NYC offers $100 to anyone who gets their first COVID-19 vaccine shot

Mayor of New York City Bill de Blasio speaks during the opening of a vaccination center for Broadway workers in Times Square on April 12, 2021 in New York City.
Mayor of New York City Bill de Blasio speaks during the opening of a vaccination center for Broadway workers in Times Square on April 12, 2021 in New York City.

  • NYC is offering $100 to anyone who goes to a city-run site to get the first dose of the COVID-19 vaccine.
  • The new vaccine incentive was announced Wednesday amid increased concerns over the the Delta variant.
  • About 41% of NYC residents still haven’t gotten the shot, according to city data.
  • See more stories on Insider’s business page.

New York City announced on Wednesday that anyone can receive $100 if they get the first dose of the COVID-19 vaccine at any city-run vaccination clinic. The incentive begins on Friday.

The announcement of a new vaccine incentive comes amid increasing concern over the spread of the Delta variant of the COVID-19 virus. The Centers for Disease Control announced yesterday that even fully vaccinated people should wear a mask in areas with “substantial or high transmission” of the virus.

According to a map from the CDC, all five of New York City’s counties have “substantial” levels of community transmission, meaning the new recommendations apply in the city.

Mayor Bill de Blasio announced on Monday that city workers must get the vacccine by September 13th or be subjected to weekly COVID-19 testing.

According to data from the Citywide Immunization Registry, 40.8% of New York City residents remain unvaccinated; 59.2% of all residents have received at least one dose.

Insider previously spoke to several top economists who proposed a similar idea — a $1,000 “vaccine stimulus” to combat vaccine hesitancy.

“If we somehow don’t get to true immunity, our economy will be operating with a huge weight on its chest,” Robert Litan, a non-resident senior fellow at the Brookings Institution who served in the Bill Clinton administration, told Insider in November.

Click this link to locate a vaccination site in New York City.

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An ethicist explains how vaccine incentive programs can help save lives without crossing ethical lines

covid vaccine
Vaccine incentives could be a way to sway those who are on the fence.

  • Cash incentives for vaccination may increase the numbers, but it could increase skepticism, too.
  • Some ethicists have raised concerns that incentives could be wrong, citing fairness and equity issues.
  • Other measures, like tax deductions and credits, could be low-cost ways for states to encourage vaccinations.
  • See more stories on Insider’s business page.

A financial shot in the arm could be just what is needed for Americans unsure about vaccination.

On May 12, 2021, the Republican governor of Ohio, Mike DeWine, announced five $1 million lottery prizes for those who are vaccinated. Meanwhile, in West Virginia, younger citizens are being enticed to get the shot with $100 savings bonds, and a state university in North Carolina is offering students who get vaccinated a chance to win the cost of housing. Many companies are paying vaccinated employees more money through bonuses or extra paid time off.

The push to get as many people vaccinated as possible is laudable and may well work. But leading behavioral scientists are worried that paying people to vaccinate could backfire if it makes people more skeptical of the shots. And ethicists have argued that it would be wrong, citing concerns over fairness and equity.

Read more: I bought a house sight unseen and moved my family from California to Missouri. As a first-time buyer, it was the best decision I could’ve made.

As a behavioral scientist and ethicist, I draw on an extensive body of research to help answer these questions. It suggests that incentives might work to save lives and, if properly structured, need not trample individual rights or be a huge expense for the government.

In the United States, incentives and disincentives are already used in health care. The US system of privatized health insurance exposes patients to substantial deductibles and copays, not only to cover costs but to cut down on what could be deemed as wasteful health care – the thinking being that putting a cost to an emergency room visit, for example, might deter those who aren’t really in need of that level of care.

In practice, this means patients are encouraged to decline both emergency and more routine care, since both are exposed to costs.

Paying for health behaviors

In the case of COVID-19, the vaccines are already free to consumers, which has undoubtedly encouraged people to be immunized. Studies have shown that reducing out-of-pocket costs can improve adherence to life-sustaining drugs, whether to prevent heart attacks or to manage diabetes.

A payment to take a drug goes one step further than simply reducing costs. And if properly designed, such incentives can change health behaviors.

Payments and cash prizes have been shown effective in encouraging blood donations, adherence to blood thinner drugs, blood glucose monitoring, physical activity, and smoking cessation.

And for vaccination in particular, payments have been successful for human papillomavirus (HPV) in England; hepatitis B in the United States and the United Kingdom; and tetanus toxoid in Nigeria. The effects can be substantial: For example, for one group in the HPV study, the vaccination rate more than doubled with an incentive.

For COVID-19, there are no field studies to date, but several survey experiments, including one my group conducted with 1,000 Americans, find that incentives are likely to work. In our case, the incentive of a tax break was enough to encourage those hesitant about vaccinations to say they would take the shot.

