We need to get more people vaccinated. The first big wave of folks who were eagerly waiting for vaccines to be released has probably already been vaccinated. Now public health practicioners are seeking to get shots into the arms of folks who are willing to get vaccinated but aren’t knocking down doors to get vaccinated for any number of very valid reasons. So we’re seeing these stories:
“Free vaccinations were offered Friday at Larry Flynt’s Hustler Club, a strip joint.” @lauriemcginley2’s report from a desperate-to-reopen Las Vegas after Sin City’s lost year. https://t.co/Qozx04FDMh
— Dan Diamond (@ddiamond) May 24, 2021
And we also see Ohio offering a $1 millions and an OSU full ride per week to get shots in arms:
Effects of the Ohio vaccine lottery (via @ATabarrok @pbump) pic.twitter.com/0k7TAORYSJ
— Charles Fain Lehman (@CharlesFLehman) May 25, 2021
Several other states are trying out different lottery schemes. Maryland is offering daily prizes. Oregon is offering a prize per county. New York will be doing something.
These are all good ideas. We need shots in arms and the social value of marginal shots in arms is large where a $1 million dollar prize easily pays for itself if it induces an extra thousand people to be vaccinated.
The only caveat on all of these lotteries is that some grad students are stuck crossing their fingers that Pennsylvania does nothing regarding lotteries for another couple of weeks so that there it can serve as the control group for a wide variety of difference in difference specifications or state line discontinuity analyses over the next couple of years. We should build up our evidence base as to what works and what does not work but pragmatically, keeping Pennsylvania or other states from adopting outreach methods that seem to be working is a tough ethical question.
Cheryl Rofer
I keep thinking about the dissertations that will be written for the next fifty years on all aspects of the pandemic. Because of the ethical considerations you mention and because there are so many things we don’t understand about the virus, the best answers are likely to come years and decades out.
But yeah, I’m sure there are graduate students working on this now.
satby
One of the doctor’s office vaccine laggards lives across the street from a pop-up vaccination site they put up yesterday, so she went there before work and got the J&J one shot. So did a friend and former employee, who came in to let me know she was available part time. Ease of access is huge, especially for working parents. Making the time, especially in case of a day or two down from side effects, has been a barrier for many.
Cheryl Rofer
bnateAZ
I still can’t, but also can, believe we live a country selfish enough to need incentives to get life saving medical treatment after watching nearly 600,000 fellow citizens die…
Xavier
While I wholeheartedly support any and all vaccination incentives (let’s just do this and get the whole thing behind us), I’d argue that the need for herd immunity is stronger when vaccines are less effective. If the effectiveness of the vaccines was closer to 50%, which is sometimes the case, you need a lot higher vax rate to prevent vaxed people from getting infected. With effectiveness at 95, herd immunity isn’t much of an issue for vaxed people.
Ken
Pity about the need for the control group state to border Ohio and New York. Without that, there are any number of states volunteering to be the control, thus greatly reducing the ethical qualms. Although many of those states are introducing their own factors that will complicate future studies, like forbidding masks. (BTW, have any of them been sloppy enough to accidentally ban the use of masks in surgical hospitals?)
Ken
@bnateAZ: If it helps, don’t think of your fellow citizens as selfish. Think of them as stupid, even suicidally so.
Xavier
@Ken: Never attribute to malice what can be attributed to stupidity.
Cermet
@Cheryl Rofer: Far too many new and even deadlier Pandemics will rage within that time span to keep people interested in this one. Even now, a fungus pandemic is likely and getting some speed in India (though, I think that will be contained.)
Spanky
@Xavier: Yeah, I used to think that, but in the last 5 years I’ve reversed the two.
Matt McIrvin
@Xavier: Yes, though the J&J, which some had been counting on as the easy choice to get some lower-propensity people, has a significantly lower efficacy against infection
(On the bright side, the storage requirements for the mRNA vaccines keep getting easier–it turns out you don’t have to go as hard and waste as much vaccine as they originally claimed.)
Cheryl Rofer
@Cermet: But data only becomes available with time and perspective.
