Real-time monitoring and evaluation of the VaxCash program: A Case Study from Columbus, Ohio

Background: The prevention of severe outcomes due to SARS-CoV-2 infection among vulnerable populations is an important public health goal. The purpose of our study was to report on the implementation and evaluation of an innovative public health prevention program. This program aimed to reduce the projected gap in COVID-19 vaccine uptake between more and less vulnerable neighborhoods by addressing issues around access and trust among communities at high risk for COVID-19 positive cases, hospitalization, and death. Methods: Columbus Public Health implemented the Vax Cash program in Columbus, Ohio, from July 6, 2021, to August 22, 2021, based on regular community feedback and using a data-driven approach. The program provided a financial incentive to eligible individuals upon receiving their first dose of a COVID-19 vaccine. A time-series model was used to create short-term forecasts for COVID-19 vaccine uptake for neighborhoods in and around the 10 clinics in the program. These projections were compared with the observed uptake as the program was implemented over a 6-week period. Results: Seven out of ten sites showed an increase in the observed COVID-19 vaccine uptake in and around the sites compared to projected uptake values. We observed a rapid increase in uptake among Black residents and a reduction in the Black-White vaccine uptake gap in and around the Vax Cash sites. Conclusion: Vaccination rates increased in areas of high social vulnerability through the Vax Cash program. Similarly designed programs could be applied to achieve other public health prevention goals.