Study: As states move to mandates, vaccine incentive programs still valuable

Dec. 9 (UPI) -- COVID-19 vaccine incentive lotteries encourage people to get shots in some parts of the United States, but not in others, moving researchers to suggest they still have value as the country shifts toward mandates, a study published Thursday by JAMA Network Open found.

Entering vaccine recipients into lotteries for potential cash prizes of at least $1 million boosted inoculation rates across all states that implemented the programs by 23%, the data showed.

However, considerable variability existed among the 11 states that employed these incentives, the researchers said.

For example, Ohio, the first state to create a lottery to increase vaccination rates, called "Vax-a-Million," saw about an 11% uptick in people who received the shots after the program was implemented, according to the researchers.

However, vaccination rates in states such as Arkansas, Kentucky and West Virginia continued to decline even with these incentives.

The findings are significant, given that many states, including California and New York, as well as some employers and academic institutions, are requiring people to get vaccinated as opposed to rewarding them for doing so, the researchers said.

Some states, on the other hand, have increased unemployment benefits for people who are fired over their refusal to receive the shots.

"Overall, we can say that these incentive programs work," study co-author Chandra Dhakal told UPI in a phone interview.

"But the programs did have a smaller effect in some states than in others, and that's because states are different culturally, geographically and socio-economically," said Dhakal, a health economist and doctoral student in applied economics at the University of Georgia in Athens.

When the COVID-19 vaccines from Johnson & Johnson, Moderna and Pfizer-BioNTech became available earlier this year, 11 states instituted lottery programs as an incentive to encourage people to get the shots.

Previous research, however, has suggested that these money-based incentive programs have not been effective at boosting vaccination rates, though Dhakal notes that these studies may have only looked at one state over a limited period of time.

Through Wednesday, just over 60% of eligible people in the United States, or those age 5 and older, are fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention.

That is up from about 50% in the summer, when President Joe Biden instituted the first federal vaccine mandates, covering government employees and healthcare workers.

Since then, more state and local governments have moved away from vaccine incentives, such as lotteries, and toward similar mandates.

For example, New York City earlier this week announced plans to require private-sector workers in the city to be vaccinated by the end of this year.

Although the study did not assess vaccine mandates, Dhakal believes state-by-state differences in success rates will occur, similar to what was seen with incentive programs.

For this study, the researchers analyzed state-level daily vaccination rates for 11 states that implemented a vaccine lottery program and 28 states that did not, between March 17 and July 5.

In addition to Ohio, of the states that instituted lotteries, New Mexico, New York and Washington, at about 40%, as well as Maryland, at about 25%, saw the biggest increases in vaccination rates after launching the programs, while Oregon saw an 18% uptick, the data showed.

However, vaccination rates remained flat, or even declined, across the five other states, including Arkansas, California, Colorado, Kentucky and West Virginia, the researchers said.

"These incentive programs are effective at overcoming vaccine hesitancy at least to some extent," Dhakal said.

"For that reason, we think they have continued value, because vaccine hesitancy remains a challenge," she said.