Author(s)

• Katherine L. 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 Jr
• John A. List
• Mitesh S. Patel
• Christophe Van den Bulte
• Kevin G. Volpp
• Maryann V. Beauvais
• Jonathon K. Bellows
• Cheryl A. Marandola
• Angela L. Duckworth

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Abstract

Encouraging routine COVID-19 vaccinations will probably 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 vaccines. One approach to encourage vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated. 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 customers in the United States testing two effects: free round-trip Lyft rides to CVS Pharmacies for vaccination appointments, and 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, which is 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.