With new COVID variants developing seemingly every few weeks, getting people vaccinated remains a public health priority. Teens and young adults account for about 14 percent of the population, so they are an important target for campaigns seeking to encourage COVID vaccination, including those that seek to incentivize this group to get COVID-19 vaccines with prizes and giveaways. But do incentives actually encourage vaccination?

Researchers from the University of Michigan recently conducted a survey to find out what teens and young adults know about incentives and how they feel about them.

Most of the teens responding to the survey felt positively about vaccine incentives such as prizes and giveaways, but a significant minority wondered whether such incentives would motivate more young people to get vaccinated. They also worried about the ethics of incentive programs. When it comes to designing programs in the future, policymakers should consider young people’s opinions about incentives in addition to their objective costs and cost effectiveness.

Almost 30 percent of the teens surveyed expressed concerns about incentives.

“It is important to understand how young people perceive these efforts, and what their attitudes might mean for future vaccine incentive programs,” Caroline Hogan, lead author of the study, told TheDoctor.

The survey responses of more than 1,100 teens and young adults between the ages of 14 and 24 were analyzed. The survey was conducted over a seven-day period using MyVoice, a text message-based platform. Participants were sent five open-ended questions about their perception of and experience with COVID-19 vaccine incentives.

Most respondents volunteered information about their vaccination status, and 80 percent said they had received at least one dose of a COVID-19 vaccine. Almost 80 percent of respondents said they were aware of vaccine incentives, and a little more than 80 percent said they thought incentives were a good thing, or had some positive attributes. However, only seven percent of respondents reported that incentive programs had motivated them to get vaccinated.

This discrepancy may have to do with teens’ and young adults’ concerns about what their peers might think of them for participating in these programs. “Even if incentive programs are viewed positively, it may not be socially desirable to admit your own vaccination decision was partly or wholly influenced by an incentive,” Hogan, a pediatrics researcher at the University of Michigan, explained.

Almost 30 percent of respondents expressed concerns about incentives, citing uncertainty that incentives would motivate people to get vaccinated (28 percent); concerns that incentives might be perceived as bribes (21 percent); belief that incentives are the wrong reason to get vaccinated (17 percent); concerns that incentives may erode confidence in vaccines and organizations offering vaccines (13 percent); and concerns about fairness to those who got vaccinated before incentive programs were introduced (11 percent).

When asked, 21 percent of respondents said incentives might motivate others to get vaccinated. Hogan found this interesting, considering that only seven percent said they got the vaccine because of an incentive program. “Some respondents may not have been transparent about their reasons for getting vaccinated, or may have lacked insight into their decision-making process,” she added.

This particular group of participants may have perceived incentives to be more effective than they really were, said Hogan. And they may have thought of incentives as a public health tool because the survey focused on incentives.

Some previous studies considered the effectiveness of vaccine incentives among adults, but incentives specific to younger people, such as scholarships, could be a useful focus of future studies, Hogan said. She also hopes to do more research asking parents about their feelings towards incentives, particularly those who have not yet had their child vaccinated.

The study is published in JAMA Network Open.