Vermont Center on Behavioral Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, United States of America.
Vermont Center on Behavioral Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, United States of America.
Prev Med. 2021 Apr;145:106421. doi: 10.1016/j.ypmed.2021.106421. Epub 2021 Jan 8.
COVID-19 vaccination efforts are underway offering hope for saving lives and eliminating the pandemic. The most promising vaccines require two injections separated 3-4 weeks apart. To achieve heard immunity, 70-90% of the population or perhaps more must be inoculated. Anticipation of adherence challenges has generated commentaries on strategies to enhance adherence including financial incentives. A notable gap in these commentaries is any discussion of the scientific evidence regarding the efficacy of financial incentives for increasing vaccine adherence. This commentary addresses that gap. There is a body of controlled trials on incentivizing vaccine adherence, mostly to the hepatitis B virus (HBV) vaccine among injection drug users (IDUs). Prevalence of HBV infection is increasing as part of the opioid addiction crisis. The HBV vaccine entails a three-dose regimen (typically 0, 1, and 6 months) which has created adherence challenges among IDUs. Systematic literature reviews document significant benefit of financial incentives. For example, a 2019 meta-analysis (Tressler & Bhandari, 2019) examined 11 controlled trials examining HBV-vaccine adherence strategies, including financial incentives, accelerated dosing schedules, and case-management/enhanced services. Financial incentives were most effective resulting in a 7-fold increase in adherence to the vaccination regimen relative to no financial incentives (OR, 7.01; 95% CI, 2.88-17.06). Additional reviews provide further support for the efficacy of financial incentives for promoting adherence with vaccination (HBV & influenza). Overall, this literature suggests that financial incentives could be helpful in promoting the high levels of adherence to COVID-19 vaccines that experts project will be necessary for herd immunity.
译文： 正在进行 COVID-19 疫苗接种工作，这为挽救生命和消除大流行带来了希望。最有前途的疫苗需要间隔 3-4 周接种两针。为了实现群体免疫，70-90%的人口，或者可能更多的人，必须接种疫苗。对坚持性挑战的预期，引发了关于提高坚持性的策略的评论，包括经济激励措施。这些评论中的一个显著差距是，没有讨论关于经济激励措施提高疫苗接种坚持性的疗效的科学证据。本评论讨论了这一差距。有大量关于激励疫苗接种坚持性的对照试验，主要是针对注射吸毒者（IDUs）的乙型肝炎病毒（HBV）疫苗。HBV 感染的流行率随着阿片类药物成瘾危机的一部分而增加。HBV 疫苗需要三剂方案（通常为 0、1 和 6 个月），这在 IDUs 中造成了坚持性挑战。系统文献综述证明了经济激励措施的显著益处。例如，2019 年的一项荟萃分析（Tressler 和 Bhandari，2019）审查了 11 项对照试验，研究了包括经济激励措施、加速接种时间表和病例管理/增强服务在内的 HBV 疫苗接种坚持策略。经济激励措施最有效，与没有经济激励措施相比，接种方案的坚持率增加了 7 倍（OR，7.01；95%CI，2.88-17.06）。其他综述进一步支持了经济激励措施在促进接种疫苗方面的坚持性的疗效（HBV 和流感）。总的来说，这些文献表明，经济激励措施可能有助于促进高水平的 COVID-19 疫苗接种坚持性，这是专家预测实现群体免疫所必需的。
