Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 37234

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : February | Volume : 16 | Issue : 2 | Page : LC01 - LC05 Full Version

Effect of Non Incentivised and Incentivised Free COVID-19 Vaccination Camps in Augmentation of State’s Efforts in Achieving Vaccination Targets Necessary for Herd Immunity


Published: February 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/52333.15929
Meghna Gupta, Vitull Kumar Gupta, Navjot Kaur, Pranav Singla, Meenakshi Singla

1. Third Year Postgraduate Resident, Department of Psychiatry, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India. 2. Professor, Department of Medicine, Kishori Ram Hospital and Diabetes Care Centre, Bathinda, Punjab, India. 3. Associate Professor, Department of Pathology, Government Medical College, Amritsar, Punjab, India. 4. Student, Goverment Medical College, Faridkot, Punjab, India. 5. District Immunisation Officer, Civil Hospital, Bathinda, Punjab, India.

Correspondence Address :
Dr. Vitull Kumar Gupta,
5042, Afim Wali Gali, Bathinda, Punjab, India.
E-mail: meghna504@gmail.com

Abstract

Introduction: Most effective way to defeat the Coronavirus Disease-2019 (COVID-19) pandemic is mass vaccination to achieve herd immunity which requires vaccination of about 80% of the population.

Aim: To compare the effect of non incentivised and incentivised free COVID-19 vaccination camps on augmentation of state’s efforts in achieving vaccination targets of covering 80% of population.

Materials and Methods: The present retrospective observational study included free COVID-19 vaccination camps, both non incentivised (8 days) and incentivised (8 days), were organised in month of June and July, 2021 at a hospital in association with an NGO under the supervision of District Immunisation Officer. Data of all vaccinations done was compared to document the effect of incentivised free vaccination camp as compared to non incentivised camps. Data was represented as frequency, percentage and Chi-square test was used.

Results: Total of 4111 vaccinations were done during the free vaccination camps, including 1406 during non incentivised and 2705 during incentivised camps. During non incentivised camps 1114 people were given 1st dose and 292 were given 2nd dose, while during incentivised camps 2334 people were given 1st dose and 371 were given 2nd dose. Analysis of the data showed that the difference in number of 1st dose and 2nd dose vaccinations done during the incentivised vaccination camps was statistically significantly higher as compared to the number of 1st dose and 2nd dose vaccinations done during non incentivised vaccination camps. Similar results showed that the difference in number of vaccination done among the age groups of 18-44 years and >44 years during the incentivised vaccination camps was statistically significantly higher as compared to the number of vaccination among the age groups of 18-44 years and >44 years done during the non incentivised vaccination camps.

Conclusion: The present study documented statistically significantly higher number of 1st dose of vaccinations, 2nd dose of vaccinations, vaccinations among 18-44 years age group and >44 years age group done during incentivised vaccination camps as compared to non incentivised vaccination camps. Results of the present study suggest that incentivised vaccination campaigns should be incorporated as an important component of COVID-19 vaccination campaign strategy to vaccinate enough Indian population and achieve herd immunity for protection from COVID-19 pandemic.

Keywords

Coronavirus disease-2019, Immunity, Pandemic, Vaccine

Global scientific community agrees that the most effective way to defeat the COVID-19 pandemic is mass vaccination. Development of vaccines for COVID-19 has been a powerful demonstration of unprecedented levels of scientific collaboration to spur innovation in a very short time. However, the rollout of vaccines does not herald immediate end of the COVID-19 pandemic, as attaining herd immunity will require the vaccination of roughly 80% of population (1). Indian Government has constituted a National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) for vaccine related guidance (2) and initiated the National COVID-19 vaccination programme to ensure free and rapid vaccination of all eligible Indians. With all efforts, vaccinations till 21st October 2021 were 1,00,75,34,203 total doses, 71,14,28,668 1st dose and 29,61,05,535 2nd dose; that is about 75% of total eligible adult Indian population had at least one dose, while about 30% are fully immunised (3). Initially, there was a slow rate of vaccination because of several reasons including shortages of vaccine, increasing skepticism, disinformation and lack of trust on vaccine, but the rate picked up in later months from August to October, 2021 (3),(4),(5),(6). Large number of strategies like community-engagement work, awareness campaigns, tailored communication to remove vaccine hesitancy among populations as well as increasing access to vaccination have been used to increase vaccinations (7).

