Eligibility for COVID-19 Vaccine Incentive Initiative:

  • 18 years of age and older
  • Eligible for the COVID-19 Vaccine
  • Have a significant disability
  • Not have received the vaccination prior to December 1st of 2021
  • Must be a Kern County Resident
  • Must become fully vaccinated to complete the program and receive the incentive:  
    • Either receiving one dose of the Johnson and Johnson Vaccine
    • Or, receive two doses of Moderna or Pfizer

Program Procedures
Please note that since the COVID-19 vaccination is offered to the public free of charge, ILCKC will not pay for any costs incurred in receiving the vaccination, including transportation or administrative fees.

Proper documentation is required to ensure that participants meet the above eligibility requirements and that demographic information is recorded for reporting purposes. Upon enrollment in the Vaccination Initiative Incentive, participants will need to provide the following:

First and Last Name

Date of Birth


Phone Number

Physical Address


Disability (self-disclosure of a significant disability)

Participants will fill out an enrollment form that collects the above
information and includes a three-question survey to determine Medi-Cal status, if they are an SSI recipient, and annual income. This information is collected for reporting purposes to our funders (all personal identifiers are removed prior to reporting information to funders—All data is reported anonymously to funders). The Participant will also sign the COVID-19 Vaccination Incentive Initiative Terms and Conditions.

The participant is required to submit a copy of their COVID-19
Vaccination Record Card after receiving either their single dose of the Johnson and Johnson vaccine, or their second dose of the Moderna or Pfizer vaccines. Upon successful receipt of the participants completed COVID-19 Vaccination Record Card and with a valid form of identification, participant will be provided with $50 in gift cards from various local stores.

**The participant will have choice in their gift card, while supplies last.
The Vaccination Incentive Initiative is performed on a first come, first served, basis.

Application for COVID-19 Vaccine Incentive Initiative

Do you receive SSI?(Required)
Are you enrolled in Medi-Cal?(Required)