A recent study published in BMJ Global Health critically examines the use of incentives—both financial and material—to increase immunization coverage in low- and middle-income countries. While incentives are gaining popularity as tools to boost vaccine uptake, the evidence for their long-term effectiveness remains limited. Researchers found that incentives can lead to short-term improvements in vaccination rates, but there is little proof of sustained impact. Moreover, incentives may unintentionally undermine community trust or reduce intrinsic motivation, especially when not aligned with local health systems or cultural contexts. The study underscores the importance of tailoring incentive programs to local settings and coupling them with broader strategies to strengthen health systems and community engagement.
Policymakers, researchers, and implementers are urged to consider and monitor for unintended consequences and avoid one-size-fits-all approaches. The authors also call for interim policy guidelines on the use of incentives in immunization campaigns and more rigorous, long-term evaluations to determine when and how incentives are most effective. Ultimately, while incentives may play a role in improving immunization outcomes, their success depends on thoughtful design, context-sensitive application, and integration with wider public health efforts.
Thumbnail image credit: Gavi/2021/Asad Zaidi
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