There is paucity of studies, both theoretical and empirical data, comparing effects of non financial incentives with financial incentives, but a study by Kevin Volpp observed that during immunisation campaigns the non monetary incentives like in-kind gifts, food handouts may attract to a few people. A universal acceptance was observed for monetary incentives which typically work better (8). Experts observe that if education, motivation, encouragement, awareness and facilitation fail to increase vaccinations sufficient for herd immunity some countries were also using other strategies involving incentives or disincentives (mandatory measures) (9). Financial incentives like cash transfers, lotteries and gift vouchers have been used in the Canada, USA, and some other countries to reduce COVID-19 vaccine hesitancy (10),(11).

A systematic review in 2019 including three randomised controlled trials, studying the interventions to promote hepatitis B vaccination among people with substance use disorders, concluded that monetary incentives were the most effective interventions to promote hepatitis B vaccination (12). Similarly in England, a randomised trial on Human Papillomavirus (HPV) vaccinations among girls of 17-18 years documented that cash incentives of USD $73 equivalent improved the vaccination rate by nearly double from 12% to 22% (13). Studies from developing countries like one from Nigeria have documented substantial effects of conditional cash payments for tetanus vaccination campaign among women in Nigeria and observed that higher cash incentives lead to dramatically higher vaccination rate (14).

Evidence suggests positive effect of financial incentives on vaccine uptake during 2009-2010 influenza pandemic before COVID-19 pandemic (15). A review that included 95 RCTs and 13 CCTs observed that patient financial incentives was the most effective intervention components, next was patient reminders, then was patient education, and last was for feedback (16). North Carolina, in the US, have announced incentivised COVID-19 vaccination programs including lotteries for $1 million to motivate COVID-19 vaccination (16). A pilot program in North Carolina, USA, providing a guaranteed small financial incentive slowed the decline in COVID-19 vaccination and alleviated barriers to vaccination, especially for Black, Hispanic and low-income population (17).

Some organisations as well as Governments worldwide have initiated incentives to promote vaccination, ranging from lotteries in Ohio, payments of $5 in Vancouver and payments of 150 in Greece (18),(19). A study in detroit observed increase in the weekly vaccination numbers by 44.19% (from 0.86 to 1.25%) for 1st dose and suggested offering of incentives early and for 2nd doses, along with education (20).

Reviews provide evidence of positive effectiveness of incentives schemes during hepatitis B and influenza vaccinations and literature suggests help of financial incentives in increasing high levels of adherence for COVID-19 vaccinations necessary for achieving herd immunity (21). Most recently Dr VK Paul, Member Niti Aayog (Health), stated that the country is at a critical juncture right now and we have to accomplish high vaccine coverage with full two dose course (22). Various reports in media suggests that a number of community organisations are conducting motivational, awareness and free vaccination campaigns to increase vaccinations among people, but there is paucity of studies from India to document the role of incentivised free vaccination campaigns as compared to non incentivised vaccination campaigns to augmenting the Government’s efforts for achieving vaccination targets. So, this study aimed to compare incentivised and non incentivised free vaccination campaign in augmenting Punjab State’s efforts to achieve appropriate herd immunity to protect Punjab state’s population intern will help achieve appropriate herd immunity for overall Indian population from COVID-19.

Material and Methods

The present retrospective observational study was approved by Institutional Ethical Committee vide letter no; 13/2021 dated 1.6.2021. COVID-19 vaccination campaign was initiated by organising free COVID-19 non incentivised as well as incentivised vaccination camps at a private primary care hospital (Kishori Ram Hospital and Diabetes Care Centre), Bathinda, Punjab in association with a local NGO, under the supervision of District Immunisation Officer in month of June and July, 2021.

Inclusion criteria: Data of all people getting vaccinated during the camps were included in the study.

