Hostname: page-component-669899f699-ggqkh Total loading time: 0 Render date: 2025-05-04T08:41:57.065Z Has data issue: false hasContentIssue false

Incentives for COVID-19 Vaccination: Implications for Public Health Preparedness in a New Pandemic

Published online by Cambridge University Press:  23 April 2025

Branko Beronja
Affiliation:
Institute of Epidemiology, Faculty of Medicine, Visegradska, Belgrade, Serbia
Jelena Dotlic
Affiliation:
Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vida Jeremic Stojkovic
Affiliation:
Department of Humanities, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Paul Cummins
Affiliation:
Department of Bioethics Clarkson University, Potsdam, NY, USA
Marija Milic
Affiliation:
Institute of Public Health of Serbia “Dr Milan Jovanovic Batut,” Belgrade, Serbia Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
Tatjana Gazibara*
Affiliation:
Institute of Epidemiology, Faculty of Medicine, Visegradska, Belgrade, Serbia
*
Corresponding author: Tatjana Gazibara; Emails: [email protected]; [email protected]

Abstract

Objective

To examine opinions about incentives for vaccination against COVID-19.

Methods

A qualitative study was conducted in spring 2022. The study population consisted of pairs of university students and their parents throughout Serbia. The qualitative content analysis was applied.

Results

A total of 18 participants (9 student-parent pairs) were included. The following themes were identified: 1) Attitudes about financial incentives for vaccination, 2) Non-financial incentives for vaccination, and 3) Suggestions to enhance vaccination coverage. Theme 1 comprised several subthemes: General response to money, Dissatisfaction with financial incentives, Satisfaction with financial incentives and Amount of money to change people’s opinion. Most parents and some students expressed a clear dissatisfaction and disapproval of the concept of financial incentives for compliance with vaccination. Financial offers would not make our participants change their position on whether to receive the vaccine, as no major differences in attitude towards vaccinations between the vaccinated and the non-vaccinated study participants was observed. Non-financial incentives were more acceptable compared to financial ones, but they were also seen as beneficial for some and not others.

Conclusions

Financial incentive programs’ potential for inefficiency and public mistrust make other methods to boost vaccine uptake better public health choices for now.

