IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v139y2024ics0168851023002518.html
   My bibliography  Save this article

How to increase COVID-19 vaccination among a population with persistently suboptimal vaccine uptake? Evidence from the North Macedonia mobile vaccination and public health advice caravan

Author

Listed:
  • Serrano-Alarcón, Manuel
  • Mckee, Martin
  • Palumbo, Leonardo
  • Salvi, Cristiana
  • Johansen, Anne
  • Stuckler, David

Abstract

Over three years since the first COVID-19 vaccine was approved, many countries still have suboptimal vaccination rates despite holding great amounts of vaccines. Overall, there is little evidence on which policies are more effective to encourage vaccination, particularly in countries where a large share of the population remains unvaccinated. In this study, we examine the effectiveness of a community-based intervention carried out in March 2022 in North Macedonia, a country with a large and persistent share of the population that remains unvaccinated. The intervention, spearheaded by the Ministry of Health and supported by the World Health Organization and UNICEF, consisted of a mobile caravan offering vaccination and public health advice to different locations across the country on different days. Results from our staggered difference-in-difference model show that the mobile vaccination caravan increased daily vaccination rates by 7.7 vaccines per 100,000 inhabitants during the three weeks after the day of the caravan visit. This corresponds to a 35 % increase with respect to pre-intervention vaccination rates. We estimate a cost-effectiveness of 25.4 US dollars (USD) per additional vaccination induced. These results point to mobile caravan vaccines as an effective and cost-effective strategy to increase COVID-19 vaccination rates, even in a context of persistently suboptimal uptake.