And it’s not a pandemic if it’s contained in India.
debbie
An Ohio state rep is introducing legislation to end the lottery. She says it’s a “horrible waste of taxpayer money.” She says this even as the vaccination rate has increased 148% in her county (Miami) since the introduction of the lottery.
Lest you doubt, they are that stupid.
satby
I venture to suggest that most readers of this here blog are white collar, professional workers or retired; people who get paid sick days or can just take it easy for a day if they have an unfortunate reaction to the vaccine. Lots of people don’t have those options. That doesn’t make them stupid or malicious, just poorer with less options and bandwidth.
Now, MAGAts: those people are deluded, stupid, and malicious.
PurpleBabied
@bnateAZ: It’s hard to wrap my head around too. Meanwhile anti-maskers and anti-vaxxers say shit like this:
Baud
@PurpleBabied:
LOL. if it was a Chinese test run, the anti-maskers and anti-vax folks just gave China the green light.
Matt McIrvin
@satby: There are still a large number of unvaccinated Americans whose primary problem is access/convenience rather than being antivaxxers or deluded Trumpsters. It bothers me a bit that so many assume that everyone who would be OK with getting vaccinated has already gotten the shots (certain people on certain other blogs say this all the time).
Belafon
My company is going to send badges to everyone who gets vaccinated which will allow us to not have to wear our masks. It’ll separate the conspiracy theorists from the rest of us.
Peale
@PurpleBabied: Well then, all the more reason to get this vaccine so that when the bubonic plague 2 bugaloo comes to a neighborhood near you, you’ll be in the habit.
Soprano2
Our manager went to urgent care on Sunday and found out she had a kidney infection. I’m hoping they said to her “While you here you could get a Covid vaccination”, because she hasn’t done it yet due to time constraints. I hope they’re offering it to everyone who comes in!
Soprano2
This describes the people who work at the pub. I think that’s the main reason a couple of them haven’t gotten vaccinated yet; they’re afraid they’re going to be sick and miss work. We’re short-staffed now, so they know it hurts if they have to call in. I’ve told them to go ahead and do it and we’ll manage it fine, but they’re still reluctant.
I wish they’d do the lottery thing here, because it would work on a lot of the people who haven’t gotten the shot yet. These are the kind of people who play Lotto and buy lottery tickets.
germy
Another Scott
@satby: +1
We know the reasons why people aren’t getting shots, and in most cases they are practical ones not ideological ones. Vaccines should be available everywhere now – at 7-11s and 24-hour groceries, at highway rest areas, at farmer’s markets, anywhere people congregate. Make it difficult to avoid getting a shot, not difficult to get a shot.
And sudden shocks in trends can be great for discovering new stuff. “Our model of vaccination rates fit the Ohio data before the May 13 lottery announcement, and the post-May 13 rates as well, indicating the importance of … in affecting behavior…”
It’s when things change that models are tested.
Thanks.
Cheers,
Scott.
Jerzy Russian
@Baud: Regardless of the origin, Trump et al. still fucked up the response. Once a threat is there, it seems to me that the first immediate step is to defend yourself, mitigate the threat, etc. After you are safe, what you do might depend on the origin of said threat.
Xavier
@Spanky: I’m trying to imagine what happened in the last five years to change your mind
dmsilev
@satby: Yeah, that’s the major issue around here. Most of the people who haven’t yet gotten vaccinated are the people working as hard as they can just to get by, and both access to vaccines and the ability to take a couple of days to recover from any side effects are limited. The Public Health folks are working hard on the access side of things, mobile clinics and worksite visits and so forth, and that’s helping, but it’s a big job.
(and yes, there is some resistance as well, but that’s not the dominant effect)
RSA
I’m old enough to remember Newt Gingrich and other Republicans arguing that funding for midnight basketball was a waste of taxpayer money. And going back further, there was Nancy Reagan and “Just say no.” Racism aside, Republicans often refuse to recognize the difference between what people should do and what they actually do (absent proposed incentives).
Al Z.