Type
Original Research
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

World Health Organization. COVID-19 Vaccines. 2022. Last access date April 15, 2025. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines.Google Scholar
World Health Organization. Serbia’s COVID-19 Vaccination Campaign Off to a Strong Start. 2021. Last access date April 15, 2025. https://www.who.int/europe/news/item/11-03-2021-serbia-s-covid-19-vaccination-campaign-off-to-a-strong-start.Google Scholar
Euronews. Serbia in ‘World First’ As Citizens Offered €25 to Have COVID Vaccine. 2021. Last access date April 15, 2025. https://www.euronews.com/2021/05/05/serbia-in-world-first-as-citizens-offered-25-to-have-covid-vaccine.Google Scholar
BBC News in Serbian. Coronavirus, Budget and Finances in Serbia: The First 30 Euros Have Been Paid, in November Another 30, and Soon 3,000 Dinars for the Vaccinated. 2021. Last access date April 15, 2025. https://www.bbc.com/serbian/lat/srbija-56913543.Google Scholar
Holt, E. Serbia begins paying citizens to receive a COVID-19 vaccine. Lancet. 2021;397:1793.CrossRefGoogle ScholarPubMed
Persad, G, Emanuel, EJ. Ethical considerations of offering benefits to COVID-19 vaccine recipients. JAMA. 2021;326(3):221222.CrossRefGoogle ScholarPubMed
Jecker, NS. Cash incentives, ethics, and COVID-19 vaccination. Science. 2021;374(6569):819820.CrossRefGoogle ScholarPubMed
Jecker, NS. What money can’t buy: an argument against paying people to get vaccinated. J Med Ethics. 2022;48(6):362366.CrossRefGoogle ScholarPubMed
Boyneburgk, KV, Bellazzi, F. COVID-19 Vaccines and the virtues. Public Health Ethics. 2022;15(3):209219.CrossRefGoogle ScholarPubMed
Thomson Reuters Foundation News. Carrot or Stick? How Countries Are Tackling COVID-19 Vaccine Hesitancy. 2021. Last access date April 15, 2025. https://news.trust.org/item/20210601155421-gr1fs/.Google Scholar
Ukoaka, BM, Okesanya, OJ, Daniel, FM, et al. Updated WHO list of emerging pathogens for a potential future pandemic: implications for public health and global preparedness. Infez Med. 2024;32(4):463477.Google ScholarPubMed
Bradshaw, C, Atkinson, S, Doody, O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4:18.Google ScholarPubMed
Sullivan-Bolyai, S, Bova, C, Harper, D. Developing and refining interventions in persons with health disparities: the use of qualitative description. Nurs Outlook. 2005;53:127133.CrossRefGoogle ScholarPubMed
Schreier, M. Qualitative content analysis. In: Flick, U., (Ed.), The SAGE Handbook of Qualitative Data Analysis. London, UK: SAGE Publications Ltd; 2015;170184.Google Scholar
Veljkovic, M, Loncarevic, G, Kanazir, M, et al. Trend in mandatory immunisation coverage: linear and joinpoint regression approach, Serbia, 2000 to 2017. .Euro Surveill 2021;26(26):2000417.CrossRefGoogle ScholarPubMed
Campos-Mercade, P, Meier, AN, Schneider, FH, et al. Monetary incentives increase COVID-19 vaccinations. Science. 2021;374(6569):879882.CrossRefGoogle ScholarPubMed
Sprengholz, P, Eitze, S, Felgendreff, L, Korn, L, Betsch, C. Money is not everything: experimental evidence that payments do not increase willingness to be vaccinated against COVID-19. J Med Ethics. 2021;47(8):547548.CrossRefGoogle Scholar
Haman, M, Khakimova, A. Money for a vaccine? Pay incentives as a solution to increase vaccination rates during the COVID-19 pandemic. Public Health. 2022;205:e23e24.CrossRefGoogle ScholarPubMed
Sargent, RH, Laurie, S, Moncada, L, et al. Masks, money, and mandates: a national survey on efforts to increase COVID-19 vaccination intentions in the United States. PLoS One. 2022;17(4):e0267154.CrossRefGoogle ScholarPubMed
Carroll, JK, Arias Hernandez, P, Brooks-Greisen, A, et al. Socioeconomic impact of COVID-19 and willingness to be vaccinated in African American/Black and Hispanic/Latinx adults. J Natl Med Assoc. 2022;114(2):182192.Google ScholarPubMed
Rosen, AD, Beltran, J, Thomas, E, et al. COVID-19 Vaccine acceptability and financial incentives among unhoused people in Los Angeles County: a three-stage field survey. J Urban Health. 2022;99(3):594602.CrossRefGoogle Scholar
Liu, S, Chu, H. Examining the direct and indirect effects of trust in motivating COVID-19 vaccine uptake. Patient Educ Couns. 2022;105(7):20962102.CrossRefGoogle ScholarPubMed
Siegler, AJ, Luisi, N, Hall, EW, et al. Trajectory of COVID-19 vaccine hesitancy over time and association of initial vaccine hesitancy with subsequent vaccination. JAMA Netw Open. 2021;4(9):e2126882.CrossRefGoogle ScholarPubMed
Brewer, NT, Buttenheim, AM, Clinton, CV, et al. Incentives for COVID-19 vaccination. Lancet Reg Health Am. 2022;8:100205.Google ScholarPubMed
Dotlic, J, Jeremic Stojkovic, V, Cummins, P, et al. Enhancing COVID-19 vaccination coverage using financial incentives: arguments to help health providers counterbalance erroneous claims. Epidemiol Health. 2021;43:e2021081.CrossRefGoogle ScholarPubMed
Dotlic, J, Jeremic Stojkovic, V, Cummins, P, et al. Authors’ reply: vaccination, payment, and COVID-19. Epidemiol Health. 2021;43:e2021100.CrossRefGoogle ScholarPubMed
Savulescu, J. Good reasons to vaccinate: mandatory or payment for risk? J Med Ethics. 2021;47(2):7885.CrossRefGoogle ScholarPubMed
Reese, A, Pies, I. Paying people for getting vaccinated? A favorable solution for both vaccine-hesitant persons and the public. Bioethics. 2022;36(4):453460.CrossRefGoogle ScholarPubMed
Pennings, S, Symons, X. Persuasion, not coercion or incentivisation, is the best means of promoting COVID-19 vaccination. J Med Ethics. 2021;47(10):709711.CrossRefGoogle Scholar
Largent, EA, Miller, FG. Problems with paying people to be vaccinated against COVID-19. JAMA. 2021;325(6):534535.CrossRefGoogle ScholarPubMed
Volpp, KG, Loewenstein, G, Buttenheim, AM. Behaviorally informed strategies for a national COVID-19 vaccine promotion program. JAMA. 2021;325(2):125126.Google ScholarPubMed
Volpp, KG, Cannuscio, CC. Incentives for immunity - strategies for increasing Covid-19 vaccine uptake. N Engl J Med. 2021;385(1):e1.CrossRefGoogle ScholarPubMed