In a recent research letter at JAMA Network Open, Georgiou et al examined the impact of a large cash incentive offered by a private employer to get their hold-out employees vaccinated against COVID.
Those fully vaccinated for COVID-19 by September 30, 2021, would receive a $1000 incentive if able to show proof of vaccination. The incentive was paid in October 2021.
Of the 2055 employees, 1,555 were fully vaccinated before the incentive program was announced. These folks were going to get the bonus no matter what they did. There were also 500 people who were not fully vaccinated when the program was announced. This is the target population where the bonus would be used to buy vaccinations.
At the end of the incentive program, 214 additional people were full vaccinated, or slightly more than 40% of the not-fully vaccinated and thus incentive influenceable population.
$1,000 is real money to me. It is real money to a lot of people. And it only modestly moved the needle on the number of people who were vaccinated. The authors found a spike in vaccinations immediately after the incentive was announced. However, there was rapid decay immediately afterwards which, to me, suggests that the incentive acted as an attention shock to people who were likely to eventually get vaccinated but had not yet done so. The value of the incentive is less than the the 214 people who finished their vaccination sequence as some of these folks were likely to have received a 2nd dose without an incentive.
I’m eyeballing the charts right now, but the story I am seeing is that there are significant groups of people who won’t respond to cash incentives for vaccinations as being anti-COVID vax has become part of their identity. Incentives might help shift timing and compress the span between doses for people who are likely to eventually get vaccinated, but non-coercive measures hit a limit.
Mike S (Now with a Democratic Congressperson!)
And they left $1K on the table that they could have spent on gas/diesel to drive uselessly around the DC Beltway too!
Butter Emails!
1. There is some value in getting the procrastinators to vaccinate sooner as opposed to some possible point in the future.
2. 1K is a decent chunk of change for most people, but it’s not going to convince someone who believes the vaccine contains tracking chips and will bring about their demise within a year.
Betsy
Okay, so since cash gains don’t move folks, invoke the classic “loss aversion” bias, instead. $1,000 is deducted from paychecks of those who aren’t vaxed.
jonas
Maybe Dave can shed some light on a question about hospitalizations: the other day, a local news story added a key detail when covering hospitalizations that I hadn’t seen in a while, though I know it has been an issue in earlier Covid waves: They noted that hospitalization stats (at least in NY) don’t differentiate between people admitted *for* Covid illness, and those who were admitted for some other issue (e.g. heart attack, having a baby) and then turn up positive during a routine Covid screening. Do we have any handle on how many cases are really people with severe Covid illness versus some other issue who just happen to test positive for Covid too?
Barbara
@Betsy: A few employers effectively did just that by imposing a surcharge for vaccine refusal. At a minimum they identified individuals likely to prioritize high risk behavior/lifestyle over their cost to the employer’s bottom line. This is usually — and usually correctly — seen as a big problem with employer-sponsored health care, but at least in this case the penalty aligns with public health policy.
Barbara
@jonas:
Yes, I have seen that data as well and had the same question. I think the best number to look at is the death rate. That number so far as I know doesn’t include people who died from other causes, e.g., heart attack, but “with” Covid.
Aunt Kathy
Yep, me raising hand. I worked in a natl distribution center co, most facilities located in red states. The headquarters is in Nashville, family owned. Bluest location was 1 (I think?) facility in CA.
They had an “incentive” vaccination program. “Incentive” is in quotations because the cash would only be given if a certain percentage threshold was reached across all facilities. X amount for 70%, increasing every 10 points. I think the highest payout was $2k. Most facilities got to about 50%. California was highest with 80 or 90 something. Allentown PA might have been stuck in the 20s. So, when you put everybody together, as a company, we never reached the 70% mark. So nobody got anything.
It’s my belief that the grand poobahs were aware of how it would shake out. They knew they’d never have to pay out, all while looking like they were being responsible employers.
And, yes. I heard MANY remarks like, “I don’t give a rats a$$ how much they’re payin’, I wouldn’t get that shot for a million dollars.”
It’s the same as our politics. Culture will cause someone to vote against their own interests, every time.
Steve in the ATL
@Barbara: also a big problem in union facilities!
Matt McIrvin
If cash incentives trumped identity I’d have become a Republican long ago, so I get it.
Ruckus ??
Those who work at faux news all were vaccinated and they make a lot of money. Of course they make that money by lying for a living. Interesting that you can pay conservatives to lie but not to protect themselves…… unless the pay is rather significant. Do they think their politics protect them from disease and make them a fair amount of cash? One wonders…
Bill in Section 147
This is a great example to use when I have to listen to friends tell me how they harangue Trumpies at work with facts and cannot understand why they always vote against their own interests.
They ALWAYS vote for THEIR own interests. What benefits everyone is not a motivator for them. Money is not more important than their soul (values). Facts are Satan’s (Progressive’s) way of testing one’s faith.
You’re better-off understanding how evangelicals convert heathens than understanding how to raise class consciousness.
Dan B
@Aunt Kathy: It’s disturbing how many people vote or go against their own economic well being. I believe it’s because they feel uncomfortable about the “geyz, coloredz, furrinerz, diseased, criminalz, etc. Do the vast majority of straight white people have no contact with any of these people that make them uncomfortable? Social media makes sorting easier. Are there any organizations working to address this issue that aren’t all Kumbaya, we should all get along? The only economic policy that seems to break through the lower middle class and middle class is “lower taxes”. Much of this may be disgust that their taxes might go to help “those people”.
This vaccination incentive story likely has broader lessons for us.
Dan B
@Bill in Section 147: Well put! I’m reminded of Black people who ask that we deal with racists in our families and acquaintances. My in laws are nice people until you question their views, even very gently. Then their inner monsters go on full tilt attack mode.
They are well bred and well mannered monsters.
FlyingToaster
@Dan B: (This is for both of your comments.)
The bitter, bitter truth is that many people are primarily motivated by fear & spite*. In my own family, one of my uncles and my lame-ass brother are those people. Since everyone lives at least 1500 miles apart (to prevent critical mass), they never get invited to anything. And, mind you, they never invite anyone of us, anyway. Because the rest of the family is “other”.
* Fear and spite. Fear of something that is sufficiently different from you — in skin color, race, religion, sexual orientation, politics, or just that that person has a house of unusual color (?). Spite in that they resent the fact that their inherent ancestral advantages (whitebois) haven’t worked out to the success that their siblings (girls!)/neighbors/competition have achieved. Thence it feeds into a victim mentality, and now Xtians and Goopers are victimized minorities in the US of A, despite all evidence to the contrary.
Dopey-o
That’s a good analysis, but just a little bit wrong.
40% of America wakes up hating. Hate is their drug, and it doesn’t matter if it’s blacks or jews or trans people or latte-sniffing liberals who want to destroy America.
The point of fascism is that I now have a position of strength and invulnerability, and I can dominate you with impunity. Might makes right, that’s as good as heroin or booze for these losers.
Martin
Daughter is currently doing a college paper on vaccine hesitancy, and I’m helping her with the sources. There’s some aggregated studies on hesitancy and the US is distinct in the role that social influence plays in hesitancy. People don’t want the shot because the people around them openly say they don’t want the shot.
That’s going to vary geographically (Deep South vs northeast) by workplace, by community, etc. If we see ourselves as cultural islands, this is the consequence of that.
ronno2018
I thought I read somewhere the vast majority of the un-vaccinated were just scared of hypodermic needles and they did not want to publicly admit it?