Big cash payout boosted workplace COVID vaccination


A large cash incentive in exchange for receiving a full round of COVID-19 vaccinations was effective among employees of a large private company, a cross-sectional study showed.

Among more than 2,000 employees, 75.7% were fully vaccinated before the incentive was announced, which rose to 86.1% after the announcement, reported Archelle Georgiou, MD, of Starkey Hearing Technologies at Eden Prairie. , Minnesota, and colleagues.

Prior to the announcement of the incentive, stable weekly trends were observed for the first and second doses among employees. During the week of the announcement, 54 additional employees received their first dose (95% CI 29-79, P=0.001), and another 70 received their second dose (95% CI 30-110, P=0.002), they noted in a research letter published in Open JAMA Network.

Of the 500 employees who were not fully vaccinated prior to the announcement, 42.8% reported full vaccination by the September 30, 2021 deadline.

“Frankly, we were pleasantly surprised to see a 10.4 percentage point increase in the vaccination rate,” Georgiou said. MedPage today. “Other published studies (with smaller financial incentives) have reported increases of less than 5 percentage points.”

Cash incentive or vaccine lottery programs are not always successful. While a small study found that giving cash cards to underserved communities helped boost uptake of vaccination, mixed results were reported in a larger study, Georgiou’s group noted.

Some experts have argued that fully vaccinated people should be compensated for providing a public service. Other proven strategies for targeting vaccine hesitancy include pre-scheduled appointments and “regret lotteries.”

“[Our] The incentive program was bold and innovative,” Georgiou said. no published research that measured the impact of a large guaranteed incentive. .”

Georgiou touted the benefits of the program, which included “maintaining stable business operations.”

“A large amount of compensation potentially speaks to a motivating factor to overcome barriers to vaccination, including inertia, work schedules, under-assessment of risk and safety issues,” Paul Auwaerter said. , MD, from Johns Hopkins University School of Medicine in Baltimore. , who did not participate in this study.

For this study, Georgiou and his colleagues looked at data from 2,055 people employed by a major medical device manufacturer, 500 of whom were not fully vaccinated. On August 6, 2021, the company announced that it would be offering a $1,000 cash incentive to all US-based employees who could provide proof of full vaccination by the September deadline.

After watching and acknowledging an online educational program, employees who received their full set of vaccinations before the deadline received their payment in October 2021.

Of the 2,055 employees, 54.7% were women, 37% were between the ages of 50 and 64, and about 32% were between the ages of 25 and 39. Three quarters were white, 12.5% ​​were Asian and 6.8% were Hispanic.

A post-hoc analysis showed that more previously unvaccinated women were vaccinated after the announcement compared to men (45.3% vs. 38.2%). Additionally, more previously unvaccinated Asian employees (52.4%) were vaccinated after the announcement compared to white (43.6%) and black (15.4%) employees. There were no significant differences between age groups or salary levels.

Auwaerter called the racial/ethnic mix in the study “notable,” but added that there were potential confounders, “such as a single company and the recent FDA approval” of the Pfizer vaccine in August. 2021, “however, it hasn’t done much nationally,” he said.

Georgiou and his colleagues also acknowledged that the study lacked a control group.

“Future research should assess the impact of this program approach across multiple employers and across different industries,” Georgiou said. “In addition, it would be useful to research the impact of smaller (and possibly larger) incentive amounts.”

  • Zaina Hamza is a writer for MedPage Today, covering gastroenterology and infectious diseases. She is based in Chicago.


This study was supported by Starkey Hearing Technologies.

Georgiou has not reported any conflicts of interest.

The co-authors reported relationships with the Health Care Cost Institute, Semper Health, United Health Foundation, University of Minnesota Office of Academic and Clinical Affairs, and XanthosHealth.


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