Washington: The first incentives were relatively modest: doughnuts, hunting licenses, baseball tickets. And cheeseburgers. Beer. Whiskey. Maybe even a savings bond, enough to buy a nice toaster someday.
The United States has a surplus of coronavirus vaccine doses on its hands, and long gone are the days when people waited hours to get jabbed. Dwindling demand has forced governors and mayors to get creative.
New York Mayor Bill de Blasio, a Democrat, tried to market the vaccines by offering burgers and fries from Shake Shack, which he dutifully, awkwardly ate on camera while trying to keep a straight face.
Now, Ohio Gov. Mike DeWine, a Republican, has upped the ante. He’s offering $1 million to five adults, provided they are vaccinated. That’s $1 million each.
They’ll be chosen by lottery once a week, starting May 26. Separately, he’ll hand out full-ride scholarships at a public state university to five vaccinated teenagers.
“There’s something magical about a million dollars,” DeWine said in an interview. “I’ve had people call me up today and say it is a crazy idea. I’ve had people say it’s a great idea.”
What it’s not: a magic wand. Public officials such as DeWine are desperate to crush the coronavirus pandemic and get their economies wide open, but they’re faced with what is known blandly and simplistically as vaccine hesitancy.
In Ohio, DeWine’s million-dollar lure appears to have had mixed success.
At Ohio State University in the capital, Columbus, traffic at vaccination sites was up Thursday, said Crystal Tubbs, associate director in the pharmacy department.
“In the first hour of today’s clinic, we saw six times the volume of patients per hour than we did last night,” Tubbs said. “If you would have asked me a week ago, I would say we were at a decline in terms of interest in the vaccine. This, quite frankly, was an unexpected boost. I’m curious to see if it holds out over time.”
The governor’s offer has raised questions.
Some health-care workers have noted that people who recently had COVID-19, the illness caused by the coronavirus, are not eligible to receive a vaccine, she said.
Muted reaction
Meanwhile, in southwestern Ohio’s village of Camden in Preble County, population 2,000, reaction to the prospect of getting a prize of $1 million for being vaccinated was muted.
The town is home to a large population of German Baptist Brethren who live modestly and conservatively and are often confused by outsiders with the Amish because of the similarity in their dress.
Camden Village Pharmacy is one of two vaccination sites in the county. Only the Johnson & Johnson shot is dispensed there. Pharmacist Carol Perry said the demand for the vaccine has decreased over the past month, and DeWine’s announcement had not boosted turnout - at least on the day after the announcement.
“It’s been no more busy than usual,” Perry said.
When the vaccine was first available, she and pharmacy staffers averaged 80 shots a day. Now, they’re down to about five.
“But maybe it will pick up once word gets out more,” Perry said. And, perhaps, the motivation of money is moving the needle in Preble County. By the end of Friday, the pharmacy had reported 10 vaccinations, the most since things slowed down a month ago.
Camden resident and retiree Mark Glidden, 66, was mailing a letter at the post office by the pharmacy. He has already been vaccinated and did not think the prize would do much to persuade people who were staunchly opposed to getting a coronavirus vaccine.
“But I think it could bring in people who are sitting on the fence,” Glidden said.
At a mobile vaccination clinic in the southwestern part of Montgomery County, Ohio, four people had just received a vaccine dose Thursday. Not one was spurred by the million-dollar lottery prize.
Nor did two mechanics walking by show any interest in the governor’s lure.
“It is a lottery. The chances of winning it are slim to none,” said Chris Cusick, 31, who said he has no plans to get vaccinated.
“I would like to see it on the market longer before I get it,” said Brad George, 37, another mechanic.
Americans are divided into three main groups when it comes to the coronavirus vaccines. The “yes” group is made up of those who have gotten vaccinated or are eager to, representing about 65% of adults, according to a Kaiser Family Foundation survey conducted in April. Those in the “no” group - 13% - say they definitely will not get vaccinated. The “maybe” group - 21% - are in “wait-and-see” mode or would get vaccinated if required.
Politics a factor
There are other ways to slice and dice the hesitancy. Politics is a factor. The pandemic has long been mired in polarising ideological battles, and some people view not getting vaccinated as a political statement. In surveys, Republicans are more likely than Democrats to be averse to vaccination. States in the Deep South are generally trailing behind the national average in their vaccination rates.
Some people are not hesitant so much as busy and need a nudge. Or they’re isolated in remote Zip codes and need a compelling reason to travel to a vaccination site. And some are still unsure about the safety of the vaccines. DeWine refers to these people as the “persuadeables.”
They stand in contrast to the hardened “anti-vaxxers” who subscribe to discredited theories about the safety of inoculations generally.
As officials and vaccine advocates across the country have tried to imagine what would make people get inoculated, they’ve focused less on money and more on things people really enjoy. Fun stuff.
New Jersey Gov. Phil Murphy, a Democrat, has endorsed a “Shot and a Beer” incentive programme, in tandem with breweries, in which people who get a first vaccine dose will get a free beer.