Exclusion criteria: Data with missing records were excluded from the study.

Non Incentivised Free COVID-19 Vaccination Camps

Non incentivised free COVID-19 vaccination camps were held for eight days in the month of June 2021- 14th (day 1), 15th (day 2), 17th (day 3), 18th (day 4), 19th (day 5), 20th (day 6), 21st (day 7), and 22nd (day 8). During non incentivised free vaccination camps only awareness and education was imparted to all people and no incentives were offered. Data from eight days of non incentivised camps regarding the 1st dose, the 2nd dose and age was recorded after informed consent was obtained for use of their data for comparative study.

Incentivised Free COVID-19 Vaccination Camps

After conclusion of non incentivised camps, incentivised free vaccination camps were held for eight days. Incentivised free vaccination camps were organised by offering ‘lucky draw coupons’ to all the people getting vaccinated for 15 prizes worth rupees 1.25 lac to be announced on conclusion of the incentivised camps and lucky draw winners got the prizes on the last day. The funds for the prizes were arranged by the local NGO assisting in organisation of free COVID-19 vaccination camps. The data regarding number of the 1st dose, the 2nd dose and age was recorded after obtaining informed consent from the participants.

Total number of vaccinations done during the non incentivised and incentivised camps were recorded and analysed according to dosage schedule of 1st dose and 2nd dose and according to age groups of 18-44 years and >44 years age groups as was being recorded by District Immunisation Officer. Individual vaccination data of people and data according to various socio-economic variables as well as gender was not recorded.

Statistical Analysis

Data was represented as frequency and percentage. Chi-square test was used to compare the frequency among two groups. The p-value <0.05 was taken as statistically significant whereas p-value <0.001 was taken as highly significant. All the analysis was done using ‘IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, N.Y., USA)’.

Results

(Table/Fig 1) shows vaccinations done during non incentivised and incentivised vaccination camps and distribution of according to age groups and dosages. Total 4111 vaccinations were conducted during the free vaccination camps, including 1406 vaccinations during non incentivised camps and 2705 vaccinations during incentivised camps.

Overall, 1114 1st dose vaccinations were done during non incentivised vaccination camps and 2334 1st dose vaccinations were done during incentivised vaccination camps. Similarly, 292 2nd dose vaccinations were done during non incentivised vaccination camps and 371 2nd dose vaccinations were done during incentivised vaccination camps.

Among age group of 18-44 years, 1086 vaccinations were done in non incentivised vaccination camps and 2170 vaccinations were done in incentivised camps. Similarly, among age group of >44 years, 320 vaccinations were done in non incentivised vaccination camps and 535 vaccinations were done in incentivised camps.

(Table/Fig 2) shows increased number of vaccinations during the incentivised vaccination camps as compared to non incentivised vaccination camps, except for the first day.

(Table/Fig 3) shows most 178 vaccinations were done among age group of 18-44 years on 1st and 5th day of non incentivised camps. Among age group of >44 years most 105 vaccinations were done on 7th day of non incentivised vaccination camp. Similarly, most (720) vaccinations were done among age group of 18-44 years on 7th day of incentivised camps and among age group of >44 years most (150) vaccinations were done on 4th day of incentivised vaccination camp.

(Table/Fig 4) shows most (190) 1st dose vaccinations were done on 1st day non incentivised camps and most (95) 2nd dose vaccinations were done on 7th day of non incentivised vaccination camp. Similarly, most (722) 1st dose vaccinations were done on 7th day of incentivised camps and most (75) 2nd dose vaccinations were done on 6th day of incentivised vaccination camp.

Discussion

Second wave of COVID-19 was branded as ‘COVID hell’ hardly leaving anyone untouched with brush of tragedy during an apocalyptic situation of collapsing public healthcare system, fleecing by private hospitals, oxygen and hospital beds shortages, overcrowded crematoriums along with numerous mind-numbing devastating stories from India (23),(24). Vaccine and COVID19 appropriate behaviour are the only weapons to combat COVID-19 pandemic (25),(26).