In Anne’s Coronavirus Updates post below there was a link to this very interesting WAPO analysis:
https://www.washingtonpost.com/health/interactive/2021/covid-rates-unvaccinated-people/
They adjusted the numbers to look at infection rates of the unvaccinated and the numbers don’t look good; rates for the unvaccinated are as bad as they were in January. It infuriates me that the overall numbers and thus the rapid re-opening and dropping of restrictions is being driven largely by the people getting vaccinations. How do they not get this? If we heeded the advice of these anti-vaxers, we would definitely be in the middle of another surge – and somehow these idiots are able to point to these lower numbers as proof of some conspiracy?
Soprano2
@Matt McIrvin: I think a lot of people forget that everyone only became eligible for vaccinations in mid-April in most places! That’s about 5-6 weeks ago.
Matt McIrvin
@Soprano2: Yep! I’m still not officially fully vaxxed, because I got access late enough that my second shot was last Thursday.
Soprano2
Stupid, stupid, stupid, stupid, stupid. If they don’t make people at least produce a vaccination card, they’ll have a bunch of MAGA anti-vaxxers on their ships, because many of those people love to take cruises. I think it’s harder for people to lie when they actually have to show a card.
Matt McIrvin
@Another Scott: One thing that changed recently is that the CDC used to advise against giving COVID shots within 2 weeks before or after any other vaccination, and now they don’t. That should make it possible to give COVID shots along with other shots (which might be rough from the perspective of side effects, but you can get all the unpleasantness over with at once).
FlyingToaster
One of the things the grad students (and policy makers, more immediately) need to take into account is downtime requirements for the mRNA vaxes.
When I took WarriorTeen to get her vax, it was half parents w/ middleschoolers, and half twenty-somethings, like Starbucks baristas. Employers need to give employees two days off to deal with the aftereffects, and many service industries have been unwilling to do so. Our local Target was actually exemplary: they gave shots at the in-house CVS at end-of-shift and scheduled the newly vaxxed employees two days off. Stop-n-Shop (grocery), well, not so much; one of the shift managers was bitching because 3 people got their shots and called in sick.
I know of two take-out joints that shut down Monday-Wednesday, instead of just Monday, a couple of weeks ago. And I think I know why.
Matt McIrvin
@dmsilev: Also, even a large fraction of the vaccine resistance is soft. It’s low-info people who have heard some antivaxxer lies and some scare headlines and reasonably don’t know what to think about balancing risk–not hardcore conspiracy theorists.
I hate it when the antivaxxers prey on these people. I saw that happen in real time recently in the comments of a Facebook post–there was a woman who was really scared because her teenage daughter had fainted after getting the first COVID shot, and didn’t want her to go back for the second one. And a bunch of us said “well, that happens sometimes, people have a vasovagal reaction to shots.” But there was one person who said “your daughter was 100% harmed by the COVID vaccine, don’t believe all these people telling you otherwise, look at all the thousands of reports of children with mysterious reactions, I don’t know why everyone here is trying to maim children.” And, well, she liked that comment too.
Matt McIrvin
@Soprano2: “I identify as vaccinated” is the go-to catchphrase for horrible people who want to do all the kinds of horribleness at once.
Jay
@Cheryl Rofer:
“Black Fungus” is just a fungal infection of one of hundreds of strains of fungi.
problem is that covid patients immune systems are rather busy with covid, to deal with fungal infections as well.
also a problem, is that there are few treatments for these types of fungal infections, and most of the treatments, are 50:50 on killing the fungus, or killing the patient.
India, Pakistan, Bangladesh have tons of these fungi that get airborne through construction disturbances of the soil.
here in BC, we have groves of trees,
http://www.bccdc.ca/health-info/diseases-conditions/cryptococcus-gattii
Soprano2
@FlyingToaster: I wish I could offer people two days off after the shot if they need it. Unfortunately, we run so thin on personnel (we could use at least one more server and one more cook right now) that I can’t do that. For small business it’s almost impossible to do right now.
satby
I just heard from India that a friend has died, his father died less than a month ago. He leaves a wife and two young children, and similar tragedy is happening thousands of times per day there. Unimaginable.
