PT - JOURNAL ARTICLE AU - Thanel, Katherine AU - Pedersen, Brian AU - Albert, Yao Kouakou AU - Ouattara, Mariame Louise AU - Gbeke, Dorgeles AU - Ranebennur, Virupax AU - Burke, Holly M. TI - Acceptability of an Incentivized Peer Referral Intervention to Address COVID-19 Vaccine Hesitancy Among Adults in Yopougon-Est, Côte d’Ivoire AID - 10.9745/GHSP-D-23-00468 DP - 2024 Jun 27 TA - Global Health: Science and Practice PG - e2300468 VI - 12 IP - 3 4099 - http://www.ghspjournal.org/content/12/3/e2300468.short 4100 - http://www.ghspjournal.org/content/12/3/e2300468.full SO - GLOB HEALTH SCI PRACT2024 Jun 27; 12 AB - Key FindingsIn response to decreased demand among adults for COVID-19 vaccinations in Yopougon-Est, Côte d’Ivoire, after integrating the vaccines into routine immunization services, an intervention was developed that gave monetary incentives to newly vaccinated individuals when they acted as peer mobilizers and referred family and friends for COVID-19 vaccination with paper coupons.Of the 450 vaccinated individuals approached to be peer mobilizers, 197 opted in, distributing up to 1,041 coupons to family and peers. From those coupons, 399 individuals returned for vaccination, for a response rate of 38%.Referred vaccine recipients reported the US$3 incentive peer mobilizers received for each referral was socially acceptable, and public health officials reported that this intervention could be integrated into routine vaccination services with relatively low cost and effort.Key ImplicationsIncentivized peer referral interventions may encourage vaccinated individuals to discuss personal experiences to allay rumors and fears that contribute to vaccine hesitancy.Practitioners can adapt this incentivized peer referral intervention to other geographies and vaccination settings using the implementation guide, training materials, and data collection tools we developed based on our experience pilot testing this intervention.Introduction:Vaccine hesitancy persists as a barrier to vaccine uptake among adults across geographies. We pilot-tested an incentivized peer referral intervention in Yopougon-Est, Côte d’Ivoire, to encourage adults who recently received COVID-19 vaccination to discuss their experiences and motivate family and friends to seek vaccination.Implementation: From May through June 2023, the intervention operated at 2 vaccination sites, where staff approached individuals immediately after receiving COVID-19 vaccination. Interested vaccine recipients received up to 9 referral coupons to distribute among their social circles, with a small financial incentive (approximately US$3) offered for each person they referred who returned to 1 of the 2 sites for COVID-19 vaccination.Methods:We collected data on numbers of people vaccinated and coupons returned. Qualitative interviews were conducted with 40 referred vaccine recipients and 7 public health officials.Results:During the 6-week intervention, 450 newly vaccinated individuals were offered the opportunity to enroll, with 197 opting to distribute coupons. Nearly half (45%) of these peer mobilizers who distributed coupons referred at least 1 person who subsequently came in for vaccination, and most of this subset had 2 or more completed referrals. Qualitative findings revealed that coupons served as effective reminders, sparking discussions within social networks and prompting vaccine-seeking behavior. According to the referred vaccine recipients, hearing about their peers’ vaccination experience influenced uptake. Vaccine recipients and public health officials found the small referral incentive acceptable. Officials noted the intervention’s potential utility and cost effectiveness, suggesting possible sustainability.Conclusion:This incentivized peer referral intervention, capitalizing on peer networks and social norms, holds promise for increasing vaccine uptake in Yopougon-Est and potentially in other vaccination contexts globally. Practitioners can leverage the implementation guide and training materials we developed to replicate the intervention at larger scale and assess impact on vaccination trends.