The present study showed that during the present vaccination campaign, 4111 vaccinations were done across 16 camps, eight non incentivised and eight incentivised vaccination camps. The media reported a few incentives based vaccination campaigns from India as well as from other parts of the world to improve vaccinations, but internet search and review of literature did not show any study documenting the effect of incentivised COVID-19 vaccination campaigns (27),(28).

The present incentivised vaccination campaign showed excellent results, where a total of 2705 (65.80%) people got vaccinated during incentivised camps as compared to 1406 (34.20%) during the non incentivised camps and the difference was statistically highly significant.

The results (Table/Fig 1) showed that in 18-44 years age group vaccinations statistically increased from 1086 among non incentivised group to 2170 among incentivised group (p-value <0.001). Similarly, statistically significant increase was observed among >44 years age group with increase in number of vaccinations from 320 in non incentivised camps to 535 in incentivised vaccinations camps (p-value <0.001). Among vaccination groups according to dosage, 1st dose vaccinations increased from 1114 in non incentivised camps to 2334 vaccinations in incentivised camps and the difference of increase was statistically significant (p-value <0.001). Among 2nd dose recipients the number of vaccinations increased from 292 in non incentive camps to 371 vaccinations in incentivised group and the difference of increase was statistically significant (p-value=0.002).

In present study more 1st dose vaccinations during non incentivised and incentivised vaccination camps were done as compared to number of 2nd dose, may be because people were becoming more and more aware of dangers of COVID-19 pandemic and as the Government has initiated vaccinations in 18-44 years age group more and more people in this age group were coming forward to get the benefit of vaccinations. Similarly higher vaccinations in age group of 18-44 years both during non incentivised and incentivised vaccination camps as compared to >44 years age group may also be because this age group was included for vaccinations only recently so more people are getting vaccinated in this age group as compared to >44 years age group. In June 2021, media reported offer of incentives like free rations and free travel by Rajasthan Government to increase vaccinations in tribal districts with low coverage, but there was no documentation of effect of incentives on vaccination campaign (29).

An article in New England Journal of Medicine stated that standard “information and education” strategies for vaccinations are inadequate and a few state Governments have initiated payments for getting vaccinated and suggested that in the short term a well-designed incentive program could increase vaccinations, but may face significant implementation problems and timely delivery of incentives would be important for success, credibility and effectiveness of incentive programme (1). Experts feel that presence of positive externalities like subsidies and incentives are a logical policy approach (30). Another observation suggests, that incentives are beneficial strategies especially when any behaviour changes can reduce future health expenditures (31). Experts believe that incentives are especially effective in modifying one-time behavioural conditions like vaccinations and cancer screening (32).

During the present study, it was observed that there was a progressive increase in vaccinations under the influence of incentives. Subgroup analysis of a systematic review and meta-analysis of 11 RCTs studying implementation of strategies to increase three-dose completion of HBV vaccine series in Persons Who Inject Drugs (PWID) showed that odds of vaccine completion in those offered financial incentives was most effective (OR, 7.01; 95% CI, 2.88-17.06), followed by accelerated vaccine schedules (OR, 1.90; 95% CI, 1.14-3.14) (12).

Another review observed that addition of financial incentives may be a useful for the behavioural change toolkit and this observation was based on evidence of benefits of financial incentives to promote vaccination and other preventive behaviours (33).

More over evidence from a recent survey from Germany suggests beneficial role of financial incentives in increasing number of COVID-19 vaccination and financial incentives were more effective in convincing the study subjects to subscribe to a COVID-19 contact tracing app as compared to providing information, cause for personal advantage or reasons for common good (34). Initial results of German conjoint experiment documented that as part of a mass vaccination scenario hypothetical financial incentive of 50 Euros could increase vaccinations among the hesitant subjects (35). Similarly, about a third of the unvaccinated subjects in a UCLA. COVID-19 Health and Politics Project survey experiment observed that cash incentives would make subjects more likely to get vaccinated (36).

Beneficial influence of incentives on children vaccination programme was documented by a clustered randomised controlled trial evaluating two interventions, one non incentivised vaccination camps and other incentivised vaccination camps offering small incentives concluding large positive effect of small incentives on the uptake of vaccinations in resource poor areas, proved to be more cost-effective than only improvement in supply (37).