Uncle Cosmo
A “fundemic,” then? (This from the same person that noted, from the rear-view-mirror-hangar he was issued for a just-pre-pandemic ceremonial procession, that FUNERAL is an acronym for REAL FUN…)
Shakti
They really should. Two days is nothing compared to a coronavirus infection rippling through a workforce. I did not feel 100% until two days afterwards.
I think it really highlights how many employers expect you to come in and work while you are sick.
Back in the aughts my shitty major hospital employer only gave me a week of PTO with no funding for insurance (but I was scheduled for 40 hours a week, all the time!) and one consequence of that decision is I dragged my sick ass into work because there was no way I’d be spending half a week on a cold. I also remember their pandemic protocol and saying out loud, “If it comes to that, I’m quitting.” I’d bet money they’re back to that pre-pandemic policy.
Ken
@Shakti: A couple of days ago, I posted part of a USA survey of things people thought wouldn’t go back to the way they were before the pandemic. “Buffets” and “bowling” were on the list, but on the more serious side, so was “feeling sick but going to work anyway”. It will be interesting to see how that shakes out.
Also on the list, one that hadn’t occurred to me – “snow days”. As in, many school districts won’t have them any more, now that they have processes for on-line classes.
Doug R
I was seeing that some states I think Mississippi was stuck at 30%? Not good.
sab
@debbie: Her county had the highest increase in the vaccination rate (up by 129%) of any county in Ohio after the lottery was announced. If I was one of her constituents I would be furious if the lottery was blocked after I had gotten myself vaccinated.
MontyTheClipArtMongoose
@bnateAZ: did 600,000 really die from the coronavirus?
Matt McIrvin
@MontyTheClipArtMongoose: Yes, that count is probably low actually.
Fair Economist
@Al Z.: Washington is somewhat misleading as they have controlled the pandemic better than most of the country, and by a lot too. Still, it’s true that if you adjust for vaccination status the current numbers are bad for the unvaxxed, and likely to get worse with reopening, fall school, and winter.
Fair Economist
@MontyTheClipArtMongoose: More like 800,000 when you add in excess deaths and deaths not yet reported (it’s a slow process).
bluefoot
@satby:
Yeah, I agree with this. The people I know who delayed in getting a shot was all about access. Either couldn’t get appointments, had problems re childcare, problems with transportation to get to a mass vaccination site, or do hourly or shift work and couldn’t get time off to get to the vaccination sites or to allow for downtime post-vaccination. Now that there have been a couple of weeks of local walk-in locations, I think everyone I know has had their first shot.
Kent
Ease of access? Most of the in-store pharmacies in my area such as Safeway, Kroger’s and Wal-Mart are doing non-appointment walk-up vaccinations. How much easier can it be than that?
Kent
@Shakti: Paid sick leave is a MUCH bigger issue than just vaccine side effects. In fact, vaccine side effects is probably one of the less important reasons to give sick leave. At least vaccinated people are not contagious compared to employees with the flu who might come staggering into the workplace due to no sick leave.
catclub
wow! that is fantastic.
catclub
When you have walkin shots at CVS and Walmart, these sound like bullshit to me.
Kent
Teacher here. I predict Covid will end up being the seminal 21st century event when it comes to education. Just like Brown v. Board of Education was the seminal event that changed everything in education (and suburban development) in the 20th Century. In 20 years we will be talking about pre-Covid education and post-Covid education.
Biggest change will be online education. School districts around the country will be scrambling to establish their own online academies for fear of losing their students to online charters and online private schools. It’s all about the money and the more students you keep under your umbrella, the more state and federal dollars you collect.
But I think schools are also going to forever be much more interventionist in student (and staff) health. Where that leads I really don’t know. But I already see it happening.
Matt McIrvin
@Kent: Just one example: I know someone living alone with a wide variety of health and mobility issues who only got his first shot recently, because he needed someone else to drive him to the place where he could get vaccinated, and he had already cancelled appointments multiple times because he felt ill for some reason or other when it was about to happen. It can be surprisingly difficult. For some people the only way to really make it easy would be to do house calls.
Pharmacies with unrestricted walk-ins have appeared in most areas, but haven’t been doing that for very long yet, and the locations aren’t necessarily easy for everyone to get to.
rikyrah
The group that I am most concerned with are the HOMEBOUND.
