Implementation Guide: Incentivized Peer Referral Approach for COVID-19 Vaccination

"...research in Côte d'Ivoire suggested that encouragement from a friend or family member can motivate a person to overcome their hesitation, however, few newly vaccinated people discuss their vaccination experience with their social network."

This document describes an approach to expanding COVID-19 vaccination that FHI 360 piloted in Côte d'Ivoire. This approach involves recruiting newly vaccinated individuals as peer mobilisers, who receive referral coupons as a reminder to share their vaccination experience with others. The practical guide is designed for implementers seeking tools to replicate or modify the approach in contexts affected by vaccine hesitancy.

The guide begins by explaining the problem: In many communities, segments of the population are hesitant to receive the COVID-19 vaccine due to rumours, fears, or a lack of perceived need; however, they are not necessarily resistant to vaccination. Most programmes do not have the financial or human resources to identify and reach these individuals. As FHI learned in Côte d'Ivoire, peer mobilisers can be encouraged to share their experience with their social network, helping to dispel rumours and fears about vaccine safety and reinforcing the perception that vaccination is increasingly widespread within the community.

Next, the guide outlines the roles of implementation team members and details key decisions and actions for implementation. It also offers lessons learned - e.g., "Gain the trust and support of local authorities and partners by providing them with regular updates on the program and answer questions to allay concerns about coercion and sustainability" - and implementation tools, such as a sample recruitment script.

The approach detailed in this resource was adapted from FHI 360's Enhanced Peer Outreach Approach (EPOA), which was developed under the LINKAGES Project and later expanded through the Meeting Targets and Maintaining Epidemic Control (EpiC) Project, both with support from the United States Agency for International Development (USAID).