Are vaccine lotteries actually working? And if so, why do they bother some people?

covid vaccine lottery
Photo via Gov. Mike DeWine/Twitter

The vaccination rate increased by 28% in Ohio since the institution of a state vaccine lottery in late May. And yet Republican Gov. Mike DeWine, the most visible proponent of the lottery, is facing criticism despite the program’s apparent effectiveness in motivating people to get vaccinated. Apparently, not everybody thinks COVID vaccine lotteries are a good way to go.

As the Washington Post noted, Republican state Rep. Jena Powell called it a “PR stunt,” while the state’s House Democratic Minority Leader, Rep. Emilia Strong Sykes, declared that “using millions of dollars in relief funds in a drawing is a grave misuse of money.”

That article also discussed lotteries as a motivating tool that some state governments used in the 1700s, and while they were seen as egalitarian and chance-based systems for raising money, they fell out of favor in the 1800s due to moral concerns and public opinion turning against them.

Alexis de Tocqueville, bemoaning the burgeoning economy of pre-Civil War America, said chance was becoming an increasingly determining factor in its citizens’ economic fates, noting that the American economy resembled “a vast lottery, by which a small number of men continually lose, but the state is always the gainer.”

One question around COVID vaccine lotteries has been whether people are really swayed by them, as there are distinct segments of the U.S. population who are pro and anti-vaccine. Ohio has anecdotal evidence that it does work, based on Amazon worker Jonathan Carlyle, who won the second Vax-a-Million prize on June 2.

“I was putting it off a lot because I was working all the time, and I just kept putting it off and off and off, but I knew I needed to get it and I wanted to get it,” Carlyle told the Cincinnati Enquirer. “When y’all announced the Vax-a-Million, as soon as I heard that, I was like ‘Yes, I need to go do this now.'”

Adam Rogers, writing on the psychology of lottery vaccines for Wired, remarked, “If someone hasn’t gotten one yet, maybe they’re just an anti-vaxxer, in which case, a lottery ain’t gonna help. But different kinds of hesitancy are sensitive to different kinds of interventions. Some people—like in the Black community—have historical reasons to distrust the medical establishment, and that requires a different kind of outreach to fix. And some people, maybe they’re busy, or they procrastinate, or they’re worried about side effects, or they’re anywhere else on the spectrum of hesitancy. Some motivational change might, well, nudge them to get a shot.”

Robert Williams, a professor in the faculty of health sciences at the University of Lethbridge and a research coordinator for the Alberta Gambling Research Institute in Canada, also opined on the matter for an ABC News story, noting that, “It’s actually very clever, in a way.” He explained that humans aren’t used to remote outcomes, which makes it hard for them to comprehend how remote the chances of winning might actually be.

He observed that those who are hesitant to get vaccinated because they fear unlikely side effects might actually be “optimally suited” for a vaccine lottery incentive, according to Williams.

“If you can convince yourself you have a realistic possibility of winning the lottery, you may be the same kind of person who has an unrealistic view of blood clots,” he said. “You’ve given disproportionate weight to unrealistic outcomes.”

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Sources: Washington Post, Cincinnati Enquirer, Wired, ABC News

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