A Social Media Campaign to Promote COVID-19 Vaccination: Cost-Effectiveness Analysis (Preprint)

<sec> <title>BACKGROUND</title> Vaccine hesitancy has increased in recent decades internationally, which sets up a critical barrier to the rapid deployment of novel vaccines against infection with SARS-CoV-2. </sec> <sec> <title>OBJECTIVE</title> This study used a quasi-experimental design to evaluate the cost-effectiveness of a social media intervention to reduce COVID-19 vaccine hesitancy implemented in Nigeria in 2022. </sec> <sec> <title>METHODS</title> The intervention targeted health care providers and adults from the general population who were users of a specific social media platform. We used published estimates from a quasi-experimental evaluation of the campaign’s effectiveness compared to the status quo across 6 intervention states and 31 comparison states over a 10-month period. We estimated the cost-effectiveness of the campaign in terms of cost (2022 US dollars) per person vaccinated using a decision tree analysis and probabilistic sensitivity analysis. </sec> <sec> <title>RESULTS</title> On the basis of the quasi-experimental trial, the campaign led to a crude 6.4–percentage point increase (219/692, 31.6% vs 117/463, 25.3%; &lt;i&gt;P&lt;/i&gt;=.045) in vaccination rates and an adjusted 7.8–percentage point increase (95% CI 1.68-14.2; &lt;i&gt;P&lt;/i&gt;=.02) controlling for age group, gender, educational level, religion, and occupation among the 20% (1933/9607) of the overall sample who were unvaccinated and in the persuadable middle. Scaled to the overall population, the campaign led to a 1.57–percentage point (95% CI 0.337-2.87; &lt;i&gt;P&lt;/i&gt;=.02) increase in the proportion of those vaccinated against COVID-19 among those reached by the social media campaign. The social media campaign resulted in 58.3 million impressions and 1.87 million people reached for a total societal cost of US $1.15 million, or US $0.61 per person reached. This resulted in an incremental cost-effectiveness ratio of US $54.70 (95% uncertainty interval US $20.90-$163) per person vaccinated. </sec> <sec> <title>CONCLUSIONS</title> A social media–based campaign to address COVID-19 vaccine hesitancy in 6 states in Nigeria resulted in an increase in vaccination rates. The cost-effectiveness of the campaign compared to no campaign is comparable to that of other campaigns promoting COVID-19 vaccine uptake. The cost per person vaccinated due to the social media campaign was 1% to 8% of the estimated cost per life year saved by vaccination against COVID-19 in low- and middle-income countries. Investing in social media campaigns would likely be a cost-effective approach to increase vaccine uptake and save lives. </sec>