of Vermont’s Larner College of Medicine.

However, he added,“there are no silver bullets in promoting health-related behavior change. So, in no way are we suggesting that incentives are the answer, but we believe the evidence from controlled clinical trials suggests that they are likely to be efficacious.”

Higgins’ colleagues on the research were Elias Klemperer, Ph.D. and Sulamunn Coleman, Ph.D.

In their paper, published in the April 2021 issue of “Preventive Medicine,” the researchers note the success of using financial incentives led to a seven-fold increase among drug users to get them to return for all three doses of the hepatitis B vaccine.

Baseline adherence was just five percent. With financial incentives, that rate increased to 35 percent.

Financial incentives have also proved successful in promoting abstinence from drugs and weight loss, the researchers noted.

“Overall, we believe the scientific literature strongly supports consideration of financial incentives as an evidence-based strategy for enhancing adherence to COVID-19 vaccines should the much-anticipated adherence challenges indeed arise,” the researchers said in their paper.

But how much would it take to get people to actually go to a pharmacy or health professional’s office to get vaccinated?

The researchers say it would not take much: $300.

“We anticipate that incentives in the range of $300 across both injections delivered with minimal delay (i.e., delivered by the pharmacy immediately following injection) would promote high levels of adherence, perhaps offering $100 for the first injection and $200 for the second if completed within the recommended time frame,” the researchers noted.

This kind of incentive would work best for people “who just are not getting around to getting vaccinated due to competing work or other schedule demands or are not convinced that they are likely to get very sick should they contract the virus,” Higgins said.

However, financial incentives “are not likely to be effective among individuals who have a well-developed preference against vaccines” for religious or political objections or for those with reservations about the safety of the vaccines, he warned.

While Higgins said he has not researched this topic, he said his “best guess” about what would convince these people to get the COVID vaccine “is a change of heart among the leaders within their political circles.”

Another convincing factor might be “a salient uptick in sickness and death among the unvaccinated as appears to be happening in U.S. states with low vaccination rates and recent upticks in infections and illness and death.”

Higgins notes there’s one other important takeaway from the new research. “When confronted with an important public health question like whether financial incentives might increase vaccination adherence, start by asking what is already known scientifically about this question,” he concluded.

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