Savings bonds, lotteries and cheap food: do vaccine incentives work?

Labor’s call for Australians who get vaccinated by Christmas to be offered a $300 cash incentive has been denounced by the government as an “insulting” and a “thought bubble” that is not necessary given the current take-up rate of vaccines.

But – insulting or not – it’s a strategy that has been incredibly popular with governments around the world throughout the pandemic. In Mei, Australia’s chief medical officer, Paul Kelly, said Australia needed “as many incentives as we can for people to become vaccinated”, and when asked about options such as lottery tickets and cash bonuses he said all ideas were “potentially on the table”.

For months, governments have been offering cash incentives, lotteries as well as gifts to citizens who opt to get the jab.

Serbia is believed to be the first country to offer a cash incentive for vaccinations, with President Aleksandar Vucic offering €25 (AU$40) to citizens who had at least one jab by the end of May.

Just last week, US president Joe Biden called for states to offer US$100 to newly vaccinated people in order to boost vaccination rates, which have begun to flag in some states. The US president also announced the federal government would fully reimburse small and medium businesses who provided paid time off for their employees to get vaccinated. In West Virginia, young people are given a US$100 savings bond to those who get the jab and Detroit is paying US$50 to those who drive another person to get vaccinated.

Elsewhere the incentives have come in the forms of goods: a gold nose pin or a stick blender to men and women in the Indian city of Rajkot; two cartons of eggs for people in some parts of Beijing; in New York, free tickets to the aquarium, zoo, theatres and sports clubs.

Food seems a popular incentive, with vaccinated Russians being given a free scoop of ice cream, while some in the US have been offered doughnuts and popcorn, and New Jersey residents have enjoyed a free drink through the state’s “shot and a beer” campaign.

In die UK, the government is working with Uber and Deliveroo to offer discounts on rides and meals for young people who get the shot, amid concerns that demand for vaccines from 18- to 25-year-olds – 60% of whom are believed to have received at least one dose – is levelling off.

Lotteries have proved popular: the state of Ohio offered adults who received at least one dose of a Covid-19 vaccine a chance to enter a lottery with prize money of US$1m. Guam introduced a “vax ‘n’ win” program to get the island’s vaccination rate above 80%, with residents entered into a draw to win US$10,000, a brand-new car and other prizes every week from mid-June until the target was reached.

CNN reported that after a Thai district introduced a campaign to allow vaccinated residents to win a cow every week for the rest of the year, the number of those registered to get the jab jumped from hundreds to thousands.

There is not a large body of research to say how effective incentives are for increasing the uptake of Covid vaccines, maar research on other vaccines has found that offering a financial incentive increases people’s adherence to the vaccine regime seven-fold.

Sameer Deshpande, associate professor of social marketing at Griffith University, said incentives will be effective for some sectors of the population.

“The incentives will work for those for whom vaccines are easily available and then they’re hesitant," hy het gesê. “I am already fully vaccinated. A person like me doesn’t need an incentive.”

Similarly, he said people who are very resistant to vaccines will not be persuaded by a cash prize. If someone had made up their mind that they considered AstraZeneca unsafe, hy het gesê, they are likely to think: “I’m not going to risk a blood clot, however small the risk is, vir 'n $300 incentive, or store coupons or frequent flyer miles or the freedom incentives we’re talking about.”

Deshpande also said cash incentives are less likely to work in Australia than the US because in Australia – which has suffered from huge undersupply of vaccine and confused messaging about the safety of the AstraZeneca vaccine – the “basics are not in place” of a successful vaccination program.

“When the US does incentives, they’re doing it from a position where vaccines are available everywhere, they have reached now the tremendous figure of 60% plus vaccination, where we are struggling with 18-19% even today. I would say that’s abysmal, it’s a failure of the government to have reached those targets. Incentives are not going to increase the vaccination rates as quickly as Labor is hoping for, because the basics aren’t in place.”

Dr Karen Price, president of the Royal Australian College of GPs, said the organisation was “open to any idea that encourages more eligible people to roll up their sleeves and get vaccinated as soon as possible.

“We are not opposed to incentives as long as there is strong evidence supporting the move. We should draw on what has been tried overseas, learn about what has had a definitive impact and proceed on that basis. For all patients out there my message remains the same – if you are eligible to be vaccinated, get vaccinated right away.”

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