April 5, 2021

A coordinated and transparent effort to conduct rapid evaluations would allow vaccination programs to quickly learn about the most effective ways to encourage vaccination. A recent article in the journal Nature¹ calls on health systems to use the COVID-19 vaccination rollout to conduct rapid evaluations on how best to encourage people to get their vaccines.

Our team at the Office of Evaluation Sciences at the US General Services Administration has done this type of work before. We have completed eight randomized evaluations of direct communications intended to boost the uptake of influenza and routine vaccinations with our agency collaborators (see oes.gsa.gov/vaccines).

Testing ways to encourage vaccination might seem too complicated to justify layering on top of the ongoing challenges of delivering COVID-19 vaccines. However, OES’s evaluations were embedded within already ongoing vaccination outreach efforts at Veterans Affairs facilities and with city and state Departments of Health. Interventions ranged from letters and email reminders to a modified clinical reminder in an Electronic Health Record system, with a median sample size of 55,000 recipients. Lessons learned from these eight studies can inform COVID-19 vaccination efforts.

Conducting these rapid evaluations required health and data systems that were able to randomly assign potential vaccine recipients to different intervention strategies. The data systems were also used to identify who was due for a vaccine, and measure vaccine uptake following the interventions, allowing the health systems to learn what communications worked to encourage vaccination.

Vaccination encouragement will be particularly important when supply exceeds demand, so right now is an opportune time to plan for incorporating rapid evaluation of different approaches to encouraging vaccination. As OES’s pre-COVID vaccination uptake interventions have shown, implementing and evaluating large scale approaches to vaccination encouragement is feasible, and will pay dividends for years to come.

  1. Patel M. Test behavioural nudges to boost COVID immunization. Nature. 2021 Feb 1;590(7845):185.