West Virginia Gov. Jim Justice made headlines at the end of April when he announced that any state resident between 16 and 35 who got vaccinated for Covid-19 would receive a $100 savings bond.
"I'm trying to come up with a way that's truly going to motivate them — and us — to get over the hump," Justice said in a statement released after the press conference.
The "hump" was a sudden slowdown in West Virginia's vaccination rate. At the beginning of the year, the Mountain State was celebrated for a very effective public rollout of the Covid shots. As that pace began to falter later in the spring, Justice and his administration got creative.
It wasn't long before West Virginia's model spread to other state and local governments. New York City started giving away everything from Lincoln Center tickets to Shake Shack french fries. The Los Angeles Unified School District began awarding cash grants to schools that got a certain percentage of their student population vaccinated.
But it was Ohio Gov. Mike DeWine who upped the ante on incentives when he announced his state would give five lucky Ohioans $1 million each through its Vax-a-Million lottery. All you had to do to enter the drawing was be vaccinated against Covid-19.
DeWine's plan was both celebrated and derided when it was first announced. But when Ohio's vaccination rate jumped in the weeks that followed, other leaders took notice: Now, at least eight other states have created some kind of cash drawing to incentivize their residents to get vaccinated.
For example, Maryland is giving away $40,000 a day for 40 days, culminating in a $400,000 jackpot drawing on July 4. New Mexico will draw a $5 million jackpot winner in late August, and California will award 10 $1.5 million jackpots in addition to another $100 million worth of prizes over the coming weeks.
Incentives don't stop with cash lotteries. In early May, New Jersey began offering vaccine recipients a free beer at participating restaurants. By May 19, it had expanded the program into Operation Jersey Summer, with giveaways including free passes to state parks and beaches, and a raffle to have dinner with New Jersey Gov. Phil Murphy and his wife Tammy.
Alabama let residents drive two laps around the Talladega Superspeedway. Minnesota is giving away free fishing licenses to people who get the Covid shot. Maine will even give you a $20 L.L.Bean gift card. But it's the lotteries that seem to have really captured people's imaginations.
Ohio's Vax-a-Million lottery, which, in addition to the five $1-million cash jackpots will also give five teenagers full four-year scholarships (including room and board) to any public university in Ohio, has drawn praise for its out-of-the box approach, but it's also garnered criticism for funding its jackpot with federal money intended for Covid relief. Critics argue that the money should be used to build the state's public health infrastructure, not fund windfalls for random Ohioans.
Kevin Volpp, professor of behavioral economics and health policy at the University of Pennsylvania, disagrees. While funding a lottery may not be ideal, he says, the gambit is worthwhile if it noticeably increases Ohio's vaccination rates.
"A lot of people decry the fact that it's $5 million plus the cost of five four-year college scholarships," he says. "But I think it's important to point out that that is a pittance when it comes to the economic impact of Covid on any state in the U.S., or the country as a whole."
Psychologically speaking, lottery entrants have a tendency not to focus on their low chance of winning (in this case, more than 1 in a million), but on the size of the prize. That excitement makes them want to participate, Volpp says.
The amount of money Ohio currently plans to spend will run a lot less per capita than if it had given all vaccine takers $100. Even if only another 1 million of the state's 11.6 million residents get Covid shots, the cost to the state per person would be just $5, Volpp argued in a recent opinion piece in The Washington Post.
"In an ideal world, we wouldn't need to be incentivizing people to get vaccinated against Covid. The vaccine is extremely safe. The risks are minimal," he says. "Many of us would have hoped that people would just get vaccinated on their own once the vaccines were available. That said, obviously that's not happening for a substantial portion of the population, so now we have to think about the best alternatives to increase vaccination rates."
Video by Stephen Parkhurst
Governors and public health officials in several states, including Minnesota, Wyoming, and Washington state, have said they're watching the results of Ohio's lotteries closely and are open to copying the program.
They shouldn't wait too much longer, says Harold Pollack, professor of public health at the University of Chicago. Infection rates are already dropping, thanks to the effective U.S. vaccination campaign, and they're likely to decrease further as summer kicks into high gear and people start spending more time outside, Pollack says. That will decrease the urgency to get vaccinated, and potentially lead to high case rates in the fall, when viruses tend to be on the upswing.
"Time is the enemy," Pollack says. "If [the incentives] work, they're definitely worth the money. The value of another person vaccinated is just enormous by any metric."
"We should be throwing spaghetti at the wall," he adds. "We should have lots of places trying lots of different things, being very open and transparent about it and seeing what seems to catch people's fancy."
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