Pennsylvania should consider a vaccine lottery
How could a lottery for getting a vaccine save lives?
Originally published in July 2021 in the Pittsburgh Tribune
This was coauthored with Jay Corrigan and Nick Clark, back when we were discussing how to induce more of the population to get the Covid vaccine. I think many government officials - and other entities - botched these processes dramatically. Less politicizing but more incentives would have meant a greater vaccination rate and fewer deaths/hospitalizations.
The logic on this would hold for the flu shot, as greater flu shot vaccination rates in the USA would save thousands of lives and billions of dollars annually.
Keep reading for our article, which I think holds up well:
In May, Ohio announced that five lucky adults who’ve received at least one dose of covid-19 vaccine will win $1 million in weekly drawings starting May 26. Nearly 5 million Ohioans have already been vaccinated, meaning each has a one-in-a-million chance of winning $1 million. Can that move the needle on vaccinations? There are reasons we think it will, and because of that, Pennsylvania should consider a vaccine lottery.
First, our research on the flu vaccine shows that even small payments can have a large motivational effect. We used carefully controlled auctions to estimate how much Susquehanna University students would need to be paid to get vaccinated against the seasonal flu. As with our earlier research estimating how much Facebook users need to be paid to go without the service and how much smokers need to be paid to quit, these were real auctions with real money at stake. Students knew the winner would be paid in exchange for getting vaccinated.
We ran this study after the university’s vaccination drive, so these weren’t the students who were the most eager to get vaccinated. Still, 75% said they’d get vaccinated for less than $10, and more than half would get vaccinated for a token payment of $1. Were there holdouts who demanded hundreds or even thousands of dollars? Yes, just as there would be with the covid-19 vaccine. But returning to normal life doesn’t require everyone to be vaccinated. We just need enough people to get vaccinated so that covid-19 can longer easily spread.
Second, while our research was based on small, relatively certain cash payments, a lottery could be even more effective. That’s because people are terrible at thinking probabilistically. Whether it’s shark attacks, plane crashes or kidnappings, we focus far too much about things that have a vanishingly small chance of happening. At the same time, we don’t eat well, exercise or save as much as we should for retirement, all of which we’re almost sure to regret.
Vaccine hesitancy plays on these same mental shortcomings. People worry too much about vaccine side effects that have only affected a handful of people, but not enough about catching a deadly disease that’s already infected tens of millions of Americans.
The public-health establishment can fall into this same trap. On April 13, the FDA recommended pausing Johnson & Johnson vaccinations in response to evidence that one in a million vaccine recipients developed serious blood clots. But that same day, nearly 1,000 Americans — three in a million — died of covid-19. The risk of the Johnson & Johnson vaccine is far lower than the risk of covid-19.
A vaccine lottery turns our problems with humans understanding probabilities into a strength. Those of us who most overemphasize low-probability events are the ones most likely to be scared off by rare vaccine side effects and the ones most likely to be most drawn to the lottery. What’s more, the groups who’ve traditionally been most likely to buy lottery tickets — men, people in their 20s and 30s, and people near the bottom of the income distribution — are the same groups who are today least likely to get vaccinated.
Given the evidence that vaccinating one more person produces more than $5,000 in benefits for society, Ohio’s lottery seems like a sensible tool for helping bring this pandemic to an end. Pennsylvania should borrow a page from the Buckeye State and introduce its own vaccine lottery.
Jay Corrigan is a professor of economics at Kenyon College. Matthew Rousu is a professor of economics and dean of the Weis School of Business, and Nick Clark is an associate professor of political science, both at Susquehanna University.