Pay-It-Forward 23-Valent Pneumococcal Polysaccharide Vaccination Among Older Adults: Protocol for a Randomized...

Area of Science:

• Public Health
• Health Economics
• Gerontology

Background:

• The 23-valent pneumococcal polysaccharide vaccine (PPV23) significantly reduces pneumonia risk in adults.
• Pneumococcal vaccination rates remain low among older adults in resource-limited areas of China.
• The pay-it-forward model offers subsidized health services and encourages community support.

Purpose of the Study:

• To assess the effectiveness of a pay-it-forward intervention on PPV23 uptake in adults aged 60 years and older.
• To evaluate the cost-effectiveness of this novel vaccination strategy.
• To explore its potential for increasing vaccination coverage in underserved populations.

Main Methods:

• A 2-arm, parallel randomized controlled trial involving 204 participants in 4 community health centers in Nanning, China.
• Participants were randomized 1:1 to either a pay-it-forward group (receiving a subsidy and donation opportunity) or a standard-of-care group.
• Primary outcome: PPV23 vaccine uptake. Secondary outcomes: costs, knowledge, attitudes, gratitude, adverse events, and recommendation likelihood.

Main Results:

• Participant recruitment and follow-up occurred from January to September 2024, with 220 individuals enrolled.
• Finalized results are anticipated in June 2026.
• The study is ongoing, and definitive results are pending.

Conclusions:

• This research will determine the effectiveness and cost-effectiveness of the pay-it-forward strategy for PPV23 vaccination in older adults.
• Findings may inform vaccination policies and offer a scalable approach for increasing immunization in resource-limited regions.
• The study contributes evidence for innovative public health interventions.