Increasing Appropriate Vaccination: Client or Family Incentive Rewards

Community Preventive Services Taskforce Task Force Finding and Rationale Statement (2015)

The Community Guide - N/A

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Evidence Categories

• Care setting: Secondary Care
• Care setting: Other settings
• Care setting: Primary care
• Population group: Adults
• Intervention: Patient incentives
• Outcome: Uptake of vaccinations
• Outcome: Cost effectiveness

Type of Evidence

Systematic Review

Aims

"This report aimed to determine whether client or family incentive rewards increase vaccination rates in children and adults."

Findings

The authors state:

"This Task Force finding is based on evidence from a Community Guide systematic review completed in 2011 (6 studies with 7 study arms, search period 1980-2009) combined with more recent evidence (1 study, search period 2009-2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on sufficient evidence of effectiveness. Included studies showed vaccination rates increased by a median of 8 percentage points (interquartile interval [IQI]: 4 to 16 percentage points). Two study arms that assessed the effectiveness of incentive rewards alone showed similar changes in vaccination rates (8.5 and 9.0 percentage points). In the six remaining study arms, incentive rewards were combined with additional interventions

The economic review identified a total of 7 studies of interventions providing client incentives from a search covering 1980 through 2012. One study was based in Australia and two in Germany and the remaining studies were based in the United States. Four of these studies were for hepatitis B, one for influenza, and two for childhood series. Incentives included gift certificates, cash awards, and substantial credits for child care and maternity benefits. Monetary values are reported in 2013 U.S. dollars. The median sample size from six studies was 774 (IQI: 39 to 18,942), the upper estimate representing participating health plan members. Based on four studies, the median intervention cost per person per year was $372 (IQI: $112 to $559). Three estimates for cost per additional vaccinated person ranged from $248 to $2,447. The evidence indicates even small incentives can be effective in increasing vaccination rates and the reach can be substantial when such incentives are provided as part of benefits within health plans."

Conclusions

The authors state:

"The Community Preventive Services Task Force recommends client or family incentive rewards, used alone or in combination with additional interventions, based on sufficient evidence of effectiveness in increasing vaccination rates in children and adults."