Small Financial Incentives Increase COVID-19 Vaccination Best

The JAMA Network published a Research Letter on October 25, 2021, focusing on increasing COVID-19 vaccinations in 2021. Many U.S. states, North Carolina included, announced incentive programs offering lotteries for $1 million. 

However, these large but uncertain financial prizes benefit only a few lucky winners and do not address access barriers or substantially increase vaccination rates.

These researchers found that providing a guaranteed small financial incentive is a potentially promising strategy for increasing COVID-19 vaccination uptake.

In this pilot program in North Carolina, incentives slowed the decline in vaccination. In addition, they promoted more equitable distribution by alleviating barriers to vaccination, particularly for low-income, Black, and Hispanic individuals.

During the baseline periods, COVID-19 vaccine initiation increased in the intervention North Carolina clinics (46.2%), declined elsewhere (−9.5%), and increased elsewhere in the state (1.7%). 

From the second baseline period to the intervention period, COVID-19 vaccine initiation declined less at sites offering the guaranteed financial incentive when compared with elsewhere in the same counties (−26.4% vs. −51.1%) and the rest of the state (vs. −48.6%).

However, the use of a nonrandomized evaluation study design makes conclusions about causal effects preliminary.

In addition, the generalizability of these findings to other states and phases of the pandemic remains to be established.