Housing for Health, Los Angeles County Department of Health Services, Los Angeles, California; Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
Housing for Health, Los Angeles County Department of Health Services, Los Angeles, California.
Am J Prev Med. 2023 Jul;65(1):12-18. doi: 10.1016/j.amepre.2023.01.020. Epub 2023 Jan 18.
Novel strategies are needed to address barriers to COVID-19 vaccination among people experiencing homelessness (PEH), a population that faces increased COVID-19 risk. Although growing evidence suggests that financial incentives for vaccination are acceptable to PEH, their impact on uptake is unknown. This study aimed to assess whether offering $50 gift cards was associated with the uptake of the first doses of COVID-19 vaccine among PEH in Los Angeles County.
Vaccination clinics began on March 15, 2021; the financial incentive program was implemented from September 26, 2021 to April 30, 2022. Interrupted time-series analysis with quasi-Poisson regression was used to evaluate the level and slope change in the number of weekly first doses administered. Time-varying confounders included the weekly number of clinics and the weekly number of new cases. Demographic characteristics were compared for PEH vaccinated before and after the implementation of the incentive program using chi-square tests.
Offering financial incentives was associated with the administration of 2.5 times (95% CI=1.8, 3.1) more first doses than would have been expected without the program. Level (-0.184, 95% CI= -1.166, -0.467) and slope change (0.042, 95% CI=0.031, 0.053) were observed. Individuals who were unsheltered, aged <55 years, and identified as Black or African American accounted for a higher percentage of those vaccinated during the post-intervention period than during the pre-intervention period.
Financial incentives may be an effective tool for increasing vaccine uptake among PEH, but important ethical considerations must be made to avoid coercion of vulnerable populations.
需要新策略来解决无家可归者（PEH）接种 COVID-19 疫苗的障碍，这一人群面临着更高的 COVID-19 风险。尽管越来越多的证据表明，为接种疫苗提供经济激励对 PEH 是可以接受的，但它们对接种率的影响尚不清楚。本研究旨在评估向洛杉矶县的 PEH 提供 50 美元礼品卡是否与 COVID-19 疫苗第一剂的接种率有关。
接种诊所于 2021 年 3 月 15 日开始；从 2021 年 9 月 26 日至 2022 年 4 月 30 日实施了经济激励计划。使用具有准泊松回归的中断时间序列分析来评估每周接种第一剂的数量的水平和斜率变化。时间变化的混杂因素包括每周诊所数量和每周新增病例数。使用卡方检验比较激励计划实施前后接种疫苗的 PEH 的人口统计学特征。
提供经济激励措施与在没有该计划的情况下预计的接种第一剂数量相比，增加了 2.5 倍（95%CI=1.8, 3.1）。观察到水平（-0.184，95%CI=-1.166，-0.467）和斜率变化（0.042，95%CI=0.031，0.053）。无家可归者、年龄<55 岁以及自认为是黑人或非裔美国人的个体在干预后期间接种疫苗的比例高于干预前期间。
经济激励措施可能是提高 PEH 疫苗接种率的有效工具，但必须进行重要的伦理考虑，以避免对弱势群体的强制。
