In the bizarro world known as covid-19-era America, the people most suspicious of a lifesaving vaccine seem to include millions who supported President Donald Trump, whose administration’s proudest achievement was to back development of that very medicine at “warp speed.” Trump himself got the shot!
And so it is understandable that President Biden and his aides are blasting those who are spreading anti-vax misinformation and conspiracy theories. Understandable, too, are calls to abandon persuasion in favor of coercive mandates, such as demanding proof of vaccination to enter public places.
In all of this, there has been far too little creative thought given to a potentially powerful means of herding the last stragglers over the vaccine finish line: financial incentives or, if you prefer, bribery.
It’s true that large employers such as Dollar General and Amtrak have offered workers a couple of hours’ pay to get vaccinated. Purdue University gave vaccinated students lottery tickets for a chance to win $9,992 in tuition relief. Ohio enrolled the newly vaccinated in a $1 million lottery. Anheuser-Busch passed out free beer. The Biden administration has asked all employers to offer their workers paid time off to get vaccinated, and extended an offsetting tax credit for small- and medium-size companies that do so.
It will take more than scattershot inducements to finish the job, though. Unvaccinated people should be offered cash — guaranteed, not lottery tickets — on a wider scale. If companies, foundations or states won’t step in, the federal government should cover the cost. Only after the possibilities for financial inducement have been exhausted should we consider mandates.
Would it work? No one can quite know the minimum vaccination rate needed to achieve “herd immunity” against covid in the United States, but physician Serpil Erzurum, chair of the Cleveland Clinic’s Lerner Research Institute, has cited a range of 70 to 85 percent.
Assume, then, that the way to get to herd immunity is to raise the current 56 percent vaccination rate of the U.S. population (including minors) by at least 14 percentage points.
Assume, further, that pro-vaccine efforts should target adults, who will have to make decisions both for themselves and their minor children.
As of June, 65 percent of U.S. adults are vaccinated, 13 percent are unvaccinated but at least considering getting the shots, 6 percent say they’ll take them “if required” and 14 percent are “definitely” not interested, according to the Kaiser Family Foundation’s latest monthly survey. (Two percent are unaccounted for in the survey.)
We should say “thanks” to the 65 percent, “suit yourself” to the 14 percent — and start negotiations with the rest. The optimum payment is open to debate, but whatever it is, the sooner a person agrees to get vaccinated, the more he or she should get: Say, $250 to sign up for the shots by next week, but $25 per week less until the offer expires. You get half the money with your first dose and the balance upon receiving the second.
Forty-three percent of the unvaccinated gave a non-safety-related concern (e.g., “too busy” or “just don’t want to”) as their main reason for avoiding the shots, according to Kaiser. Cash has a way of dissolving mushy objections such as those.
Certainly, it could motivate some of the 13 percent of adults — 27 million people — who are unvaccinated but still thinking about it. If all 27 million received $250, the cost would be $6.7 billion. The price tag would rise if — as seems likely — some of the 6 percent who have said they’ll get the shots only “if required” change their tune when there’s money to be made.
Still, $6.7 billion would be a rounding error amid trillions in federal anti-covid spending. Perhaps unused funds from previous legislation could be reprogrammed.
The foregoing is a thought experiment; the precise form financial inducements might take is less important than the fact that they would pay for themselves in accelerated economic recovery.
It certainly seems less costly, socially and politically, than mandates, which — to the extent they’re even enforceable — risk validating anti-vaccine rhetoric about a public health police state.
Bribing vaccine stragglers would be unfair to those who did their patriotic duty, and acted in their own self-interest, for free. (Though not to those who got paid by their employers to do so.) So what? This is a life-or-death situation. And circumstantial evidence suggests the unvaccinated are disproportionately low-income. College-educated suburban Whites are the group most likely to have been vaccinated already, according to Kaiser’s survey.
For them, let virtue — and self-preservation — be their own rewards. For the others: Let’s make a deal.