September 23, 2023
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Opinion: Lottery prizes can encourage vaccination, but they can’t replace trust


By Gary Charness

Medical experts and the federal government have stressed the importance of reaching herd immunity, which requires that a high proportion of the population cannot fall prey to COVID-19.

While there was a huge initial wave of interest, there are still many people who have not been vaccinated. This has led to the idea of providing incentives to induce people to do so. These range from providing $100 savings bonds to giving out cannabis, alcohol, burgers and fries, and even a chance to win $1 million or more in a lottery.

The question is what degree of effectiveness to expect from these incentive programs.

Gary Charness
UC Santa Barbara

As an economist, I am a big believer in providing incentives to effect change. In “Incentives to Exercise” (Econometrica, 2009), my co-author and I showed that providing cash incentives to exercise on a regular basis was quite effective in raising exercise rates for those people who had not exercised regularly. Incentives work best when as a “bribe” to help people overcome behavioral problems and to produce a desirable outcome in the short term.

But here there may be other barriers (perhaps socio-economic) in place that dissuade people from being vaccinated. Some people would not get vaccinated unless one holds a gun to their heads. An NFL player stated he would rather retire than get vaccinated, which is rather extreme considering his alternative employment options seem rather poor.

There may be concerns about safety, or getting the vaccine might present logistical challenges, or people might be hesitant due to a lack of trust in the government and even medical professionals. But since one cannot really hold guns to people’s heads, one can only appeal to the fairly narrow range of people who were neither eager to get vaccinated or unalterably opposed to the idea.

Offering incentives is potentially counterproductive, as it could be seen as a signal, since people might feel that no one would offer money to get vaccinated if getting vaccinated was a good thing. On the whole, immediate incentives might get a few wavering people “over the hump,” but the really big incentive (concern for one’s own health) has already been present and proved ineffective.

An alternative strategy would be to reduce barriers. It might help to let people pick their preferred vaccine and get the shot at their doctor’s office. Being able to do so would also be more convenient and trusted than mass vaccination sites.

Incentives that are perceived to be manipulative may not be as appealing to most people as choice, particularly where safety is a concern. Offering choices might relax some resistance. Incentives are highly useful, but they are not always sufficient or suited to the issue at hand. This is most likely the case with incentives for vaccination.

Of course, greater trust in government and serious educational campaigns (as with tuberculosis and polio in the 20th century) would also go a long way towards changing the views of some. While it may be too late to implement educational campaigns for COVID-19 (if people even trust these now), this should certainly be considered for the future.

• Gary Charness is a professor of economics at UC Santa Barbara and the director of the department’s Experimental and Behavioral Economics Laboratory.