Taken collectively, the experiments suggest previous findings demonstrating increased vaccination intentions due to financial incentives may be context specific and may not fully generalize outside of the context of those studies. The risk of a “backfire” effect suggests that it is prudent to systematically pretest incentive programs in novel settings.

# Context

Vaccination campaigns against COVID-19 in Central Asia began from February to April 2021 and were focused first among high-risk groups. By March 2021, widespread vaccination campaigns had begun in all three countries, with Kazakhstan typically leading in terms of the share of the target population vaccinated.

Different vaccines were available in each of the three countries, and among those who planned to be vaccinated, preferences varied substantially. In Kazakhstan, there were three main vaccine options available at the time of the study: QazCovid, produced in Kazakhstan jointly with Chinese manufacturers, Sputnik V, produced in the Russian Federation alongside some local production in Kazakhstan under license, and Sinovac, produced in China. Survey results show that Sputnik V was the most trusted option, particularly when manufactured in the Russian Federation. In Uzbekistan, four different vaccines were available. The first on the market was ZFSW, a locally produced vaccine, followed by AstraZeneca and Sputnik V (imported from producers in Russia). These were later supplemented with the Moderna COVID19 vaccine through the COVAX platform in late July 2021. In Tajikistan, the COVAX platform first supplied the AstraZeneca vaccine, follow by shipments of Sinovac, a small number of Sputnik V doses, and later the Moderna vaccine.

Panel surveys conducted throughout the COVID-19 pandemic by the World Bank in Central Asia (see details in the following section) revealed a varied and complex set of challenges to achieve widespread vaccination. In June 2021, only 40 percent of respondents in Kazakhstan said they were either already or planned to be vaccinated, compared to 43 percent who would “definitely not” be vaccinated (Table 1). In the same month, at 54 percent, the share in Uzbekistan open to vaccination was consistently higher than Kazakhstan, but still below levels needed to minimize future outbreaks. Of the three countries surveyed, Tajikistan’s respondents were on average most open to being vaccinated against COVID-19, with between 80 and 84 percent willing in summer and autumn in 2021. But due to limited supply, Tajikistan struggled with the lowest vaccination rate among the three in 2021 at the time of the survey experiment.

However, despite relatively high rates of hesitancy when campaigns began in early 2021, vaccination uptake and intentions to be vaccinated have consistently improved, and hesitancy has fallen throughout the region. In Kazakhstan, about 80 percent of adult respondents said that they were either vaccinated or “definitely” would be in June 2022. By that time, the share of people who said they “definitely” would not be vaccinated had fallen from 47 percent of respondents in April 2021 to just 15 percent in June 2022.

Very similar trends were clear in Uzbekistan. There, the share who said they “definitely would not” be vaccinated fell from about 20 percent in April 2021 down to 12 percent in April 2022. The share of saying that they were either already vaccinated or would definitely be rose to 74 percent of adult respondents by April 2022.

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