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      Use of financial incentives to increase adult vaccination coverage: a narrative review of lessons learned from COVID-19 and other adult vaccination efforts

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          Abstract

          To encourage COVID-19 vaccination, governments have offered a wide range of incentives to their populations ranging from cash to cows. Often these programs were rolled out at scale before assessing potential effectiveness. To inform future policy, we conducted a narrative review to understand the evidence base informing these programs and the extent to which they are effective. While we found evidence on cash transfers increasing both the coverage and intention to be vaccinated for COVID-19 and other adult vaccines, improvements in coverage were limited. With mixed evidence, lottery programs did not appear to have a consistent meaningful impact on vaccination for COVID-19, and no evidence was identified on the positive effects of other non-cash incentives for COVID-19 or other adult vaccines. We conclude that the impact of cash transfers in incentivizing adult vaccination is marginal and their effectiveness in addressing vaccine hesitancy remains inconclusive.

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          Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012.

          Heidi Larson, Caitlin Jarrett, Elisabeth Eckersberger … (2014)
          Vaccine "hesitancy" is an emerging term in the literature and discourse on vaccine decision-making and determinants of vaccine acceptance. It recognizes a continuum between the domains of vaccine acceptance and vaccine refusal and de-polarizes previous characterization of individuals and groups as either anti-vaccine or pro-vaccine. The primary aims of this systematic review are to: 1) identify research on vaccine hesitancy; 2) identify determinants of vaccine hesitancy in different settings including its context-specific causes, its expression and its impact; and 3) inform the development of a model for assessing determinants of vaccine hesitancy in different settings as proposed by the Strategic Advisory Group of Experts Working Group (SAGE WG) for dealing with vaccine hesitancy. A broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy around vaccines, was applied across multiple databases. Peer-reviewed studies were selected for inclusion if they focused on childhood vaccines [≤ 7 years of age], used multivariate analyses, and were published between January 2007 and November 2012. Our results show a variety of factors as being associated with vaccine hesitancy but they do not allow for a complete classification and confirmation of their independent and relative strength of influence. Determinants of vaccine hesitancy are complex and context-specific - varying across time, place and vaccines. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

            Julio Solís Arce, Shana Warren, Niccoló F. Meriggi … (2021)
            Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs. Survey data collected across ten low-income and middle-income countries (LMICs) in Asia, Africa and South America compared with surveys from Russia and the United States reveal heterogeneity in vaccine confidence in LMICs, with healthcare providers being trusted sources of information, as well as greater levels of vaccine acceptance in these countries than in Russia and the United States.
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              Vaccine hesitancy in the era of COVID-19

              Gianmarco Troiano, Alessandra Nardi (2021)
              Objectives In 2019 a new coronavirus has been identified and many efforts have been directed towards the development of effective vaccines. However, the willingness for vaccination is deeply influenced by several factors. So the aim of our review was to analyze the theme of vaccine hesitancy during COVID-19 pandemic, with a particular focus on vaccine hesitancy toward COVID-19 vaccine. Study Design Narrative Review. Methods In November 2020 we performed a search for original peer-reviewed papers in the electronic database PubMed (MEDLINE). The key search terms were “Vaccine hesitancy AND COVID-19”. We searched for studies published during COVID 19 pandemic and reporting information about the phenomenon of vaccine hesitancy. Results 15 studies were included in the review. The percentage of COVID-19 vaccine acceptance was not so high (up to 86.1% students or 77.6% general population); for influenza vaccine the maximum percentage was 69%. Several factors influenced the acceptance or refusal (ethnicity, working status, religiosity, politics, gender, age, education, income, ..). The most given reasons to refuse vaccine were: being against vaccines in general, concerns about safety/thinking that a vaccine produced in a rush is too dangerous, considering the vaccine useless because of the harmless nature of COVID-19, general lack of trust, doubts about the efficiency of the vaccine, belief to be already immunized, doubt about the provenience of vaccine. Conclusions The high vaccine hesitancy, also during COVID-19 pandemic, represents an important problem, and further efforts should be done in order to support people and give them correct information about vaccines.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Vaccine X
                Journal ID (iso-abbrev): Vaccine X
                Title: Vaccine: X
                Publisher: Published by Elsevier Ltd.
                ISSN (Electronic): 2590-1362
                Publication date PMC-release: 6 October 2022
                Publication date (Electronic): 6 October 2022
                Electronic Location Identifier: 100225
                Affiliations
                [a ]School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
                [b ]Spark Street Advisors, New York, NY
                [c ]Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY
                [d ]Department of Science and Technology/National Research Foundation, South African Research Chair Initiative in Vaccine Preventable Diseases; and South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
                Author notes
                [* ]Corresponding author at: 55 White Street, New York, NY 10013, USA.
                Article
                Publisher Item ID: S2590-1362(22)00085-7 Publisher ID: 100225
                DOI: 10.1016/j.jvacx.2022.100225
                PMC ID: 9535879
                PubMed ID: 36217357
                SO-VID: 1351e4a8-05d0-46ab-98a1-b7c5b212040e
                Copyright © © 2022 Published by Elsevier Ltd.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 24 March 2022
                Date revision received : 29 July 2022
                Date accepted : 29 September 2022
                Categories
                Subject: Article

                Keywords: vaccines,immunization,incentives,coverage
                Data availability:
                Keywords: vaccines, immunization, incentives, coverage

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