Suggested Citation

  • Serrano-Alarcón, Manuel & Mckee, Martin & Palumbo, Leonardo & Salvi, Cristiana & Johansen, Anne & Stuckler, David, 2024. "How to increase COVID-19 vaccination among a population with persistently suboptimal vaccine uptake? Evidence from the North Macedonia mobile vaccination and public health advice caravan," Health Policy, Elsevier, vol. 139(C).
    • Handle: RePEc:eee:hepoli:v:139:y:2024:i:c:s0168851023002518
    DOI: 10.1016/j.healthpol.2023.104966
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851023002518
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2023.104966?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Barber, Andrew & West, Jeremy, 2022. "Conditional cash lotteries increase COVID-19 vaccination rates," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Vincenzo Galasso & Vincent Pons & Paola Profeta & Michael Becher & Sylvain Brouard & Martial Foucault, 2022. "From Anti-Vax Intentions to Vaccination: Panel and Experimental Evidence from Nine Countries," CESifo Working Paper Series 9564, CESifo.
    3. Alexander Karaivanov & Dongwoo Kim & Shih En Lu & Hitoshi Shigeoka, 2022. "COVID-19 vaccination mandates and vaccine uptake," Nature Human Behaviour, Nature, vol. 6(12), pages 1615-1624, December.
    4. Sant’Anna, Pedro H.C. & Zhao, Jun, 2020. "Doubly robust difference-in-differences estimators," Journal of Econometrics, Elsevier, vol. 219(1), pages 101-122.
    5. Robertson, Christopher & Schaefer, K. Aleks & Scheitrum, Daniel, 2021. "Are vaccine lotteries worth the money?," Economics Letters, Elsevier, vol. 209(C).
    6. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    7. Hengchen Dai & Silvia Saccardo & Maria A. Han & Lily Roh & Naveen Raja & Sitaram Vangala & Hardikkumar Modi & Shital Pandya & Michael Sloyan & Daniel M. Croymans, 2021. "Behavioural nudges increase COVID-19 vaccinations," Nature, Nature, vol. 597(7876), pages 404-409, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alexander Karaivanov & Dongwoo Kim & Shih En Lu & Hitoshi Shigeoka, 2022. "COVID-19 vaccination mandates and vaccine uptake," Nature Human Behaviour, Nature, vol. 6(12), pages 1615-1624, December.
    2. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2021. "When Reality Bites: Local Deaths and Vaccine Take-Up," GLO Discussion Paper Series 999, Global Labor Organization (GLO).
    3. Xin Nie & Jianxian Wu & Han Wang & Weijuan Li & Chengdao Huang & Lihua Li, 2022. "Contributing to carbon peak: Estimating the causal impact of eco‐industrial parks on low‐carbon development in China," Journal of Industrial Ecology, Yale University, vol. 26(4), pages 1578-1593, August.
    4. Pronkina, Elizaveta & Berniell, Inés & Fawaz, Yarine & Laferrère, Anne & Mira, Pedro, 2023. "The COVID-19 curtain: Can past communist regimes explain the vaccination divide in Europe?," Social Science & Medicine, Elsevier, vol. 321(C).
    5. Cotti, Chad & Courtemanche, Charles & Maclean, Joanna Catherine & Nesson, Erik & Pesko, Michael F. & Tefft, Nathan W., 2022. "The effects of e-cigarette taxes on e-cigarette prices and tobacco product sales: Evidence from retail panel data," Journal of Health Economics, Elsevier, vol. 86(C).
    6. Lewis, Blane D., 2022. "The impact of democratic elections on taxation: Quasi-experimental evidence from subnational Indonesia," Economics Letters, Elsevier, vol. 211(C).
    7. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    8. Hans-Bernd Schaefer & Rok Spruk, 2024. "Islamic Law, Western European Law and the Roots of Middle East's Long Divergence: a Comparative Empirical Investigation (800-1600)," Papers 2401.14435, arXiv.org, revised Mar 2024.
    9. Bonander, Carl & Ekman, Mats & Jakobsson, Niklas, 2022. "Vaccination nudges: A study of pre-booked COVID-19 vaccinations in Sweden," Social Science & Medicine, Elsevier, vol. 309(C).
    10. Dmitry Arkhangelsky & Guido Imbens, 2023. "Causal Models for Longitudinal and Panel Data: A Survey," Papers 2311.15458, arXiv.org, revised Mar 2024.
    11. Lyndon Moore & Gertjan Verdickt, 2022. "Railroad Bailouts in the Great Depression," Papers 2205.13025, arXiv.org, revised May 2023.
    12. Roth, Jonathan & Sant’Anna, Pedro H.C. & Bilinski, Alyssa & Poe, John, 2023. "What’s trending in difference-in-differences? A synthesis of the recent econometrics literature," Journal of Econometrics, Elsevier, vol. 235(2), pages 2218-2244.
    13. Cornelia Chadi, 2022. "Smoking Bans, Leisure Time and Subjective Well-being," Journal of Happiness Studies, Springer, vol. 23(8), pages 3765-3797, December.
    14. Prem, Mounu & Purroy, Miguel E & Vargas, Juan F., 2021. "Landmines: The Local Effects of Demining," Working papers 86, Red Investigadores de Economía.
    15. Hoang, Thoa & Noy, Ilan, 2023. "The income consequences of a managed retreat," Regional Science and Urban Economics, Elsevier, vol. 100(C).
    16. Aldunate, Felipe & Gonzalez, Felipe & Prem, Mounu, 2021. "Make the Economy Scream? U.S. Banks and Foreign Firms During the Cold War," SocArXiv bhwk7, Center for Open Science.
    17. Münch, Florian Anselm & Scheifele, Fabian, 2023. "Nurturing national champions? Local content in solar auctions and firm innovation," Energy Policy, Elsevier, vol. 179(C).
    18. William N. Dowd, 2023. "The effect of untargeted naloxone distribution on opioid overdose outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2801-2818, December.
    19. Jha, Chandan Kumar & Joshi, Swarup, 2023. "Municipal bankruptcies and crime," International Review of Financial Analysis, Elsevier, vol. 89(C).
    20. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:139:y:2024:i:c:s0168851023002518. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.