From $ 1 Million Lotteries to Free Beer: Do COVID Vaccination Incentives Work?


Want a chance to win millions of dollars? A university scholarship? A free shotgun? All you have to do is get the COVID vaccine.

As vaccination rates have slowed, a growing number of states, businesses and organizations have started offering incentives ranging from cash gifts to free beer. The need to promise such rewards in return for protection against a deadly disease can seem overwhelming, especially when so many people around the world do not have access to vaccines. But the medical community has long used incentives to influence people to take action for the good of society.

“I think the incentive for desired public health behavior is absolutely appropriate and has in fact already been shown to be [effective] in the vaccination campaign, ”says Monica Gandhi, professor at the University of California, San Francisco, School of Medicine, who has a lot of experience in using incentives to encourage healthy behaviors in the HIV community. . “Beer, donuts, million dollar lottery tickets, that’s just human behavior. “

Ohio was among the first of several states to offer a cash lottery for residents who get vaccinated against COVID. Its Vax-a-Million program awards a total of five million dollar prizes to Ohioans aged 18 and older who have received at least one dose of the vaccine. Ohio also offers opportunities for 12 to 17 year olds to get five full scholarships at any college or university in its state system. Less than a week after the program was announced, the Ohio Department of Health said vaccination rates jumped 28 percent.

New York State gives scratch lottery tickets with a grand prize of $ 5 million to adults who get vaccinated at one of its designated mass vaccination sites. And it offers 12 to 17 year olds tickets to weekly raffles for a full scholarship at the colleges of the State University of New York or the University of the City of New York system. The state also offers a seven-day unlimited use subway pass or two train tickets to people who get vaccinated at one of New York’s train station walk-in sites. And the city gives way free tickets to local attractions, such as the New York City Football Club and the Statue of Liberty.

California Vax for victory The program awarded a total of $ 116.5 million in prizes to residents who received at least one dose of the vaccine. Thirty of these winners were selected for big “$ 50,000 Fridays” in the first two weeks of June. And 10 Californians were selected to receive $ 1.5 million each on June 15. To claim their prizes, participants must complete their vaccination process (for those who had received one dose of a vaccine in two injections). Additionally, the state handed out $ 50 prepaid cards or grocery gift certificates to the first two million people to get vaccinated starting May 27.

Other states are taking even more creative approaches to persuading the unvaccinated. West Virginia is hosting a lottery with shotguns and shotguns as price. New Jersey and Connecticut offer free beer and other drinks. In May, Alabama offered people who had been vaccinated or tested for COVID the chance to ride on his famous Talladega Superspeedway. And Washington state recently began allowing retailers to offer people a free cannabis joint in exchange for a vaccine.

Private companies are also getting into the incentive craze: back in March Krispy kreme has started handing out donuts to those who present their official COVID vaccination card. Healthcare company CVS Health offers customers who get vaccinated at any of its pharmacies or other outlets the chance to win free trips, cruises, VIP tickets and Super Bowl trips, and other prizes.

“When we think of human behavior and people’s decision-making, there are two main approaches: you can have incentives, or carrots, and you can have sticks or penalties,” says Karen Sepucha, Director of Health Decision Sciences Center in Massachusetts. General Medicine Division of the General Hospital. She notes that public health experts use incentives all the time to get people to quit smoking, exercise more, etc.

In the first phase of the COVID vaccination, demand was high and people were desperately fighting over limited dates. Now that vaccines are widely available, those that are not vaccinated fall into roughly two groups: one is reluctant to be vaccinated and the other is fundamentally opposed. “The idea of ​​using incentives to get that middle group over that bump and push them is a very reasonable idea that has certainly worked in the past for those kinds of concrete short-term activities that we want to get people to do. do, ”Sepucha says.

In a study that has yet to be published, Sepucha, Lynn Vavreck, professor of politics and public policy at the University of California, Los Angeles, and their colleagues tested how well various incentives might work for the COVID vaccination . They interviewed a sample tens of thousands of people who were not vaccinated and had not yet made an appointment on their willingness to do so in different circumstances. In one experiment, researchers randomized participants into multiple groups and asked them how likely they would be to get the vaccine if they received a cash reward, with amounts ranging from $ 25 to $ 100. In another experiment, scientists asked people the same question, but instead of a cash reward, some were told that they would no longer have to wear a mask or social distancing after being vaccinated, while that others have been told that they should continue these behaviors.

About a third of those polled for a cash reward said they would be more likely to get the shot if they received it, and the percentage of those who expressed their will increased with the amount of money. The prospect of not needing to wear a mask or follow social distancing guidelines has also increased people’s reported willingness to get vaccinated. Interestingly, participants who identified as Democrats were slightly more likely to respond to the cash reward, while self-proclaimed Republicans were slightly more likely to be influenced by the lifting of behavioral restrictions.

The results are in line with a recent CNN report which found that increased interest in vaccination after the U.S. Centers for Disease Control and Prevention announced that vaccinated people would no longer need to wear masks in most situations.

“People are motivated by different things. One incentive won’t work for everyone, ”Sepucha says. Plus, such rewards only work to a certain extent, notes Vavreck. They can, for example, help influence the set of people who say they just want to see how well vaccines work on others before they feel comfortable rolling up their sleeve. But some people, including many who are highly suspicious of the authorities, will still oppose the vaccination. “No amount of money is likely to change someone’s mind [if they think] that the government is not planning anything good, ”says Vavreck.

The calculation of the risks and benefits of getting the vaccine is also different for young people, who are less likely to become seriously ill if they contract COVID. Some colleges are require students to be vaccinated before coming to campus in the fall. It’s one way of doing things, Gandhi notes. Alternatively, she says, colleges could make vaccination optional but attract students with promises of normalcy. “You could say, ‘Guess what, life is going to be normal,’ she adds. “You don’t need to hide. You can go out and have as many parties as you want.

Many employers have offered heavy incentives for workers to be vaccinated, and some are making it a requirement. But a few of these are already draw backlash.

Gandhi says she doesn’t think warrants are the ideal approach to getting people vaccinated. “I just think that positive motivating behavior is the way to get to where we need to be,” she says.

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