Analysis

Vaccine incentives don't need to convince everyone

Free beer and baseball tickets probably won't sway hardcore anti-vaxxers. That's fine.

When warning Americans that getting the COVID-19 vaccine is "life or death" fails, there's only one next logical step: bribe them with beer.

That's the thinking of New Jersey, anyway, where Gov. Phil Murphy (D) this week announced a new program to incentivize state residents to get their shots by offering them a brew on the house. "The focus of the drive is to get as many new vaccinations as possible," a spokesperson for the governor told ABC News. And as the pace of vaccinations continues to decline, more and more states are considering similar carrots in order to get their populations over that all-important hump of 70 to 80 percent to reach herd immunity.

While much has been made about anti-vaxxers, Slate recently pointed out that "the pool of refusers is small," about 15 percent of the overall population. It's the "hesitaters" — what Kaiser's Vaccine Monitor Project calls the "wait-and-see" group, the people who are "not dead set against it" and who tend to be younger than the "ASAP group" — that make up the pivotal 20 percent of the population, and who the government is so desperate to entice. Governors are trying everything from offering people a free beer (like in New Jersey, Connecticut, and Washington, D.C.), to free baseball tickets in New York. Other states are cutting to the chase with cold, hard cash: Detroit is giving $50 prepaid credit cards to people who drive their neighbors to clinics, and West Virginia is dangling $100 bonds in front of young people who still have yet to get their shots. Private companies are also chipping in, from offering free donuts to free weed to customers who show proof of vaccination.

Some experts warn that while monetary incentives might work to an extent, it's not a great look for Americans. "When people are clamoring for vaccines in India and in Brazil, it just makes us look like a nation of sulky adolescents," Dr. Peter Hotez, the dean for the National School of Tropical Medicine at the Baylor College of Medicine, told CNBC. Separately, a UCLA study suggests that the offer of money makes those who were already hesitant about shots even more suspicious: "[A]bout 15 percent of unvaccinated people report a decrease in willingness to vaccinate because of payments," The New York Times reports.

But the alternative to the carrot is the whip. While the government can't force people to get their shots, people's bosses can. "It is settled law in most states that employers can require vaccination because they have the right (and sometimes the obligation) to set health and safety requirements for their workplaces," The Brookings Institute's Joshua Gotbaum writes, adding that "action by even a third of U.S. businesses would, by my estimate, lead to vaccination of an additional 12 million adults and get vaccine acceptance over 80 percent." Others have gone as far as suggesting insurance premiums could be tied to vaccination status.

Of course, there's a third concern that governments and employers need to consider: that is, you don't want to offer a carrot that is too good. To quote one enterprising Twitter user in response to the New Jersey campaign, "Boutta get two flavors of vaccine for a beer."

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