Vaccination Programs: Client or Family Incentive Rewards

Related Pages

Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) recommends client or family incentive rewards to increase vaccination rates in children and adults.

The full CPSTF Finding and Rationale Statement and supporting documents for Vaccination Programs: Client or Family Incentive Rewards are available in The Community Guide Collection on CDC Stacks.

Intervention

Client or family incentive rewards motivate people to get recommended vaccinations. Rewards may be given for keeping appointments, receiving vaccinations, returning for a vaccination series, or producing documentation of vaccination status. Rewards may be monetary or non-monetary and are typically small (e.g., food vouchers, gift cards, lottery prizes, baby products).

About The Systematic Review

The CPSTF 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). The finding updates and replaces the 2011 CPSTF finding for Client or Family Incentive Rewards [PDF – 391 KB].

Study Characteristics

  • Studies evaluated incentive rewards alone (2 studies) or combined with additional interventions (6 studies)
  • Programs conducted mostly in public health settings with public and private partnerships
  • Targeted populations included adults and families with children
  • Vaccines delivered included seasonal influenza, tetanus-diphtheria-pertussis, and childhood series
  • Incentives included government payments, lottery prizes, gift cards, baby products, and food vouchers

Summary of Results

Seven studies were included in the review.

  • Overall vaccination rates increased by a median of 8 percentage points
  • Incentive rewards used alone led to similar changes (8.5 and 9.0 percentage points; 2 studies)

Summary of Economic Evidence

Economic evidence indicates even small incentives can increase vaccination rates, and the reach can be substantial when incentives are provided within health plans.

Seven studies were included (search period 1980-2012). Monetary values reported in 2013 U.S. dollars.

  • Median sample size: 774 (6 studies)
  • Median intervention cost per person per year: $372 (4 studies)
  • Cost per additional vaccinated person: $248 to $2,447
  • Studies conducted in United States (4), Germany (2), and Australia (1)

Applicability

Evidence is applicable to vaccinations for children and adults in a wide range of clinical and community settings, and for various types of incentive rewards.

Evidence Gaps

  • How effective are client or family incentive rewards when used alone?
  • What is the relationship between the size of the incentive reward and intervention effectiveness? Are there potential thresholds for effectiveness?
  • How long do program effects last?
  • How effective are interventions on vaccination rates among adolescents, adults, or older adults?
  • How effective are interventions in communities with disparities in vaccination rates?

Implementation Considerations and Resources

Client or family incentive rewards can be included in multicomponent intervention approaches recommended by CPSTF:

Incentive rewards may increase contact between clients and healthcare providers, providing opportunities for additional preventive care. However, they may be considered coercive and could influence the decision-making process when clients decide whether to accept vaccination.

Crosswalks