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State Lotteries Didn’t Help Boost Vaccination Rates

The report was published online Oct. 15 in JAMA Health Forum.

Dr. Kevin Schulman, a professor of medicine at Stanford University’s Clinical Excellence Research Center in Palo Alto, Calif., thinks lotteries were worth trying.

“Lotteries were important tactics to try and increase vaccination at a state level. Many of the states implementing lotteries were ‘red’ states, so I’m grateful that the Republican leadership began to get engaged in vaccination efforts. In the end, a tactic is not a communication strategy,” Schulman said.

Communication tactics should be tested and evaluated to see if they are effective, Schulman added. “However, if a tactic fails, you need to implement other approaches to vaccine communication. In many cases, the lottery was a single effort and when it didn’t have the intended effect, we didn’t see follow-up with other programs,” he said.

Another expert isn’t surprised that offering money to people to go against their beliefs doesn’t work.

“Most people make health choices weighing the risks, costs and benefits. In the case of vaccines, many chose to get vaccinated, as they value leading a long, healthful life,” said Iwan Barankay. He is an associate professor of business economics and public policy at the University of Pennsylvania’s Wharton School, in Philadelphia

“Those who did not get vaccinated were not swayed by those precious health benefits, so it seems illogical that a few dollars in expected payouts could convince them otherwise. The result that small incentives do not affect health outcomes has been replicably shown in multiple recent clinical trials,” he explained.

Also, a recent randomized field experiment in Philadelphia that varied incentives to get vaccinated also showed no effect on vaccination rates, Barankay said.

“There are, however, real socioeconomic and cultural barriers which lead people to avoid vaccines based on their preferences or experiences – but again, small dollar amounts won’t be able to address these,” he added.

It is the experience of seeing friends, family and colleagues becoming sick, and the gains vaccine mandates bring in vaccination rates that make a difference, Barankay said.

“It is important to continue the effort to show people real data from their communities on the hospitalization rates of vaccinated versus unvaccinated people, and how mandates inside companies reduce COVID case numbers due to an increase in vaccination rates,” he said.

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