In the District of Columbia, a group called DC Marijuana Justice gave away more than 4,200 joints at vaccination sites on April 20. In Memphis, Tenn., a “Shot for Shot Sweepstakes” offers a free car to a lucky winner with an official vaccination card. And at a southern Illinois recreational shooting facility, anyone getting a shot from a mobile vaccination unit there can receive 100 targets of trap, skeet or sporting clays.
One state that is not offering cash or college tuition - or any other goody - is Pennsylvania. It developed its own incentive: If 70% of eligible people got their shots, the state would lift its mask mandate for everyone.
That incentive now looks less generous, given new guidance on masking from the Centres for Disease Control and Prevention. On Thursday, the agency said fully vaccinated people did not need to wear masks indoors or outdoors in most situations. Will that make people more likely to get a shot? It’s unclear.
Surveys suggest that relaxing guidelines on masks and social distancing will have a minimal effect on willingness to get vaccinated. An Economist-YouGov poll found that this could be because vaccine skeptics are already less likely to obey those guidelines in the first place.
Monetary reward
Cash is a different story.
In an ongoing study by University of California at Los Angeles researcher Lynn Vavreck that involves more than 75,000 people, more than one-third of unvaccinated people said they would be motivated by a monetary reward. More were swayed by $100 than $25.
The bottom line is that incentives have been shown to work, said Noel Brewer, a University of North Carolina professor who studies the intersection of public health and human behaviour. Studies show that vaccination uptake increases by a median of 8 percentage points when people are offered incentives, Brewer said.
The Biden administration is getting into the game. It has teamed up with some of the country’s largest corporations to offer incentives. The deals include 10% off a grocery bill at Safeway or Albertsons, a $5 Target coupon, and a free snack or beverage at a Vitamin Shoppe.
President Joe Biden set a goal: 70% of adults with at least one vaccine dose by July 4. As with previous goals, the administration picked one that’s achievable, possibly well in advance of the target date. The CDC reported Sunday that 59.8% of adults had received at least one dose. About 26 million more people need a shot for the country to reach the 70% goal. That would require about 540,000 newly dosed people a day on average. The country in recent days has been administering close to 2 million shots daily.
In Seattle, the city government this month began to offer free food at pop-up vaccine clinics that target holdout populations. Don Blakeney, executive director of the U District Partnership, a business development group in the area that helped sponsor a vaccine clinic, said the incentives were there to give “a little nudge.”
“They are not there to persuade people who will never ever get the vaccine, but really for community members who just haven’t found the time,” he said.
Maine Gov. Janet Mills, a Democrat, announced the state’s public-private initiative - titled “Your Shot to Get Outdoors” - during a Tuesday discussion with Biden and fellow governors.
The collaboration between the state and companies such as L.L.Bean and Oxford Plains Speedway will offer newly vaccinated adults incentives such as fishing, hunting licences, tickets to watch the Portland Sea Dogs minor league baseball team.
“A whole lot of people are sitting on the fence,” said John Hebert, chief pharmacist of Hebert Rexall Pharmacy in rural Van Buren, Maine.
The dramatic move by Ohio’s governor to offer high-dollar incentives has already drawn criticism, with state Rep. Jon Cross, a Republican, calling it “game-show gimmicks” and state Rep. Emilia Sykes, the top House Democrat, calling it a “grave misuse” of federal relief funds.
Andy Slavitt, a Biden adviser on the virus, said he supports the attention to vaccines that the lottery brings. He told CNN that the Treasury Department has not looked into whether this is an appropriate use of federal funds.
In Cleveland, patients trickled into walk-in vaccination sites Thursday after DeWine’s announcement. At the Wolstein Center, an arena downtown where National Guard members have presided over a mass vaccination site since March, staffers far outnumbered patients. The site in recent days has administered a few hundred doses, a far cry from the 6,000 distributed daily when it opened. Numbers rose modestly Thursday and Friday - after DeWine’s announcement - compared with Wednesday, but they were lower than on Tuesday.
Chance of a million
Maj. Kim Snow said her sister’s husband had not been vaccinated, but “maybe that chance of the million will get him on board.”
At a Rite Aid in the St. Clair-Superior neighbourhood, where three-quarters of residents are Black and virus vaccination rates are low, nine of the 10 parking spaces reserved for people getting vaccinated sat empty.
Inside, Lana Davis, 64, said that she was nervous about getting vaccinated but was motivated because she works as a home health aide, and that her family members had encouraged her. The governor’s million-dollar prize played no role: “I think it’s crazy,” she said.
Lyria Ford, 68, said her family was a bigger factor than the vaccination lottery in helping her overcome her fear of the side effects.
“I’ve got, like, 30 grandkids,” she said. “I don’t want to not be around them.”
About the cash prize, she added: “I’m not going to win it.”
Columbus resident Sadea Bryant said she’s delaying vaccination until she’s comfortable that the long-term effects have been thoroughly studied. The newness of the coronavirus vaccines worries her.
“I just need a little bit more time,” she said.
She and her husband were watching television Wednesday night when they saw the governor’s announcement about the million-dollar lottery. She was not sold.
“I understand that they want to push people to really think about their health and get vaccinated,” she said. “But it feels to me kind of like a bribe.”
