Despite great progress, the willingness to vaccinate seems to be declining in Germany as well. A problem that the US has been dealing with for a long time with strange lottery campaigns. That has a decisive advantage.
Whether it’s free burger menus in New York or free hunting licenses in Maine – in the USA authorities and companies are constantly coming up with more ideas to get the stalled vaccination campaign up and running again. There are guns and pickup trucks in West Virginia or even free cannabis, beer, wine and cocktails in Washington State.
It is true that the goal announced by US President Joe Biden for July 4th continues to be missed: 70 percent of adult Americans should now be vaccinated at least once. But the vaccination curve still goes up, albeit more slowly. So what is to be made of such free campaigns? Should Germany also strive for such actions, even if, as recently, the desire to vaccinate is gradually waning due to falling incidences?
Kathleen Silard is the chairwoman of a hospital in Stamford, east coast state of Connecticut, north of New York City. In a guest article for the US newspaper “The Hill”, she recently wrote enthusiastically about the nationwide success of using public lotteries to convince many vaccine hesitants to take part in vaccinating against the coronavirus.
“After the first COVID-19 lottery was launched in the state of Ohio this spring, participation in vaccination programs in the state rose 45 percent,” wrote Silard. California also recorded an increase of 22 percentage points in the vaccination campaign there after the governor raffled off amusement park tickets worth around 3.8 million euros.
Financial incentives work in the event of a tie
A direct connection between these lottery campaigns and an increase in vaccinations cannot be proven. While in Republican-ruled Ohio only 48 percent of citizens got their first vaccination, in Democratic-ruled California it is now more than 61 percent. A recent study by the Kaiser Family Foundation (KFF) suggests that there is a correlation between basic political attitudes and willingness to vaccinate.
But at least: The KFF survey showed that actually 31 percent of the hesitants would be convinced of a state lottery campaign in which they could win a million dollars. Even ten percent of those who refused to do so stated that they would allow themselves to be changed by possible money winnings.
This is one of the reasons why hospital boss Kathleen Silard is so impressed by these actions that she even suggests in her article that this concept should also be applied to other diseases and their prevention. This is much cheaper for the state than rewarding each individual person with amounts of money, as some states have already tried. It is irrelevant why this lottery mechanism works for people. It is important that he works. “Irrational behaviors could be changed with irrational temptations,” wrote Silard. That is always better than frightening people. “Who wants to think about dying when you can think of becoming a millionaire?”
In Germany, however, this discussion is rather hesitant. In an interview with t-online said the SPD health expert Karl Lauterbach, incentives such as gifts for vaccinated people are not appropriate. “We have to convince people of the value of vaccination. And not work with cheap tricks.” He believes that vaccination will increase because people will see that the value of vaccination can be felt immediately.
A study by the Humboldt University of Berlin published at the beginning of May with the question “How can the willingness to vaccinate in the population be increased?” however, at least examined the possible effects of financial incentives. It was not about lotteries – it would be conceivable, for example, to raffle Bahncards 100 or Tesla automobiles – but at least possible amounts of 25 or 50 euros that could be paid out per person. The researchers of the study came to the conclusion that the financial offers definitely had an effect on the willingness to vaccinate. Especially in the group of those who are still undecided, but also in the group of hesitants and skeptics. Financial incentives might not be the only solution, according to the authors, but in combination with other incentive systems such as the promise of freedoms.
In an interview with “Spiegel”, game theorist and behavioral economist Axel Ockenfels recently criticized the federal government’s corona policy as being “too timid, too stingy and too averse to risk”. In order to increase the motivation to vaccinate, he therefore advised a vaccination lottery in the next step. All citizens should automatically take part in this. But only those who have already been vaccinated could win. Ockenfels spoke out in favor of high amounts in the millions, because “the lottery could become the most interesting topic of conversation in Germany”.
