Megastudy shows that reminders boost vaccination but adding free rides does not
Milkman, Katherine L.; Ellis, Sean F.; Gromet, Dena M.; Jung, Youngwoo; Luscher, Alex S.; Mobarak, Rayyan S.; Paxson, Madeline K.; Silvera Zumaran, Ramon A.; Kuan, Robert; Berman, Ron; Lewis, Neil A., Jr.; List, John A.; Patel, Mitesh S.; Van den Bulte, Christophe; Volpp, Kevin G.; Beauvais, Maryann V.; Bellows, Jonathon K.; Marandola, Cheryl A.; Duckworth, Angela L.
2024
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Abstract
Encouraging routine COVID-19 vaccinations is likely to be a crucial policy challenge for decades to come. To avert hundreds of thousands of unnecessary hospitalizations and deaths, adoption will need to be higher than it was in the autumn of 2022 or 2023, when less than one-fifth of Americans received booster vaccines. One approach to encouraging vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated. However, the value of providing free round-trip transportation to vaccination sites is unknown. Here we show that offering people free round-trip Lyft rides to pharmacies has no benefit over and above sending them behaviourally informed text messages reminding them to get vaccinated. We determined this by running a megastudy with millions of CVS Pharmacy patients in the United States testing the effects of (1) free round-trip Lyft rides to CVS Pharmacies for vaccination appointments and (2) seven different sets of behaviourally informed vaccine reminder messages. Our results suggest that offering previously vaccinated individuals free rides to vaccination sites is not a good investment in the United States, contrary to the high expectations of both expert and lay forecasters. Instead, people in the United States should be sent behaviourally informed COVID-19 vaccination reminders, which increased the 30-day COVID-19 booster uptake by 21% (1.05 percentage points) and spilled over to increase 30-day influenza vaccinations by 8% (0.34 percentage points) in our megastudy. More rigorous testing of interventions to promote vaccination is needed to ensure that evidence-based solutions are deployed widely and that ineffective but intuitively appealing tools are discontinued.
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Title Megastudy shows that reminders boost vaccination but adding free rides does not
Author Milkman, Katherine L. : University of Pennsylvania : (http://orcid.org/0000-0002-9706-4830)
Ellis, Sean F. : University of Pennsylvania : (http://orcid.org/0000-0001-6099-0999)
Gromet, Dena M. : University of Pennsylvania : (http://orcid.org/0000-0001-9153-7193)
Jung, Youngwoo : University of Pennsylvania : (http://orcid.org/0009-0002-9621-6676)
Luscher, Alex S. : University of Pennsylvania : (http://orcid.org/0009-0005-1077-4020)
Mobarak, Rayyan S. : University of Maryland : (http://orcid.org/0000-0003-0452-965X)
Paxson, Madeline K. : University of Pennsylvania : (http://orcid.org/0009-0005-5327-4958)
Silvera Zumaran, Ramon A. : University of Pennsylvania : (http://orcid.org/0009-0007-1239-320X)
Kuan, Robert : University of Pennsylvania : (http://orcid.org/0000-0001-5686-1289)
Berman, Ron : University of Pennsylvania : (http://orcid.org/0000-0002-8594-3627)
Lewis, Neil A., Jr. : Cornell University
List, John A. : University of Chicago : (http://orcid.org/0000-0002-1740-3848)
Patel, Mitesh S. : Ascension Health
Van den Bulte, Christophe : University of Pennsylvania : (http://orcid.org/0000-0001-9708-1596)
Volpp, Kevin G. : University of Pennsylvania
Beauvais, Maryann V. : CVS Health
Bellows, Jonathon K. : CVS Health
Marandola, Cheryl A. : CVS Health
Duckworth, Angela L. : University of Pennsylvania : (http://orcid.org/0000-0002-2644-3729)
Content Type Article
Published in Nature
Identifier(s) DOI: https://doi.org/10.1038/s41586-024-07591-x
Data availability statement The experimental data analysed in this article were provided by CVS Pharmacy. The data were de-identified pursuant to 45 CFR 164.514(b)(2). Our study’s analysis plan was pre-registered on the Open Science Framework (OSF; pre-registration 1: bit.ly/3n3KUh2; pre-registration 2: bit.ly/3ZRPzBk). Pre-registration 2 updates part of pre-registration 1 to address unexpected problems stemming from the failure to send messages, as planned, in interventions 7 and 8 on 3 November. This second pre-registration was posted before any outcome data were received or analysed. Fully anonymized and de-identified data on each study participant’s intervention condition, launch date and bivalent COVID-19 booster vaccination decision during our follow-up period are available on the OSF as are aggregated summary statistics (https://bit.ly/3MhRHgm). However, to protect patient privacy, we cannot publicly post individual-level data on patients’ covariates. Source data are provided with this paper. All codes used to analyse study data can also be found at the OSF (https://bit.ly/3MhRHgm).
Funding Information Rockefeller Foundation
Robert Wood Johnson Foundation
Craig Newmark Philanthropies
Alfred P. Sloan Foundation
Wharton Behavioral Laboratory
AKO Foundation
Publication Date 2024-06-26
Language English
Copyright Statement © The Author(s) 2024 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Record Created 2024-06-26
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