Cash for COVID-19 Vaccines in Africa: A Financial Incentives Trial in Rural Ghana (preprint)

We implemented a clustered randomized controlled trial with 7,227 residents in six rural Ghana Districts to determine whether financial incentives produce substantial increases in COVID-19 vaccine uptake. Villages were randomly assigned to receive one of four video treatment arms: a placebo, a standard health message, a high cash incentive ($10) and a low cash incentive ($3). Non-vaccinated subjects, assigned to the Cash incentive treatments had an average COVID-19 vaccine intention rate of 81% compared to the 71% for those in the Placebo treatment arm. Two months after the initial intervention the average self-reported vaccination rates for subjects in the Cash treatment were 3.5% higher than those for subjects in the Placebo treatment (95% CI: 0.001, 6.9; P < 0.03) - 40% versus 36.5%. We verified the vaccination status of subjects: in the Cash treatment arm, 36.6% of verified subjects had at least one dose of the COVID-19 vaccine compared to 30.3% for those in Placebo - a difference of 6.3% (95% CI: 2.4, 10.2; P < 0.0001). For all three outcomes, the low cash incentive ($3.00) had a larger positive effect on COVID-19 vaccine uptake than the high cash incentive ($10.00). There is no evidence of spillover effects of the financial incentives that depress the vaccine uptake of subjects in non-financial treatment arms nor of non-treated proximate residents.

Receptiveness of and Implementation Considerations for COVID-19 Vaccination Certificates in Asia: A Survey Across 9 Countries (preprint)

: COVID-19 vaccination certificates (CVCs) have played a key role in safe reopening of borders for international travel and trade, so understanding key stakeholder perceptions of enablers and barriers for their effective use is critical. The COVID-19 Vaccination Policy Research and Deci-sion-Support Initiative in Asia (CORESIA) was established to address policy questions related to CVCs. We conducted two online surveys, i.e., one for the public and one for health and non-health sector experts, from June to October 2021 in nine Asian countries. Descriptive analysis identified participants, enablers, and barriers. Most participants (78% public, 89% experts) accepted the use of CVCs, primarily to resume international travel (76%). Most respondents in both surveys wanted the minimum vaccination coverage to be 60% before CVCs were implemented nation-wide. Most of the public (82%) agreed to maintain existing non-pharmaceutical interventions, while most experts wanted risk-based testing and quarantine policy for incoming travellers (51%) and both digital and paper format CVCs (64%). Support for CVCs for international travel remains high in Asia. Recognising key enablers and barriers for effective use of CVCs from COVID-19 pandemic may help policymakers draft effective border policies for future epidemics.