Million dollar lotteries fail to overcome vaccine apathy

The states running the lotteries hoped they could push a group of persuasive refractories to get vaccinated and reduce the risk of further waves of infection in pockets of the country with less protection against the coronavirus. Even as the nation slowly approaches President Joe Biden’s goal of vaccinating at least 70% of adults, public health officials have increasingly warned that these areas are more at risk from the highly transmissible variant and most severe of the Delta virus, which was first identified in India and now accounts for at least 10 percent of total cases in the United States.

“I certainly don’t see things getting better if we don’t increase our immunization rates,” said Scott Allen, co-administrator of the Webster County Health Department in Missouri, where an outbreak caused by the Delta variant has caused infections and daily hospitalizations have almost doubled in the past two weeks.

Daily new cases of Covid have essentially peaked at just below 15,000 for more than a week after dropping dramatically this spring as the country’s vaccination campaign gathered pace. The number of people receiving their first dose fell from just under 2 million in mid-April to 360,000, the lowest for the whole year.

It was the teens who backed the numbers, with 12-15 year olds taking 25 percent of the country’s shots since they became eligible last month, though they only make up 7 percent of the population. , according to federal and state data.

This has raised questions about the effectiveness of the state’s efforts to offer marijuana, alcohol, and cash rewards to attract adults, with little success.

Ohio got the most bang for its buck. Republican Gov. Mike DeWine’s announcement in mid-May that five adults would earn $ 1 million each week has garnered renewed national attention, and the number of Ohioans receiving an injection has increased by about 40% in the country. over the next 10 days. Four weeks later, however, the number of people receiving daily doses is lower than when DeWine made the announcement, according to the POLITICO analysis. And despite the lottery bump, the state continues to lag behind the national average in the proportion of adults who received a first dose.

Dan Tierney, spokesperson for DeWine, said the governor’s team did not expect the bump to last over the five weeks of the lottery, but added that the increase seen in the days since follow-up the ad exceeded expectations.

“It changed the tenor of the conversation,” Tierney said. “The discussions on the coronavirus had been tough. If you’re trying to persuade people… you want them to feel good about their decisions.

Oregon Democratic Governor Kate Brown announced a million-dollar-a-week award after DeWine, and state officials said there had been an uptick in adoption in counties from the East, more conservative. But overall, the lottery has done little to stop the decline in interest in vaccines, according to POLITICO analysis.

Charles Boyle, spokesperson for Brown, said the lottery was just one effort among many and was never expected to have a disproportionate impact.

“No individual strategy should have a singularly massive impact or completely reverse the trends in vaccination rates,” he said. “Each strategy adds a bit of energy to the overall effort. And when you look at the data, we see a more stable vaccination rate compared to many of our neighbors. “
Ashby Monk, a Stanford researcher who helped design the Oregon Vaccine Lottery, said the state had hoped to capitalize on media gained by being the first to roll out the new idea, but was beaten in the fist by Ohio.

Even though the Oregon Lottery had a more marginal effect, Monk still thinks the effort was worth it, as his research consistently shows people overestimate lottery prizes relative to the cost of setting them up.

“There is an advantage to being the first, people were blown away by the concept,” said Monk. “It’s always nice to see a slight uptick, but the point of these programs, if I’m being honest, is to keep the declines from being faster and bigger. ”

This is largely why governors continue to experiment with incentives. On Wednesday, Democratic Governor of Maine Janet Mills announced a raffle with a twist: the price goes up by $ 1 for every person vaccinated in the state.

“If it helps reverse the direction of the rate cut, that’s the best, but if it just doesn’t lower the rate further, that’s also a victory,” said Nirav Shah, director of the Center. Maine disease control. and Prevention. “When you compare the money spent versus the benefit of getting a few more people immunized, it’s a winning investment. “

In New York City, the number of adults receiving their first shot jumped about 10% in the week following the announcement of a lottery in late May, about a quarter of the size of the apparent bump of the Ohio. But in the weeks that followed, the adult vaccination rate fell nearly 40%, according to CDC data.

Noel Brewer, professor of health behavior at the University of North Carolina and responsible for evaluating the North Carolina incentive program, noted that these drawings, while far from perfect, capture the people’s imagination and are among the few tolerable vaccine policies at the far ends of the political spectrum.

Democratic Governor of North Carolina Roy Cooper’s $ 1 million prize was announced last week and preliminary data from the Department of Health suggests the state’s vaccination rate, which is below the national average , will not see any news bump.

Lotteries and state giveaways appear to offer diminishing returns in part because the so-called mobile community – the group that is willing but unconvinced of getting the vaccine – is getting smaller and smaller every day.

At this point, incremental progress is probably the best a governor could hope for, said David Asch, director of the Center for Health Care Innovation at the University of Pennsylvania.

“In most of my experience using behavioral health to drive change, you capture yards on the pitch, but no single approach produces a touchdown,” he said. “Most of the changes are happening at a fairly gradual level – there are no quick fixes.”

But even though public health officials admit they are in for a long job, they say they are willing to do anything to lift the public out of its torpor.

“There are really two pandemics,” said Robb Cowie, spokesperson for the Oregon Health Authority. “A pandemic is disappearing, but among the unvaccinated there is a pandemic that is still raging. “