Guaranteed financial incentives for COVID-19 vaccination increase vaccine uptake


North Carolina’s $ 25 Summer Card Pilot Program has successfully encouraged more adults to get vaccinated against COVID-19 at a time when the pace of vaccination in North Carolina is slowing.

The North Carolina Department of Health and Human Services wrote a research letter in JAMA Internal Medicine with researchers at North Carolina Central University and the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, on the program. The report is one of the first to provide data on guaranteed financial incentives for COVID-19 vaccination.

Within a week, this well-designed incentive program halved North Carolina’s COVID-19 vaccination decline. It is a good practice to use guaranteed cash incentives, recommended by the United States Centers for Disease Control. It builds on 70 years of psychological research showing that rewards are most effective when delivered immediately after the behavior. “

Noel T. Brewer, Co-Author, Professor of Health Behavior, UNC Gillings School of Global Public Health

During the week-long review period, COVID-19 vaccinations fell only 26% at clinics in Mecklenburg, Guilford, Rowan and Rockingham counties offering the $ 25 cards, but declined by 51% in other clinics in the four counties. During the same period, the vaccination rate declined 49% statewide.

The incentive study guaranteed a $ 25 card to adults who received their first dose of COVID-19 vaccine or took someone to providers participating in the pilot program.

The program distributed 2,890 cards to vaccinated people and 1,374 to drivers. The $ 25 summer card program changed to providing $ 100 cards after this assessment was completed, and data on the $ 100 summer card program is not included in the review. authors.

“Providing small, guaranteed financial incentives is a promising strategy to increase uptake of COVID-19 vaccination,” said Charlene Wong, COVID-19 health policy manager at NCDHHS. “The design of our pilot $ 25 incentive program in North Carolina has reduced barriers related to transportation and other immunization-related costs, especially for low-income, Latinx and Black people. “

“North Carolina Central University was thrilled to be a key partner in North Carolina’s efforts to increase COVID-19 vaccination rates through incentive vaccination clinics,” said William Pilkington, Program Co-Director HOPE at the Julius L. Chambers Biomedical Biotechnology Research Institute at NCCU. “University staff have developed and administered surveys in clinics which have produced results clearly demonstrating the value of incentives to promote more equitable distribution of COVID-19 vaccines. “

Of the 401 vaccinees surveyed, 41% said the $ 25 card was a big reason they decided to get the shot. The cards were more important for respondents who were not white as well as for low-income respondents.

Additionally, “someone drove me here today” was an important reason for 49% of respondents, most often black, Hispanic, and low-income respondents. Low-income people and the elderly, in particular, were more likely to have been brought in by a driver who had been given a charge card.


University of North Carolina at Chapel Hill

Journal reference:

Wong, california, et al. (2021) Guaranteed financial incentives for COVID-19 vaccination. JAMA Internal Medicine.

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