The Problem

There’s a Covid vaccination problem in the US, and it’s a very different one than the rest of the world faces. Unlike many nations, the US has enough vaccine to inoculate its citizens.

Yes there’s a problem with refusers, some of whom claim some pretty crazy things. IF you want to see this in action look no further than this video.

But there is a large number of citizens who are vaccine hesitant, or just can’t get motivated to get their shot. What can agencies, both public and private, that are concerned for public health do to encourage these people? Below I look at the initiatives – some imaginative, some obvious –to overcome vaccine reluctance.

Show me the Money

A number of economists and politicians have proposed direct cash incentives of up to $1,500. This obviously is designed to appeal to what Kahneman calls System Two. Proponents of these direct cash incentives include two former presidential candidates, Andrew Yang and John Delaney. And they’re having some success.

A variation on the direct benefit approach involves lotteries. Several states have created lotteries that only vaccinated people can enter:

• New York: parents can enter a draw on behalf of their children for university scholarships.
• Ohio: “Vax-a-Million” lottery for $1 million cash prizes
• California: “Vax for the Win” offers prizes ranging from $50 (2 million winners) to $1.5M (10 winners).
• West Virginia: prizes here include cash, trucks, hunting licenses, and, in a seemingly unironic initiative, guns.

Non-financial Approaches

Perhaps more interesting than the cash motivators are the non-financial approaches being used to encourage vaccination. Many of these are what we in the decision science community call nudges. A nudge is defined as “any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives.”  Here are a few examples of what government agencies and companies are doing to encourage vaccination:

Nudges offered by Public Entities and Charities:

• Residents of Washington state are now eligible for a free join in the “Joints for Jabs” campaign, where participating dispensary owners will provide a marijuana cigarette to people who receive a vaccine at the in-store clinic.

Not to be outdone, Arizona has created a program that allows vaccinated individuals to choose between rolled joints and edible CBD gummies. (Gummies are edible candies that contain cannabidiol (CBD) oil.)

• New Jersey is offering a “Shot and a Beer” program where individuals who have recently received either their first or second injection are entitled to a free beer:

• For the food-motivated, a multifaith cultural arts center in Los Angeles is offering a free bag of produce to anyone who visits their free vaccine site.

Nudges offered by the Corporate Sector

While it’s not as healthy as a bag of produce, the Krispy Kreme company is offering a free donut to anyone who presents a vaccination card:

There is likely additional benefit for a corporation like this endorsing the vaccine, as it often operates in areas where vaccination rates have lagged.

The ride-sharing services Uber and Lyft are providing free rides to vaccination sites. In a country where public transit is often lacking, this is especially important to engage those who are remote and need a jab.

Get a Vaccine and Get…  A Date?

Another vaccination nudge in the corporate section is coming from dating apps including Tinder, OkCupid, and Hinge, which collectively reach over 50 million people in the US alone. These apps are now promoting the idea that getting a shot could help users get a date. Additionally, Tinder plans to launch a “Vaccine Center” to help users find nearby vaccination sites.

Policy Nudges

While it’s too early to determine the effectiveness of any of the nudges thus far, there is a policy nudge that does provide some data. As states have begun to relax their masking and social distancing guidelines, this has provided researchers with the unique opportunity to frame the question: “Would the relaxing of said guidelines make you more likely receive the vaccine?” The U.C.L.A. COVID-19 Health and Politics Project found that, in general, relaxing the mask and social distancing guidelines increased vaccine uptake likelihood by 13 points. Interestingly the largest gains came from Republicans, who reported an 18-point increase in willingness to get vaccinated, perhaps because mask-wearing and other public health policy has been perceived as an undue infringement of personal liberty by conservatives.

Next Steps for Nudging

As the campaign to vaccinate as many people as possible continues, we’ll continue to analyze the effectiveness of various vaccine-inducement strategies, including cash payments, lotteries, and non-financial. While not a single point solution, the non-financial incentives described above have the potential to nudge a number of people towards the needle.