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Vaccination Programs: Monetary Sanction Policies


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2011 pdf icon [PDF - 463 KB] (2 studies, search period January 1980-November 2009). A more recent search for evidence (search period 2009-February 2012) did not identify any new studies to be included in the systematic review.

This review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice and policy related to increasing appropriate vaccination.

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 495 KB].

The systematic review included two studies.

  • One study evaluated vaccination outcomes for 1,324 young children in families who receive assistance from the Aid to Families with Dependent Children (AFDC) program in Maryland. The program showed a 0.7 percentage point decrease in vaccination rates.
  • Another study of 2,500 families on AFDC assistance in Georgia reported an 11.8 percentage point increase in vaccination rates among children.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • Are there circumstances when monetary sanction policies are effective and beneficial?

Study Characteristics

  • Both of the included studies were from the United States and evaluated the use of state monetary sanction policies for families receiving assistance through the Aid to Families with Dependent Children (AFDC) program.
  • Both studies used randomized controlled trials.
  • One study was conducted over two years, one was over three years.