A study recently published in PLOS Global Public Health evaluates the effectiveness of a pay-it-forward strategy for increasing influenza vaccination among children and older adults compared to a self-paid vaccination strategy in China. Pay-it-forward is an innovative community-engaged intervention in which participants receive a free influenza vaccination and are then asked if they would like to donate or create a message to support subsequent vaccinations. Researchers from the University of Hong Kong, Yale University, and the London School of Hygiene and Tropical Medicine used a decision-tree model to compare pay-it-forward to a standard of care arm in which patients had to pay for their own influenza vaccine.
In the base case analysis, pay-it-forward was more effective (111 vs. 55 people vaccinated) but more costly than standard-of-care (US$4477 vs. $2725 from the health care provider perspective). Pay-it-forward spurred 96.4% (107/111) of individuals to voluntarily donate to support influenza vaccination for high-risk groups in China. Further costing and implementation research is needed to inform scale up.
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