Promoting large scale COVID-19 vaccination in India

The objective of the proposed study is to identify the most effective strategy to promote large scale vaccination among adults in India. Towards this end, the eligible sample of unvaccinated individuals will be randomly assigned to a control group or one of the five treatment arms. There will be five treatment groups: Information will be disseminated about the available vaccines, benefits, and costs associated with getting vaccinated via awareness campaign from a reliable source to all the five treatment groups. While the first treatment group will receive only the information treatment, the other four treatment groups will receive another additional intervention each. Thus, in addition to the information campaign, the other four treatment groups will receive one of the four different interventions (sure gift vis-à-vis lucky draw vis-à-vis accessibility vis-à-vis campaign to address misconception via an ambassador) to isolate the effect of each of the different treatments. The five different treatments that we will focus on in the proposed project are as follows: Treatment 1 (T1): Information campaign only. In this treatment, participants will receive basic information about the available Covid19 vaccines and the benefits of having it to protect from Covid19 for themselves and for their loves ones. The information will be delivered verbally by the field workers on behalf of the researchers to each participant based on a 1-page information sheet (maximum time will be about 10-15 minutes) and the information will be designed specifically for this study based on the information provided from reliable sources such as WHO as well as national health ministries. Treatment 2 (T2): Information + sure gift worth INR 400 (i.e., $6 approx) conditional upon vaccination in order to compensate them for lost daily wages due to travel and forgone earnings for additional day's work in case of any side effects that may arise. Our enumerators will give respondents the gift within two weeks upon confirmation of vaccination (e.g., physical or digital vaccination certificate). Treatment 3 (T3): Information + participation in a lucky draw with a 5% chance of winning a gift worth INR 8,000 ($120 approx), conditional upon vaccination. The expected value from this lucky draw will be the same as the sure payment treatment (Treatment 2). Our research team, including enumerators and field coordinators, will be involved in drawing the lucky draw each month, determine eligible participants (i.e., respondents confirmed to have received vaccine), and deliver the gifts to the winner. Thus, as part of the lucky draw one out of 20 individuals (who participated in the study, got the information from us and got vaccinated) will be randomly selected by the research team to receive a gift worth INR 8,000. The gift will be made available to the winner within two weeks of the lucky draw results being declared. Treatment 4 (T4): Information + Accessibility (helping them with registration/enrolment, travelling to get vaccinated, and reminding/encouraging them to get vaccinated at the right time via brief telephone reminders). In addition, a gentle and brief reminder will be provided both through a phone call as well as a SMS about two weeks after the intervention is delivered. We will help the target group with the registration procedure and will track their progress from registration to vaccination, reminding them to get vaccinated (all free of cost). They will also be provided help with identifying the nearest vaccination center and travelling to the same, and any transport cost using the most convenient travel mode as well as any other logistics needed to travel to get vaccinated, as locally available. Treatment 5 (T5): Information + campaign/motivation by eminent figures in the community (e.g., village leaders, teachers, doctors, etc). We will approach village leaders, elders, shopkeepers, teachers, doctors to identify the most respected and trusted eminent figure in their community (e.g., religious leaders, teachers, doctors) and ask him/her to campaign and propagate information to address misconceptions related to the available vaccines. The selected individuals (leaders) should already be vaccinated. Campaigning by eminent figures will start as soon as he/she is selected, as around the same time with other treatments. Specifically, the selected eminent figures (we call them 'Ambassadors') will be asked to campaign and propagate specific information (in addition to basic information being provided to all) to address misconceptions related to the available vaccines. Ambassadors will speak with the unvaccinated selected individuals one-to-one by visiting them while following strict health protocols (e.g., every respondent and ambassador will wear mask, maintain 1.5 meters between individuals, open air space), and try to convince them to get vaccinated. The meeting will occur once during the campaign period (1 month) and each meeting will last for a maximum 1 hour. The campaign will be based on context-specific information and guidelines provided by the central and local government bodies and will dispel misperceptions about the disease, the available vaccines, distribution of infection and fatality rates and improve knowledge about COVID-19 prevention and transmission etc. In addition, to enhance information retention about the information session, the ambassadors will deliver a pamphlet that summarizes key information about COVID-19 vaccines. The control group on the other hand will receive no such information campaign about the vaccines or any specific incentives. The research team will visit the participants about one month after the intervention to verify their vaccination status. They will be visited again one month after the first verification to update the vaccination status and conduct the endline and spillover surveys (which will ask randomly selected individuals from the villages about their vaccination status- to understand if the intervention also influenced other people to get vaccinated). The vaccination status will be verified using the registration information and text messages sent by the govt's department of public health confirming the dose of the vaccine and the date being vaccinated. We will select a total of 884 locations (villages) and on average about 9 individuals from each of these locations. From each household, we will focus on adult individuals who are eligible for COVID19 vaccine free of cost and are unvaccinated. Only one participant will be recruited for the purpose of the survey and the intervention from each household. Randomization into treatment and control groups will be done next at the village level. About 8,000 selected individuals identified from the 884 locations will be randomized (using a computer program), with 295 locations in the pure control (T0), 103 in information campaign only (T1) arm, 124 locations in T2, 133 locations in T3, 118 locations in T4 and 111 locations in the T5 arm. All these changes were made prior to enrolment commencement