COVID-19 Vaccine Preference and Opinion Survey (CANDOUR)

The CANDOUR Collaboration is a multi‑disciplinary research programme established in response to the COVID‑19 pandemic to address urgent global challenges at the intersection of health, economics and public policy. At the outset of the pandemic, a key research gap was the lack of robust, cross‑country evidence on how to increase vaccine uptake, reduce inequalities in health outcomes and access to care, and design policies aligned with public preferences in diverse settings—particularly in low‑ and middle‑income countries.

To address this, CANDOUR brought together researchers across economics, public health and political science to implement large‑scale experimental and observational studies across multiple countries. The programme has used a range of methods, including randomised controlled trials, cross‑country surveys and discrete choice experiments, to generate causal and policy‑relevant evidence.

A central strand of the work involved field experiments in Ghana testing interventions to increase COVID‑19 vaccination. A large clustered randomised controlled trial showed that modest financial incentives increased both vaccination intentions and uptake, with smaller incentives proving more effective than larger ones. Complementary cross‑country studies examined socioeconomic inequalities in vaccine acceptance and uptake across 13 countries, finding widespread pro‑rich inequality in both. However, inequalities in realised uptake were generally smaller than those in stated acceptance, suggesting that policy can mitigate disparities over time.

Further work explored inequalities in access to healthcare during the pandemic across 16 countries, demonstrating substantial income‑related disparities, particularly in lower‑income settings, and highlighting the potential for digital health services to reduce—but also risk exacerbating—inequality depending on access to infrastructure. Additional studies investigated public preferences for vaccine allocation, finding broad international consensus on prioritising health workers, vulnerable populations and lower‑income groups, as well as strong support in high‑income countries for donating vaccines to lower‑income countries.

Overall, the programme has generated high‑quality, policy‑relevant evidence on how to increase vaccine uptake, design equitable health policies and understand public preferences in global health crises. Findings have been published in leading journals, including Nature Medicine and PNAS, and have informed debates on vaccine incentives, equity and global vaccine distribution.

PROJECT TEAM

The CANDOUR Collaboration comprises an international, multi‑disciplinary team of researchers spanning economics, public health and political science. The team includes academics and policy‑focused researchers working across high‑, middle‑ and low‑income country contexts.