What are we doing to get shots in the arms of the HOMEBOUND.
Matt McIrvin
@rikyrah: Jinx!
catclub
@Matt McIrvin:
People looking for advice prefer confident and certain predictions. Charlatans are happy to provide that.
catclub
@Kent:
Interesting that big school districts – like LA, are announcing today that fall school will have no online option. I think being prepared (just in case!) for online at a moments notice will be double hard for teachers.
Enhanced Voting Techniques
How fucking stupid does someone have to be to say crap like this anti-vaccer? Never mind Bubonic Plague is endemic in US West wild life, what were they in a coma during SARS and the Bird Flue pandemics in East Asia?
Matt McIrvin
@catclub: I also suspect that some of the places that theoretically do walk-ins aren’t actually doing walk-ins. I know I’ve heard stories of people going to pharmacies or stores that were supposedly offering them, only to see an “appointment only” sign and having to talk to a manager before getting it done.
lee
Here’ an interesting article about how young adults are lagging behind in vaccination rate.
This is 100% my oldest daughter. She says that ‘some of her friends’ have had a bad reaction to the shot so she is worried. We told her to GTFOOH with that nonsense and just get vaccinated. She is supposed to get vaccinated this week. I have my doubts.
lee
@rikyrah: Several cities in Texas are going door-to-door in older neighborhoods. I think Corpus Christi was the first and started it a couple months ago.
My Dad lives in senior living apartments and they vaccinated everyone at the location back in Feb.
Kent
I predict they will develop online academies. But what they won’t do is hybrid learning where classroom teachers are asked to simultaneously teach both online and in-person students in the same class. That is an exhausting recipe for failure and I expect teacher’s unions will stop that from continuing. So students will have to choose at the beginning of they year whether they are enrolling in regular in-person school or online school but won’t be bouncing back and forth like now. Or doing online learning with their existing teachers.
I expect big districts like NYC and LA will most likely come up with their own separate online academies, otherwise they will lose too many students to online charter operators or other districts that are doing it.
For example, here in WA there are two districts that have long-term robust online academies that have been in place for many years. Spokane and Federal Way (suburban Seattle). Any public school student in any district in WA can, by law, enroll in either of those online academies and they take their funding with them. Both my daughters have taken summer online courses through them.
bnateAZ
@Ken: Yeah that is also true. Suicidally seeking “liberty” from “the government”
terry chay
I see the carrot, but where is the stick?
what will incentivize these people even more is that. No public venues, no transportation planes or trains unless vaccinated if eligible or proof of ineligibility (and masked), etc.
My father asked me to delay visiting him to see his first and only grandchild whine he has never met in person. I’m hundred percent sure it is because he realized he’d have to kick out his unvaccinated girlfriend from the house during our and my brother’s visit (he, of course, has been fully vaccinated for many months because he’s no moron).
The delay asked exactly matches the time to allows her to get vaccinated before then. She either doesn’t want to be kicked out or wants to see our child. He was okay with her being unvaccinated when the only person inconvenienced was himself (can’t eat out, etc.) but when it’s his grandson, well that’s going to take priority. Plus, he won’t have to tell my brother, who iwill NOT have an eye rolling reaction to his stupid girlfriend under the thrall of her Trumper friends.
Matt McIrvin
@lee: Among my daughter’s school friends, it’s the reverse–they all want to get vaccinated but at least one has antivaxxer parents who won’t let her.
Kent
@rikyrah: I agree. but the homebound are a tiny fraction of the unvaccinated population. And by definition they are at very low risk of either catching or spreading Covid if they are truly homebound. And if all of the caretakers who visit are vaccinated.
The homebound are not why say Mississippi is at 30% vaccinated.
Kent
Here in the Pacific Northwest, teenagers have the right to get vaccinated against their parent’s wishes. That law has been in place for years and pre-dates Covid. Now there are a few MAGA counties in Oregon that are trying to pass their own local ordinances to overrule that state law within their counties But they are being slapped down by the state. In Oregon any teen age 15 and above can get vaccinated without parent consent. In Washington the age is 14 and above.