Coercion concerns

Even if incentives will save lives by increasing vaccinations, there are still other ethical considerations. A key concern is protecting the autonomous choices of people to decide what they put into their own bodies. This may be especially important for the COVID-19 vaccines, which – although authorized as likely safe and effective – are not yet fully approved by the Food and Drug Administration.

But already people are often paid to participate in clinical trials for drugs that have not yet been approved by the FDA. Ethicists have worried that such payments may be “coercive” if the money is so attractive as to override a person’s free choices or make them worse off overall.

One can quibble about whether the term “coercion” applies to offers of payment. But even if offers were coercive, payments may still be reasonable to save lives in a pandemic if they succeed in greater levels of immunization.

During the smallpox epidemic nearly 100 years ago, the US Supreme Court upheld the power of states to mandate vaccines. Compared with mandating vaccination, the incentives to encourage vaccines seem innocuous.

Exploitation and paternalism

Yet some still worry. Bioethicists Emily Largent and Franklin Miller wrote in a recent paper that a payment might “unfairly” exploit “those US residents who have lost jobs … or slipped into poverty during the pandemic,” which could leave them feeling as if they have “no choice but to be vaccinated for cash.” Others have noted that vaccine hesitancy is higher in nonwhite communities, where incomes tend to be lower, as is trust in the medical establishment.

Ethicists and policymakers should indeed focus on the poorest members of our community and seek to minimize racial disparities in both health outcomes and wealth. But there is no evidence that offering money is actually detrimental to such populations. Receiving money is a good thing. To suggest that we have to protect adults by denying them offers of money may come across as paternalism.

Some ethicists also argue that the money is better spent elsewhere to increase participation. States could spend the money making sure vaccines are convenient to everyone, for example, by bringing them to community events and churches. Money could also support various efforts to fight misinformation and communicate the importance of getting the shot.

The cost of incentives

Financial incentives could be expensive as a policy solution. As in Ohio, lottery drawings are one way to cap the overall cost of incentives while giving millions of people an additional reason to get their shot.

The tax code could also allow for a no-cost incentive for vaccination. Tax deductions and credits are often designed to encourage behaviors, such as savings or home ownership. Some states now have big budget surpluses and are considering tax relief measures. If a state announced now that such payments would be conditional on being vaccinated, then each person declining the shot would save the government money.

Ultimately, a well-designed vaccination incentive can help save lives and need not keep the ethicists up at night.

Christopher Robertson, professor of law, Boston University

The Conversation
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Ohio administered the most vaccines in weeks 2 days after it announced a $1 million vaccine lottery

Ohio vaccine
An Ohio resident receives a COVID-19 vaccine in March 2021.

  • Ohio vaccinated more people in a single day than in three weeks after announcing a major incentive.
  • Gov. Mike DeWine on May 12 said five vaccinated residents would win a $1 million lottery prize.
  • US states have offered incentives to encourage COVID-19 vaccinations and reach herd immunity.
  • See more stories on Insider’s business page.

Ohio recorded more than 25,000 new vaccinations last Friday, a number not seen in three weeks. It came two days after the state announced a major incentive: the potential for five vaccinated residents to win $1 million.

According to state data, Ohio administered more than 25,400 COVID-19 vaccines on May 14 – two days after Gov. Mike DeWine announced the program during a televised address the evening of May 12. It was the highest number of shots the state had administered in three weeks, when residents received 28,000 shots on April 23.

The program comes at a time when states across the US have scrambled to incentivize vaccinations as interest in them has plateaued. Experts predict the country will need to vaccinate at least 70% of the population to reach herd immunity for COVID-19.

In total, more than 124 million people in the US are now fully vaccinated against COVID-19 – about 38% of the total population. And 60% of adults have received at least one dose, according to US Centers for Disease Control and Prevention data.

DeWine’s announcement drew ire from some in and outside his own Republican Party, who questioned the use of millions in pandemic relief funds, local CBS affiliate WHIO reported.

“I know that some may say, ‘DeWine, you’re crazy!” DeWine said in a tweet last week announcing the “Vax-a-Million” program. “This million-dollar drawing idea of yours is a waste of money.’ But truly, the real waste at this point in the pandemic — when the vaccine is readily available to anyone who wants it — is a life lost to COVID-19.”

People in Connecticut who have been vaccinated against COVID-19 can get a free drink at participating restaurants. The state of Kentucky partnered with Walmart and Kroger to give every vaccinated adult a lottery ticket, which carries a top prize of $225,000. And New Jersey Gov. Phil Murphy announced that vaccinated people could get a free beer after they had been vaccinated with his “shot and a beer” campaign.

According to data analyzed by Johns Hopkins University, about 35% of Ohio residents are fully vaccinated against COVID-19. The state with the highest percentage of fully vaccinated people is Connecticut, with more than 44%.

The first Ohio drawing winner will be announced on May 26. The other four winners will be announced on the four Wednesdays that follow. If a 12- to 17-year-old wins the drawing, they’ll get a full-ride scholarship to any Ohio state university.

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