Worldwide insufficient number of COVID-19 vaccinations poses a threat to public health and the Governments are considering the use of monetary incentives to increase vaccination. A large pre-registered RCT including 8286 subjects in Sweden studied the effect of guaranteed payments on COVID-19 vaccination rates and found that modest cash payments of 24 US dollars increased number of vaccinations by 4.2% points (p=0.005) as compared to small and statistically not significant effect on number of vaccination by behavioural nudges highlighting the potential of modest financial incentives in increasing the number of vaccinations (38).

Data from controlled studies exploring the overall health promoting interventions suggests that Health Promoting Financial Incentive (HPFI) interventions are more effective as compared to the usual care or no intervention for promoting and encouraging healthy behaviour change amongst populations residing in high income countries (34). Moreover, evidence suggests that in changing one-off health behaviours like vaccination and screening, HPFI may be more effective as compared to changing more complex behaviours like smoking (39).

Present study is a small step forward to document the beneficial effect of incentivised COVID-19 vaccination programme but also stress very strongly that incentives alone may not be sufficient to achieve the vaccination targets. India needs to strengthen National COVID-19 vaccination programme with an over-reaching commitment involving community based organisations, increased awareness and motivation, curbing rumours and misconceptions, making vaccination mandatory for attending Institutions, person to person contact activities, travel, frequent reminder, feedback, education, legislative action, organisational change, or mass media campaign along with incentivising vaccination programme.

Limitation(s)

Small sample size is one of the major limitations. Other limitation is that the study capture only total daily data rather than data of individual subject related to various socio-demographic variables making it difficult for data analysis related to association of various socio-demographic variables with incentivised vaccination campaigns as compared to non incentivised vaccination campaigns. Present study did not consider the influence of factors like government awareness and educational campaigns, reminders, NGO’s education campaigns, celebrity vaccination campaigns etc., which may also have influenced vaccinations in addition to the incentivised campaign of present study.

Conclusion

Present study documents statistically significant higher response of number of vaccinations in incentivised vaccination camps as compared to non incentivised vaccination camps. Statistically significant higher number of vaccinations among 1st dose recipients and among age group of 18-44 years as compared to 2nd dose vaccinations and among >44 years age group was observed in incentivised group may be because vaccinations were permitted late in age group of 18-44 years. Favourable response to incentives in the present study suggest that option of incentivised vaccination campaigns should be part of multifaceted campaigns comprising on-site vaccination, vaccination stands, educational and promotional campaigns, an overreaching commitment involving community based organisations, increased awareness and motivation, curbing rumours and misconceptions, making vaccination mandatory for attending institutions, person to person contact activities, travel, reminder, feedback, education, legislative action, organisational change, or mass media campaign.

Findings of present study will help policymakers in developing effective immunisation policies, implementing immunisation programs, addressing vaccine hesitancy and generating public interest in the vaccinations and encourage further extensive research to explore effect of incentivised vaccination campaigns in achieving vaccination targets among various social, cultural and religious population groups and a well-tailored incentivised vaccination campaigns may help boost vaccination rates needed to achieve herd immuntiy.

