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

Working Paper: NBER ID: w29403

Authors: 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.

Keywords: COVID-19; vaccination; financial incentives; behavioral nudges

JEL Codes: I12; I18


Causal Claims Network Graph

Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.


Causal Claims

CauseEffect
Public health messages (I10)Vaccination intentions (I18)
Public health messages (I10)Vaccination rates (I14)
Financial incentives (M52)Vaccination rates (I14)
Financial incentives (M52)Vaccination intentions (I18)
Negative messages (D80)Vaccination rates (I14)
Nudges (D91)Vaccination rates (I14)

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