More than half of adults in the United States have been inoculated with at least one dose of a Covid-19 vaccine. The speed is a triumph of modern science and a relentless effort by the Biden administration to increase availability. However, roughly 30 percent of the population is still hesitant to be vaccinated, according to polls, and daily vaccination rates are dropping. As the country moves from a lack of supply to a potential lack of demand, the White House will need to adapt its strategy to try and reach a level of herd immunity. Results from recent experiments by the UCLA Covid-19 Health and Politics Project provide clues about what incentives may move the needle for different segments of the population.
Pay Americans Money To Get Vaccinated
One experiment run by the UCLA project found that a cash payment would make roughly a third of unvaccinated people more likely to get a shot. Researchers trialed different levels of cash payments and, unsurprisingly, found that a $100 cash payment increased willingness more than a $25 or $50 payment.
The idea of paying individuals to get vaccinated is not new. I covered a proposal by Robert Litan, a non-resident Senior Fellow in the Economic Studies Program at the Brookings Institution, late last year. Litan’s solution harnesses the power of one of the most basic economic principles, incentives, to nudge human behavior by paying individuals $1,000 to get vaccinated. Litan’s proposal was championed as “textbook economics” by Gregory Mankiw, a Harvard economist and former chair of George W. Bush’s Council of Economic Advisors, who, not so coincidentally, has authored leading economic textbooks. The UCLA results show that a much lower payment could still be effective.
The finding also substantiate a criticism of Litan’s proposal, which is that offering a cash payment may actually dissuade some from getting inoculated. In the UCLA experiment, 15 percent of unvaccinated individuals said being offered a cash payment would actually decrease their willingness to get a vaccination. However, as Lynn Vavreck, a principal investigator of the U.C.L.A. Covid-19 Health and Politics Project, noted in The New York Times, “at this later stage of a vaccine campaign — when attention has now turned to the hesitant — the net benefit seems to be tilting toward payment.”
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UCLA’s findings may provide more ammunition for state and local leaders who have been offering different forms of cash payments. Governor Larry Hogan of Maryland announced a $100 payment to incent state employees to get the vaccine. “Incentives like this are another way to reinforce the importance of getting vaccinated, and we strongly encourage businesses across the state to consider offering incentives to their workers as well,” Mr. Hogan, a Republican, said. “These vaccines are safe and effective, they’re free, and they’re readily available with or without an appointment.”
Like pretty much else in the United States at the moment, there was a partisan split in the effectiveness of monetary payments. 48 percent of Democrats said they would be more willing to get vaccinated if they received a $100 payment, whereas a much lower percentage of Republicans were motivated by cash. Luckily, another experiment showed a method that resonated more with Republicans.
Messaging Resonated More With Republicans
Early experiments by the UCLA team found that different messaging strategies only had a small effect on individual’s willingness to get vaccinated. For example, framing the benefits in a self-interested way compared to a more socially-minded approach (”it will protect you” versus “it will protect you and those around you”) didn’t change uptake significantly. The team found similar results when vaccinations were endorsed by prominent figures or personal medical sources.
However, in more recent experiments, a specific message did seem to work. “The incentive to stop wearing a mask and social-distancing in public also had a strong result,” wrote Vavreck. “On average, relaxing the mask and social distancing guidelines increased vaccine uptake likelihood by 13 points. The largest gains came from Republicans, who reported an 18-point increase in willingness to get vaccinated.”
A Multi-Prong Approach
The Biden administration’s vaccination effort is shifting into new gear, including a strategy to lean on employers, houses of worship, and many community organizations to reach individuals who have yet to be vaccinated. “We need to be more creative about meeting people where they physically are,” Erica Johnson, chairwoman of the American Board of Internal Medicine’s infectious diseases specialty board and Johns Hopkins assistant professor of medicine, told Axios. Working with trusted individuals “can help remove structural barriers and provide persuasive pro-vaccine messages,” Johnson said. The administration is also targeting more surgical approaches by moving away from mass vaccinations and towards community clinics and even door-to-door campaigns to reach holdouts, especially in rural areas.
The results from the the UCLA experiments “show both the difficulty of getting the remaining unvaccinated people to clinics and the promise of efforts aimed at doing so.” Adopting a more holistic and multi-prong approach may help to move the needle even further. It behooves the Biden administration to tailor to consider these tactics and adapt its strategy to different constituencies.
If those plans fail, there’s always the approach that Governor Phil Murphy of New Jersey is trying: free beer. “Any New Jerseyan who gets their first vaccine dose in the month of May and takes their vaccination card to a participating brewery will receive a free beer,” Murphy tweeted. Perhaps free beer is a stronger motivating force than the prospect of not dying.