My wife who is a primary care physician will gleefully give vaccines to all of her teen patients who request them, even if a parent is in the waiting room and objects. The law is the law and teens have legal autonomy over their health in these states.
Enhanced Voting Techniques
The State of California pays for 80 hours of time off for dealing with the vaccine aftereffects.
debbie
@sab:
Right. If it was so horrible, why has she waited this long to talk about getting rid of it?
lee
@Matt McIrvin: The demographic is a weird one 18-24 are lagging behind.
The younger ones are not noticeably behind.
Matt McIrvin
@lee: Actually, that makes sense. For the younger teens, their parents are probably mostly driving vaccination. 18-24 is college-age and young adults on their own, mostly socializing with other people their age.
artem1s
@debbie:
She’s even stupider than appears on the surface. The lottery money is coming from unclaimed lottery wins. The state is required to find a way to distribute those funds. They have several special games that draw their winnings directly out of this pool of money. Vaximillion or no Vaximillion the state is going to give it away to someone. I’m tempted to wish her actions resulted in one of her constituents losing out on the funds but we really need that cesspool of Cult45 to get on board before classes start up at Miami U.
Matt McIrvin
@lee: …reading it again, the article says the opposite: younger teens are even further behind than the 18-24s. But for some of them, they only became authorized to get vaccinated in the past couple of weeks.
Matt McIrvin
For teenagers and young adults, I actually understand some of the hesitancy because we’ve been told so many times that teens are at very low risk from COVID. So as soon as there’s any kind of marginal question about vaccine safety, the question immediately becomes, why bother? These kids aren’t in danger anyway.
The problem is the lack of any quantitative sense of “how low is low risk”–it’s intuitively hard to compare small probabilities. Teenagers *are* at low risk of serious harm from COVID compared to older adults, but my sense is that “low risk” is actually much higher than their risk of being harmed by the vaccines. But the latter gets media attention because it’s man-bites-dog.
Steve in the ATL
@terry chay: wait a minute—when did you have a kid? Did you get married too? Same chick from the Thirsty Bear meetup?
Kay
I entered the Ohio lottery and I entered my youngest.
I’ll let you know if we win. When we win.
There’s a bill in the Ohio legislature opposing the lottery, but I feel it is motivated by jealousy from Trump supporters that we’re having fun. They can’t play with us. Why are we so mean to them?
Jay
@MontyTheClipArtMongoose:
Epidemiologists and statisticians believe the real numbers so far are over 900,000 in the US and over 12,000,000 world wide.
rikyrah
@Kent:
You and I know why.
and, it kills me…
their Orange Savior has been FULLY VACCINATED SINCE DECEMBER.
trnc
@Matt McIrvin:
Agreed. I feel like it was way too early to introduce a high dollar incentive. People without access can’t get it no matter how big the prize is. Use some of the money to get the vaccine to those people and then do a more modest prize with more winners after that. Any anti-vaxxers who don’t find $1000 to be enough of an incentive probably won’t do it for the much lower odds of getting a million.
trnc
A lot of places in this country are food and service deserts or close to it. Even if you live in a pretty small town, you can’t extrapolate much from that and apply it across the country.
Matt McIrvin
@trnc: I’m actually fine with the lottery–it gets to people who CAN get vaccinated and aren’t averse to it, but it’s just not top-of-mind for them. The more people we can get it somehow, the better.
Brachiator
The Vons supermarket near me is offering walk-in vaccine doses, and 10 percent off on groceries.
Matt
@PurpleBabied:
Hot take: anybody who thinks the virus was a bioweapon and still argues against vaccination is clearly working for “the enemy” – send ’em to Gitmo and throw away the key.
Humanities Prof
@debbie: She’s my rep. She IS that stupid – homeschool grad who then went to Liberty U.
Humanities Prof
@artem1s: Jena Powell represents Miami County.
Miami University is in Oxford, which is some distance away to the southwest. We’re stuck with her, they’re not
Edit: The first post from “me” here (the reply to debbie) was actually from Mrs. HP, who probably hates Jena Powell even more than I do.