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Millions of lotteries cannot overcome vaccination apathy

The states that launched the lotteries hoped they could get a compelling group of objectors to get vaccinated and reduce the risk of new waves of infection in parts of the country with less protection from the coronavirus. As the nation slowly approaches President Joe Biden’s goal of vaccinating at least 70 percent of adults, public health officials are increasingly warning that these areas are at greater threat from the highly communicable and more severe variant of the Delta virus, which was first identified in India and now accounts for at least 10 percent of all US cases.

“I certainly don’t see things getting better if we don’t increase our vaccination rates,” said Scott Allen, co-administrator of the county health unit in Webster, Missouri, where a Delta variant outbreak has caused daily infections and hospitalizations have increased almost doubled in the past two weeks.

New daily Covid cases have essentially stabilized at just under 15,000 for over a week after falling dramatically this spring as the country’s vaccination campaign accelerated. The number of people getting their first dose has fallen from just under 2 million in mid-April to 360,000, the lowest level in the whole year.

It was teenagers that drove the numbers, with 12-15 year olds getting 25 percent of the country’s vaccinations since they were eligible last month, despite making up just 7 percent of the population, federal and state data show.

That raises questions about the effectiveness of government efforts to offer marijuana, alcohol and cash rewards to lure the adults, and there is little to show for it.

Ohio has the best for its money. Republican Governor Mike DeWine’s announcement in mid-May that five adults would win $ 1 million a week caught nationwide attention, and the number of Ohioans receiving injections rose about 40 percent over the next 10 days. However, four weeks later, the number of people receiving daily doses is lower than when DeWine announced, according to POLITICO analysis. And despite the wave of lotteries, the state continues to lag behind the national average in the proportion of adults receiving a first dose.

Dan Tierney, spokesman for DeWine, said the governor’s team never expected the surge to continue during the lottery’s five weeks, but added that the surge exceeded expectations in the days following the announcement.

“It changed the tone of the conversation,” said Tierney. “The conversation about the coronavirus was grumpy. When you’re trying to convince people … you want them to feel good about their decisions. “

Oregon Democratic Governor Kate Brown announced $ 1 million in prize money a week after DeWine, and state officials say there has been increased uptake in the eastern, more conservative counties. Overall, however, the lottery didn’t do much to stop the falling interest in vaccines, according to POLITICO’s analysis.

Charles Boyle, a spokesman for Brown, said the lottery was just one effort among many and one would never expect it to have an oversized impact.

“No individual strategy is expected to have a uniquely massive impact or completely reverse vaccination rate trends,” he said. “Each strategy adds a little energy to the overall effort. And if you look at the data, we see a more even vaccination rate compared to some of our neighbors. “
Ashby Monk, a Stanford researcher who helped develop Oregon’s vaccine lottery, said the state was hoping to capitalize on the media it deserved by being the first to introduce the novel idea but was beaten by Ohio.

Although the Oregon lottery had a marginal effect, Monk still believes the effort was worth it, as his research consistently shows that people overstate lottery prices relative to the cost of setting up.

“There is an advantage to being first, people were blown away by the concept,” said Monk. “It’s always nice to see an uptrend, but the purpose of these programs, if I’m honest, is to keep the downward sticks from getting faster and bigger.”

Because of this, governors continue to experiment with incentives. On Wednesday, Maine Democratic Governor Janet Mills announced a sweepstakes with a twist: the prize increases by $ 1 for every person vaccinated in the state.

“If it helps to change the direction of the falling rate, that’s best, but if it just doesn’t make the rate fall further, that’s a win too,” said Nirav Shah, director of the Center for Disease Control in Maine and Prevention. “If you compare the money that is spent getting a few more people vaccinated, it’s a profitable investment.”

In New York, the number of adults getting their first shot rose about 10 percent in the week following the announcement of a lottery in late May – about a quarter the size of Ohio’s apparent bump. But in the weeks since then, the vaccination rate in adults has dropped nearly 40 percent, according to CDC data.

Noel Brewer, a professor of health behavior at the University of North Carolina who is responsible for evaluating North Carolina’s incentive program, noted that while these drawings are far from perfect, they spark the imagination and lead to the few vaccine guidelines that are tolerable for both end of the political spectrum.

The multimillion dollar award from Democratic Governor of North Carolina Roy Cooper was announced last week, and preliminary data from the Department of Health suggests the state’s lagging behind the national average vaccination rate will not be boosted by the news.

One of the reasons state lotteries and giveaways seem to offer diminishing returns is because the so-called moving center – the group that is willing but not convinced to get vaccinated – is getting smaller and smaller every day.

At this point, gradual advancement is probably the best a governor can hope for, said David Asch, director of the Center for Health Care Innovation at the University of Pennsylvania.

“In my experience with behavioral health, to motivate change, you conquer yards that go down the field, but no single approach leads to a touchdown,” he said. “Most of the changes happen on a fairly incremental level – there is no silver bullet.”

But even when public health officials admit they are facing lengthy drudgery, they say they are ready to try almost anything to pull the public out of their torpor.

“There really are two pandemics,” said Robb Cowie, spokesman for the Oregon Health Authority. “A pandemic is going away, but a pandemic is still raging among the unvaccinated.”

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