Studies probe how payouts affect U.S. vaccination rates

doi:10.1126/science.373.6555.611

GSTDTAP > 气候变化

DOI	10.1126/science.373.6555.611
	Studies probe how payouts affect U.S. vaccination rates
	Anil Oza
	2021-08-06
发表期刊	Science
出版年	2021
英文摘要	What does it take to convince someone to get vaccinated? U.S. officials all the way up to President Joe Biden are hoping cash will do the trick. In the past few months, as COVID-19 vaccination rates slowed across the United States and the Delta coronavirus variant spread, companies and local governments have offered creative incentives for people to get their shots, including free doughnuts, baseball tickets, and cars. Nearly 20 states now entice those hesitant to get vaccine with a lottery. And the White House last week called on state and local governments to directly pay $100 to anyone willing to get a first dose—an incentive New York City began to offer on 30 July. Behavioral researchers and other scientists are closely watching, and in a few cases helping set up, these financial incentives to see how well they work. Early data on vaccine lotteries, for example, suggest they can convince a modest number of people teetering on the edge of committing to a shot. “Incentives of various different types, including lotteries, may be one effective strategy,” says Dena Gromet, a psychologist at the University of Pennsylvania who helped set up Philadelphia's vaccination lottery, which has a grand prize of $50,000. “But we are likely going to have to rely on a multiprong approach to be able to really make a dent in vaccination going forward.” Directly giving Americans money to get a vaccine hasn't been tested before, but studies in Africa and Latin America have shown cash payments prod individuals to make use of health services, including pediatrician visits, nutrition consultations, and educational sessions, according to Amanda Glassman, a public health expert at the Center for Global Development. One study, conducted in Nigeria, found that conditional cash transfers increased childhood measles vaccination rates by 27%. Although there are few studies of the effectiveness of lotteries as a medical incentive, some economists suggest they appeal to unvaccinated people who are more tolerant of risks. A lottery could also capitalize on a phenomenon called “probability neglect,” where individuals will irrationally interpret probabilities in their favor. “Certain people just underestimate, say, the risks of a disease like COVID-19 for themselves, or spreading it to others, and also simultaneously would overweight, or be overoptimistic about their odds of winning the lottery,” says economist Jeremy West of the University of California (UC), Santa Cruz, a co-author of a recent working paper about Ohio's vaccine lottery. A lottery may also be more cost-effective than direct cash payments. West and his colleagues calculated that Ohio's $5.6 million lottery has enticed 80,000 residents to get vaccinated—a figure they arrived at by comparing the state's actual vaccination data with a simulation incorporating rates for demographically similar states that did not implement a lottery. That amounted to $68 for each new person vaccinated—a bargain compared with a $100 payment. West also estimates that the lottery payout saved Ohio $66 million in intensive care unit costs. “Meaning, it's a no-brainer to do. But it's also not going to be the cure-all for the pandemic, or for vaccination hesitancy,” West says. Three other recent analyses of the Ohio lottery have come to similar conclusions, with estimates of new vaccinations produced ranging from no significant change to 100,000. Cash payments and lotteries may change cost-benefit calculations for individuals. Although COVID-19 vaccines are free to everyone in the United States, many people face indirect costs, from transportation expenses to a vaccine provider to taking time off from work for the shot or subsequent side effects. For the poor or those who perceive they are at lower risk for severe disease, that may be enough to put off vaccinations. “The lotteries aren't really about changing beliefs [about vaccine safety and need]. They are intended to increase the perceived benefit of receiving the vaccine and motivate indecisive people to go get the shot,” says Oberlin College economist Maggie Brehm, who is a co-author of another study of Ohio's vaccine lottery. Political scientist Lynn Vavreck of UC Los Angeles notes that cash incentives can only go so far. “We are not trying to get everyone—we are trying to get the people on the margin, the next set of people who can imagine themselves [getting vaccinated] under some circumstance,” she says. Glassman and others raise the concern that financial incentives could set a bad precedent, turning vaccination or other public health precautions into something done for selfish reasons rather than altruistic ones. “People should be motivated by intrinsic motivation to do this thing for pro-social reasons,” she says. But Glassman also doesn't see the middle of a pandemic as the time to debate the moral fiber of the country. “How could we not test every tool in the armament to make sure that people get vaccinated?” she asks.
领域	气候变化 ; 资源环境
URL	查看原文
引用统计
文献类型	期刊论文
条目标识符	http://119.78.100.173/C666/handle/2XK7JSWQ/335555
专题	气候变化资源环境科学
推荐引用方式 GB/T 7714	Anil Oza. Studies probe how payouts affect U.S. vaccination rates[J]. Science,2021.
APA	Anil Oza.(2021).Studies probe how payouts affect U.S. vaccination rates.Science.
MLA	Anil Oza."Studies probe how payouts affect U.S. vaccination rates".Science (2021).