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Perceptions of COVID-19 Vaccine Incentives Among Adolescents and Young Adults

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  What do US adolescents and young adults know and think about COVID-19 vaccine incentives?

Findings  In this qualitative study of 1125 adolescent and young adult respondents, youth awareness of COVID-19 vaccine incentives was high, and their opinions were generally favorable. However, more than a quarter of youth expressed concerns about incentives, including but not limited to their effectiveness, ethical use, fairness, and impact on vaccine motivations and confidence.

Meaning  These findings suggest that more research is needed to understand the incidence, characteristics, and effectiveness of COVID-19 vaccine incentives targeted to children and young adults. Policymakers considering interim implementation of incentive programs should consider youths’ perspectives on these public health measures.

Abstract

Importance  Vaccine incentives have been used across the US to encourage COVID-19 vaccine uptake and include programs targeted to adolescents and young adults. However, little is known about youths’ views regarding these initiatives.

Objective  To assess experiences and perceptions of COVID-19 vaccine incentives in a nationwide sample of US youth.

Design, Setting, and Participants  A qualitative survey study was conducted using the MyVoice text message-based polling platform from October 22 to October 29, 2021. Participants were US adolescents and young adults aged 14 to 24 years, who were sent 5 open-ended questions to assess their experiences and perceptions of COVID-19 vaccine incentives. Qualitative responses were analyzed thematically. Descriptive statistical analysis was performed in January 2022.

Main Outcomes and Measures  Experiences, perceptions, and opinions related to COVID-19 vaccine incentives as measured by survey response.

Results  A total of 1125 of 1206 youth (93%) responded to the survey and had a mean (SD) age of 20 (2) years, 664 (59%) identified as male, and 769 (68%) identified as non-Hispanic White. Of respondents, 871 (79%) reported having heard of vaccine incentives, and 892 (82%) believed they were a good idea or had positive attributes. Notably, 305 youth (28%) expressed concerns about vaccine incentives, citing uncertainty about their effectiveness (86 [28%]), their ethical use (63 [21%]), the impact on vaccine motivations (51 [17%]), and confidence (39 [13%]), and lack of fairness (35 [11%]). Only 73 youth (7%) reported that an incentive influenced their decision to get a COVID-19 vaccine. When asked what they thought would motivate others to get a COVID-19 vaccine, youth with an opinion (536 of 1032 [52%]) most commonly reported incentives (112 [21%]) and additional COVID-19 vaccine testing, safety, or regulation (115 [21%]).

Conclusions and Relevance  COVID-19 vaccine incentives are well known to youth but not a significant self-reported motivator for vaccination. Although generally viewed favorably, more than a quarter of youth expressed concerns regarding vaccine incentives, including but not limited to their ethics, effectiveness, fairness, and impacts on vaccine motivation and confidence. Policymakers considering targeted use of COVID-19 vaccine incentives should weigh youths’ perspectives on these initiatives alongside objective effectiveness and cost-effectiveness data.

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Article Information

Accepted for Publication: April 20, 2022.

Published: June 8, 2022. doi:10.1001/jamanetworkopen.2022.16628

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Hogan CM et al. JAMA Network Open.

Corresponding Author: Caroline M. Hogan, MD, 2800 Plymouth Rd, Bldg 14, Rm G128, Ann Arbor, MI 48109 (hogancm@umich.edu).

Author Contributions: Dr Hogan and Ms Waselewski had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Hogan, Waselewski, Chang.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Hogan, Chang.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Hogan.

Administrative, technical, or material support: Waselewski.

Supervision: Waselewski.

Conflict of Interest Disclosures: Dr Hogan reported serving as an advocacy campaign chair for the American Academy of Pediatrics Section on Pediatric Trainees during the conduct of the study. No other disclosures were reported.

Funding/Support: Dr Hogan was supported by a research stipend from the University of Michigan National Clinician Scholars Program and the Susan B. Meister Child Health Evaluation and Research Center. MyVoice research is funded by the Michigan Institute for Clinical and Health Research, the University of Michigan MCubed program, and the University of Michigan Department of Family Medicine.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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