Lottery-based incentives do not increase COVID-19 vaccination rates

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With COVID-19 vaccinations slowing to a crawl relative to the rush that occurred when the vaccines first became available, some states and governments are offering cash and prize incentives for getting vaccinated. But when people were asked if they would be more likely to get a coronavirus vaccine if they could compete in a lottery for cash and prizes, the answer more often than not was no.

That's according to Boston University School of Medicine researchers, who found that Ohio's "Vax-a-Million" lottery-based incentive system, intended to increase COVID-19 vaccination rates, was not associated with an increase in COVD-19 vaccinations.

Prior reports in the media had suggested that the Ohio lottery increased COVID-19 vaccinations, leading other states to use COVID-19 vaccine incentive lotteries in an attempt to increase slowing vaccination rates. 

But prior evaluations of the Ohio vaccine incentive lottery didn't account for other changes in COVID-19 vaccination rates in the U.S., such as those that may have been due to the expansion of vaccination to those aged 12-15.

WHAT'S THE IMPACT?

If vaccination rates remain below the threshold needed to achieve herd immunity – in which virus spread is all but halted due to a mostly inoculated public – then hospitals and health systems could be dealing with COVID-19 cases for a long time, perhaps indefinitely.

Using data from the U.S. Centers of Disease Control and Prevention to evaluate trends in vaccination rates among adults 18 and older, the researchers compared vaccination rates before and after the Ohio lottery against other states in the U.S. that did not yet have vaccine-incentive lottery programs. 

Vaccination rates in other states served as a "control" for vaccination trends measured in Ohio, which allowed the researchers to account for factors besides the Ohio lottery – such as expanding vaccine eligibility to adolescents.

The results suggest state-based lotteries have limited value in increasing vaccine uptake, meaning the resources devoted to vaccine lotteries may be better directed toward programs that target the underlying reasons for vaccine hesitancy.

Identifying interventions that can successfully increase COVID-19 vaccination rates is a critical public health issue necessary to curb the pandemic, authors said. They hope the findings will lead to a shift in focus away from lotteries and onto further study of other programs that may more successfully increase uptake.

THE LARGER TREND

A May survey of physicians showed that doctors are working hard to combat vaccine hesitancy, even among those who have already received their first dose.

More than 72% of physicians surveyed said that patients continue to voice concerns over vaccine side effects. Still others have reported ongoing misinformation discouraging people from getting vaccines. And close to 30% of physicians reported encountering patients who have skipped their second dose due to unpleasant side effects from the first dose, or because of concerns over side effects.

A KFF survey published March 30 found that 17% of the public said they would take a wait-and-see approach before getting vaccinated. Another 20% said they would never get a vaccine or would only get it if required to do so for work, school or other activities.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com