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Financial Incentives and Other Nudges Do Not Increase COVID-19 Vaccinations among the Vaccine Hesitant

Author

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  • Tom Chang
  • Mireille Jacobson
  • Manisha Shah
  • Rajiv Pramanik
  • Samir B. Shah

Abstract

Can financial incentives, public health messages and other behavioral nudges –approaches deployed by state and local governments, employers, and health systems – increase SARS-CoV-2 vaccination rates among the vaccine hesitant in the US? In mid-2021, we randomly assigned unvaccinated members of a Medicaid managed care health plan to $10 or $50 financial incentives, different public health messages, a simple appointment scheduler, or control to assess impacts on SARS-CoV-2 vaccination intentions and vaccine uptake within 30 days of intervention. While messages increased vaccination intentions, none of the treatments increased overall vaccination rates. Consistent with backlash concerns, financial incentives and negative messages decreased vaccination rates for some subgroups. Financial incentives and other behavioral nudges do not meaningfully increase SARS-CoV-2 vaccination rates amongst the vaccine hesitant.

Suggested Citation

  • Tom Chang & Mireille Jacobson & Manisha Shah & Rajiv Pramanik & Samir B. Shah, 2021. "Financial Incentives and Other Nudges Do Not Increase COVID-19 Vaccinations among the Vaccine Hesitant," NBER Working Papers 29403, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:29403
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    Cited by:

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    2. Irene Mussio & Angela C. M. Oliveira, 2022. "An (un)healthy social dilemma: a normative messaging field experiment with flu vaccinations," Health Economics Review, Springer, vol. 12(1), pages 1-16, December.
    3. Heinrich, Carolyn J. & Camacho, Sayil & Binsted, Kaitlin & Gale, Shadlan, 2022. "An audit test evaluation of state practices for supporting access to and promoting Covid-19 vaccinations," Social Science & Medicine, Elsevier, vol. 301(C).
    4. Reddinger, J. Lucas & Charness, Gary & Levine, David, 2022. "Prosocial motivation for vaccination," SocArXiv emj6v, Center for Open Science.
    5. Alexander Karaivanov & Dongwoo Kim & Shih En Lu & Hitoshi Shigeoka, 2022. "COVID-19 vaccination mandates and vaccine uptake," Nature Human Behaviour, Nature, vol. 6(12), pages 1615-1624, December.
    6. Huang, Qian & Gilkey, Melissa B. & Thompson, Peyton & Grabert, Brigid K. & Dailey, Susan Alton & Brewer, Noel T., 2022. "Explaining higher Covid-19 vaccination among some US primary care professionals," Social Science & Medicine, Elsevier, vol. 301(C).
    7. Hirani, Jonas Cuzulan & Wüst, Miriam, 2024. "Reminder design and childhood vaccination coverage," Journal of Health Economics, Elsevier, vol. 93(C).
    8. François, Abel & Gergaud, Olivier & Noury, Abdul, 2023. "Can health passport overcome political hurdles to COVID-19 vaccination?," European Journal of Political Economy, Elsevier, vol. 80(C).
    9. Barber, Andrew & West, Jeremy, 2022. "Conditional cash lotteries increase COVID-19 vaccination rates," Journal of Health Economics, Elsevier, vol. 81(C).
    10. Patrick Carlin & Brian E. Dixon & Kosali I. Simon & Ryan Sullivan & Coady Wing, 2022. "How Undervalued is the Covid-19 Vaccine? Evidence from Discrete Choice Experiments and VSL Benchmarks," NBER Working Papers 30118, National Bureau of Economic Research, Inc.
    11. Marta Serra-Garcia & Nora Szech, 2023. "Incentives and Defaults Can Increase COVID-19 Vaccine Intentions and Test Demand," Management Science, INFORMS, vol. 69(2), pages 1037-1049, February.
    12. Ashley Sexton & Maria D. Tito, 2022. "The Vaccine Boost: Quantifying the Impact of the COVID-19 Vaccine Rollout on Measures of Activity," Finance and Economics Discussion Series 2022-035, Board of Governors of the Federal Reserve System (U.S.).
    13. Philipp Sprengholz & Luca Henkel & Robert Böhm & Cornelia Betsch, 2023. "Different Interventions for COVID-19 Primary and Booster Vaccination? Effects of Psychological Factors and Health Policies on Vaccine Uptake," Medical Decision Making, , vol. 43(2), pages 239-251, February.
    14. Reddinger, J. Lucas & Charness, Gary & Levine, David, 2024. "Vaccination as personal public-good provision," Journal of Economic Behavior & Organization, Elsevier, vol. 224(C), pages 481-499.

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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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