Abstract
Background
COVID-19 vaccine uptake in low- and middle-income countries (LMICs) remains suboptimal, yet heterogeneous. As of December 2022, Our World in Data reports that less than 40% of South Africans are vaccinated, while about 85% of Ecuadorians have received at least one shot.
Research objective
We used nationally representative survey data from N=3,608 respondents in South Africa (collected during November 2021 – March 2022), and N= 85,459 respondents in Ecuador (September – December 2021) to measure the extent to which (already existing) government cash grants increased vaccine uptake and intentions to vaccinate; and to explore a potential mechanism: trust in the government’s information regarding COVID-19 and the vaccine.
Methods
We used country-specific logit models with relevant dichotomous dependent variables: vaccination status (1=vaccinated or 0=not vaccinated) in Ecuador; and intention to vaccinate among the unvaccinated (1=intends to vaccinate as soon as possible; and 0=otherwise) in South Africa. We controlled for demographic, health, and socio-economic characteristics (including age, gender, educational level, province of residence, previous COVID-19 infection, chronic conditions, etc.), and report an adjusted odds ratio (aOR).
Results
In Ecuador, 9% of the population received cash transfers. Holding all other variables constant, having received government cash transfers almost doubled the likelihood of being vaccinated for COVID-19 in the rural areas (adjusted Odds Ratio, aOR: 1.705, p<0.001).
In South Africa, 55% of households were receiving a government grant. Respondents in households receiving grants were over 50% more likely to intent to vaccinate as soon as possible (aOR: 1.53, 95%, p<0.001). The evidence supports the hypothesis of trust being a potential mechanism: people in households receiving grants were 53% more likely to “trust a lot” the information provided by the government about COVID-19 and the vaccine; and those with a lot of trust were over five times more likely to intend to vaccinate.
Conclusions and policy implications
Government cash grants in South Africa and Ecuador seem to exhibit spillover effects over and above the original intent for which they were originally instituted. The overall anti-poverty assistance seems to contribute to increasing COVID-19 vaccination rates as well as intentions to vaccinate.