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.
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.