When One Shot Is Not Enough: Ensuring New Yorkers Complete the COVID-19 Vaccine Series
December 17, 2020
The administration of the first doses of the COVID-19 vaccine to Americans less than a year after the start of the pandemic was a historic achievement.
An equally important achievement will be ensuring that all patients who receive their first shot successfully return for the second one in the series a month later. Prior studies have shown that more than half of people who initiate other types of vaccine series often fail to complete them.
A new NYHealth issue brief explores the logistical challenges of multi-dose vaccines to identify strategies for improving series completion. Key barriers for people are lack of vaccine education, not having a usual source of health care, and vaccine cost. The brief also draws on research from other fields, like psychology and behavioral economics, to learn how simple, low-cost tools—such as reminders, commitment devices, and social comparisons—can help people successfully complete vaccine series. Finally, the brief identifies how behavioral nudges are integrated into New York State’s COVID-19 Vaccination Plan, with additional recommendations for using these tools to achieve high rates of completed vaccinations.
- Prior studies have shown that a substantial proportion of people—often more than half—who take a first dose of a vaccine do not complete multi-dose vaccine series. This applies to a variety of vaccinations and populations.
- Factors associated with people not completing a vaccine series include a lack of knowledge about the vaccine, not having a regular source of health care, and cost of the vaccine.
- These factors could be used to identify populations at greater risk for not completing the COVID-19 vaccine series and that might benefit from interventions to help improve completion rates.
- Research from psychology and behavioral economics suggests that simple, low-cost solutions—such as reminders, commitment devices and social comparisons—can help people follow through on their intentions to complete a vaccine series.
- Federal and State agencies are incorporating behavioral nudges into their vaccine distribution plans, and it is critical that they execute the plans effectively. In particular, it will be important for New York State to ensure that providers are connected to the State’s immunization database, which plays a central role in its COVID-19 Vaccination Program. In addition, businesses, schools, and other organizations, as well as individuals, can use these nudges to help ensure high rates of completed vaccinations.