References

1.
Volpp KG, Cannuscio CC. Incentives for immunity-strategies for increasing Covid-19 vaccine uptake. N Engl J Med. 2021;385:1. [crossref] [PubMed]
2.
Ministry of Health and Family Welfare (2020) COVID-19 Vaccine Operational Guidelines. Ministry of Health and Family Welfare, Government of India. 28 December 2020. https://main.mohfw.gov.in/sites/default/files/COVID19VaccineOG111Chapter16.pdf.
3.
Co-WIN, Ministry of Health and Family Welfare. https://dashboard.cowin.gov.in/.
4.
Haryax Pathak. India’s COVID-19 Vaccination Campaign: A Marathon, Not a Sprint. Observer Research Foundation Special Report No. 143, June 2021. https://www.orfonline.org/research/indias-covid-19-vaccination-campaign/.
5.
Kumari A, Ranjan P, Chopra S, Kaur D, Kaur T, Kalanidhi KB, et al. What Indians Think of the COVID-19 vaccine: A qualitative study comprising focus group discussions and thematic analysis. Diabetes Metab Syndr. 2021;15(3):679-82. [crossref] [PubMed]
6.
Kumari A, Ranjan P, Chopra S, Kaur D, Kaur T, Upadhyay AD, et al. Knowledge, barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: A cross-sectional survey from one thousand two hundred and forty-nine participants. Diabetes Metab Syndr. 2021;15(3):987-92. [crossref]
7.
Razai MS, Chaudhry UAR, Doerholt K, Bauld L, Majeed A. Covid-19 vaccination hesitancy. Br Med J. 2021;373:n1138. [crossref] [PubMed]
8.
Odorczyk K. Vaccine lotteries and beyond: a behavioral economics expert on what motivates healthy behaviors-and what doesn’t. June 22, 2021. https://www.pennmedicine.org/news/news-blog/2021/june/vaccine-lotteries-and-beyond.
9.
Kumar VM, Pandi-Perumal SR, Trakht I, Thyagarajan SP. Strategy for COVID-19 vaccination in India: The country with the second highest population and number of cases. NPJ. Vaccines. 2021;6:60. [crossref] [PubMed]
10.
Politico. ‘Jabs for kebabs’-The art of coronavirus vaccine persuasion. August 12, 2021. https://www.politico.eu/article/coronavirus-vaccine-reward-europe-skepticism/.
11.
Gandjour A. Financial Incentives in the Path to Recovery from the COVID-19 Pandemic [published online ahead of print, 2021 Nov 1]. Appl Health Econ Health Policy. 2021; 1-4. [crossref] [PubMed]
12.
Tressler S, Bhandari R. Interventions to increase completion of Hepatitis B vaccination in people who inject drugs: A systematic review and meta-analysis. Open Forum Infect Dis. 2019;6:(12):ofz521. [crossref] [PubMed]
13.
Mantzari E, Vogt F, Marteau TM. Financial incentives for increasing uptake of HPV vaccinations: a randomized controlled trial. Health Psychol. 2015;34(2):160-71. [crossref] [PubMed]
14.
Sato R, Fintan B. Effect of cash incentives on tetanus toxoid vaccination among rural Nigerian women: A randomized controlled trial. Hum Vaccin Immunother. 2020;16(5):1181-88. [crossref] [PubMed]
15.
Yamin D, Gavious A. Incentives’ effect in influenza vaccination policy. Management Science. 2013;59 (12):2667-86. [crossref]
16.
National Governors Association. COVID-19 vaccine incentives. 2021. https://www.nga.org/center/publications/covid-19-vaccine-incentives/.
17.
Wong CA, Pilkington W, Doherty IA, Zhu Z, Gawande H, Kumar D, et al. Guaranteed Financial Incentives for COVID-19 Vaccination: A Pilot Program in North Carolina. JAMA Intern Med. Published online October 25, 2021. [crossref] [PubMed]
18.
Oza A. Studies probe how payouts affect U.S. vaccination rates. Science. 2021;373(6555):611. [crossref] [PubMed]
19.
Terrell K. “These Companies Are Paying Employees to Get Vaccinated.” 2021. www.aarp.org/work/working-at-50-plus/info-2021/companies-paying-employees-covid-vaccine.html.
20.
Kim H, Rao VR. Vaccination diffusion and incentive: Empirical analysis of the US State of Michigan. Front Public Health. 2021;9:740367. [crossref] [PubMed]
21.
