Megastudy shows that reminders boost vaccination but adding free rides does not

Katherine Milkman, Sean F. Ellis, Dena M. Gromet, Youngwoo Jung, Alex S. Luscher, Rayyan S. Mobarak, Madeline K. Paxson, Ramon A. Silvera Zumaran, Robert Kuan, Ron Berman, Neil A. Lewis, John List, Mitesh S. Patel, Christophe Bulte, Kevin G. Volpp, Maryann V. Beauvais, Jonathon K. Bellows, Cheryl A. Marandola and Angela L. Duckworth
Additional contact information
Sean F. Ellis: University of Pennsylvania
Dena M. Gromet: University of Pennsylvania
Youngwoo Jung: University of Pennsylvania
Alex S. Luscher: University of Pennsylvania
Rayyan S. Mobarak: University of Maryland
Madeline K. Paxson: University of Pennsylvania
Ramon A. Silvera Zumaran: University of Pennsylvania
Robert Kuan: University of Pennsylvania
Ron Berman: University of Pennsylvania
Neil A. Lewis: Cornell University
Mitesh S. Patel: Ascension Health
Christophe Bulte: University of Pennsylvania
Kevin G. Volpp: University of Pennsylvania
Maryann V. Beauvais: CVS Health
Jonathon K. Bellows: CVS Health
Cheryl A. Marandola: CVS Health
Angela L. Duckworth: University of Pennsylvania

Nature, 2024, vol. 631, issue 8019, 179-188

Abstract: 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 vaccines1,2. One approach to encouraging vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through3 and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated4. 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.

Date: 2024
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DOI: 10.1038/s41586-024-07591-x

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