Excerpt

In May 2021, the Governor of Ohio announced the launch of the state’s Vax-a-Million initiative, under which any adult resident who had received at least one dose of a COVID-19 vaccine could enter a weekly lottery with a million-dollar prize. Youth aged twelve to seventeen could also enter the lottery and stood to win a full scholarship to a state school. There were five winners in each category over the course of the program, at a total cost to the state of $5.6 million. Similar initiatives were adopted in other states and in countries worldwide, often involving fixed payments to each vaccinated adult rather than lotteries.

Attempts to influence individual choices by offering  financial incentives—conditional cash transfers or conditional cash lotteries— have become increasingly common. They have been used to influence a variety of behaviors and outcomes, including school attendance, academic achievement, smoking cessation, and regular exercise (Bastagli et al. 2019; Gneezy, Meier, and Rey-Biel 2011).

Sometimes the incentives work as anticipated, sometimes they fail to do so, and on occasion they backfire. Even in the case of Ohio’s conditional  cash  lottery,  there  is  some  dispute  about  effectiveness: Barber and West (2022) and Brehm, Brehm, and Saavedra (2022) found the program to have significant benefits in boosting vaccination rates and lowering hospital admissions, while Lang, Esbenshade, and Willer (2023) found negligible and possibly even negative effects. Similarly, modest cash payments were found to be effective in raising vaccination rates in Sweden (Campos-Mercade et al. 2021), but a randomized controlled trial in the United States found negative effects for vaccine-hesitant individuals (Chang et al. 2021).

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