Higgins ST, Klemperer EM, Coleman SRM. Looking to the empirical literature on the potential for financial incentives to enhance adherence with COVID-19 vaccination. Prev Med. 2021;145:106421. [crossref] [PubMed]
22.
Vinod Paul in TOI Edit Page, Edit Page, India, Times of India. 23.10.2021.https://timesofindia.indiatimes.com/blogs/toi-edit-page/critical-3-months-after-the-1-billion-dose-landmark-double-dose-all-adults-lets-be-careful-as-people-surveillance-teams-must-quickly-track-variants/.
23.
Hannah Ellis-Petersen. The Guardian. 21.4.2021. https://www.theguardian.com/world/2021/apr/21/system-has-collapsed-india-descent-into-covid-hell.
24.
Shrivastava R. India Today. 28.6.2021. https://www.indiatoday.in/coronavirus-outbreak/story/after-second-wave-has-india-upgraded-its-healthcare-system-for-next-big-challenge-read-to-know-1820077-2021-06-28.
25.
Covid Prevention Practices- Covid Safety Measures in India. https://www.mygov.in/.
26.
https://www.icmr.gov.in/pdf/covid/techdoc/EC_Guidance_COVID19_06052020.pdf.
27.
https://www.zee5.com/news/details/covid-vaccination-incentives-in-india-freebies-to-encourage-people-to-vaccinate/0-0-newsauto_5al3qr2pfgi0.
28.
American states offer cash incentives for Covid vaccinations. The Economic Times. 21.5.2021 https://economictimes.indiatimes.com/news/international/world-news/american-states-offer-cash-incentives-for-covid-vaccinations/ohio/slideshow/82825839.cms.
29.
Goswami M. The Logical Indian Crew. Rajasthan Govt Offers Free Rations, Free Travel As Incentives For Jab In Tribal Districts. The Logical Indian. 22 Jun 2021. https://thelogicalindian.com/good-governance/rajasthan-govt-offers-free-rations-free-travel-for-jab-in-tribal-districts-29065.
30.
Stiglitz JE, Rosengard JK. Economics of the public sector, 4th edition. New York: W.W. Norton & Company, 2015.
31.
Pauly MV, Held PJ. Benign moral hazard and the cost-effectiveness analysis of insurance coverage. J Health Econ. 1990;9:447-61. [crossref]
32.
Schumacher S, Salmanton-García J, Cornely OA, Mellinghoff SC. Increasing influenza vaccination coverage in healthcare workers: A review on campaign strategies and their effect. Infection. 2021;49(3):387-99. [crossref] [PubMed]
33.
Giles EL, Robalino S, McColl E, Sniehotta FF, Adams J. The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis. PLoS One. 2014;9(3):e90347. [crossref] [PubMed]
34.
Munzert S, Selb P, Gohdes A, Stoetzer LF, Lowe W. Tracking and promoting the usage of a COVID-19 contact tracing app. Nature Human Behaviour. 2021;5(2):247-55. [crossref] [PubMed]
35.
Klüver H, Hartmann F, Humphreys M, Geissler F, Giesecke J. What incentives can spur Covid-19 vaccination uptake? Proceedings of the National Academy of Sciences. 2021;118(36):e2109543118. [crossref] [PubMed]
36.
Vavreck, Lynn. “$100 as Incentive to Get a Shot? Experiment Suggests it can Pay Off.” The New York Times. 2021. May 4. https://www.nytimes.com/2021/05/04/upshot/vaccine-incentive-experiment.html.
37.
Banerjee A, Duflo E, Glennerster R, Kothari D. Improving immunisation coverage in rural India: Clustered randomised controlled evaluation of immunisation campaigns with and without incentives. BMJ. 2010;340:c2220. [crossref] [PubMed]
38.
Campos-Mercade P, Meier AN, Schneider FH, Pope D, Meier S, Wengström E. Monetary incentives increase COVID-19 vaccinations. Science. 2021;374(6569):879-82. [crossref] [PubMed]
39.
Jochelson K. Paying the patient: improving health using financial incentives. London: King’s Fund 2007. https://www.kingsfund.org.uk › field_document.

DOI and Others

DOI: 10.7860/JCDR/2022/52333.15929

Date of Submission: Sep 10, 2021
Date of Peer Review: Oct 22, 2021
Date of Acceptance: Dec 09, 2021
Date of Publishing: Feb 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 11, 2021
• Manual Googling: Dec 08, 2021
• iThenticate Software: Jan 06, 2022 (7%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com