Keep the vaccination topic present
Maryland Governor Larry Hogan presents his vaccination lottery. (Source: imago images)
In fact, the real win from the weird US vaccination campaigns is that the media is reporting it nationally and even internationally. The National Governors Association (NGA), an organization in which all US governors are represented, currently lists all state-organized vaccination incentives from Alabama to West Virginia on its website. In Illinois, the government is giving away 50,000 tickets to the Six Flags theme parks. California beckons with free surf lessons in San Diego. In Hawaii there are pizza, spa visits or vouchers for low-carb products.
But no matter how creative the USA is in recruiting vaccinees, the incentive programs ranging from free driving on the Talladega Superspeedway in Alabama to a full college scholarship and custom-made hunting rifles in West Virginia cannot hide one fact: the vaccination quota is indeed in many US states already at around 70 percent. In 22 of 50 US states, however, less than 50 percent of US citizens received their first vaccination. Idaho and Mississippi currently have the lowest first vaccination rate at just 36 percent. Followed by Louisiana, Wyoming and Alabama with 38, 39 and 40 percent. Texas, Alaska, Kentucky and Nevada are scratching the 50 percent mark, which is still 20 percentage points away from Biden’s vaccination target.
Of these 22 “under 50 percent” states, almost all of them are ruled by Republican governors; only in Louisiana, North Carolina, Kentucky, and Nevada are Democratic governors responsible. A few days ago, the US President’s immunologist and chief advisor on health issues, Anthony Fauci, warned that there should not be “two Americas” – one vaccinated and one non-vaccinated. The health dangers of such a split between the often more rural republican “Red States” and the more urban democratic “Blue States” are well known: In the non-vaccinated part of the population, new virus mutants, such as the current Delta variant, can spread rapidly and then lead to ever new, more resistant mutations, which in turn could endanger people who have already been vaccinated.
In view of the delta danger for the whole country, the three Republican governors of Arkansas, West Virginia and Utah appealed to their residents to please finally overcome their own vaccination skepticism. “In the Red States there are probably a lot of people who think very, very conservatively and think, ‘Well, I don’t have to do that.’ But they don’t think right, “said the governor of West Virginia, Jim Justice, the TV broadcaster ABC. Arkansas’ Prime Minister Asa Hutchinson expressed his “great concern” on CNN and spoke of a “race” against the Delta variant.
The graph shows the percentage of residents in the USA and Germany who have already received the first dose of vaccine (source: Our World in Data):
Education remains an important factor
The recently published study by the Kaiser Family Foundation provides information about the social groups that have a hesitant to refusing attitude towards vaccination. The makers of the representative survey found that mostly white Evangelical Christians (58 percent), young people aged 18 to 29 years (55 percent), people in rural areas (54 percent), Republican voters (52 percent) and People under 65 (48 percent) who do not have health insurance are reluctant to get vaccinated.
The scientists of the German Humboldt study, however, could not determine that there is a significant difference between AfD sympathizers and other respondents. Nor could they make out a large gap between the left and the right-wing political spectrum. So it could be all the more worthwhile in this country to rely on financial incentives. The ideological hurdles at least seem to be less pronounced in Germany than in the USA.
However, it is important to educate certain groups on both sides of the Atlantic. The reasons given for their own wait-and-see or even defensive attitude in the KFF survey in the United States at least allow conclusions to be drawn that there too, lotteries and other monetary incentive programs alone are not enough.
A considerable part of the hesitants and even a part of the complete refusers would be convinced if the state approval authority FDA allowed the vaccines not only through emergency approval, but also in the regular test procedure. Concerns about side effects and long-term consequences still predominate too much. Many people feel that the preparations have come onto the market too quickly for them to simply trust them.
In Germany and the European Union, the vaccines were approved later and after a more detailed review by the European Medicines Agency Ema. Nevertheless, many people in this country are also skeptical. Even a thorough admission test apparently only helps to a limited extent to generate more trust.
In the KFF survey for the USA, more than 50 percent of those questioned said that they believe certain vaccination myths to be true or at least do not know whether they are true or false. This means that more than half of the respondents were at least unsure whether the vaccines could lead to infertility, damage the genetic material or embryos, or whether they could even get Covid-19 through the vaccination. It is fears, ignorance and false reports that are also widespread in Germany. In the end, there is no lottery to counter this.