Beer, donuts, childcare, rides, lotto prizes — will vaccination incentives work?

With the Fourth of July just weeks away, federal officials have ramped up their campaign to hit President Biden’s announced goal of having 70% of adults in this country vaccinated against the coronavirus. The aim is for the rapidly opening nation to safely and fully declare its independence from the deadly pandemic.

Biden, while thanking those who already have gotten their shots, has pressed the 20 million or so unvaccinated among us to get on board, asap. The administration will try multiple ways to increase the 63% or so of adults vaccinated, including by:

• relaunching outreach efforts with a national tour featuring Vice President Kamala Harris in the South and Midwest
• working with pharmacies — including Albertsons, CVS, Rite-Aid and Walgreens — so they offer extended hours on Fridays in June starting next week to boost the number of vaccinations
• partnering with four of the nation’s largest childcare providers — KinderCare, Learning Care Group, Bright Horizons, and hundreds of YMCA locations — so they offer free drop-in childcare to all parents and caregivers getting vaccinated or recovering from a shot
• launching a new initiative called, “Shots at the Shop” to recruit black-owned barbershops and beauty shops to help with outreach
• prodding all employers to “do the right thing” and make it easy for employees to get vaccinated during work hours, reminding them the government is offering a tax credit to cover the cost

The White House and other officials also have sought to promote corporate-offered and other incentives to get more people to get their shots, as NBC News reported:

“The administration said it supports a plan by Anheuser-Busch to give adults 21 and over a free beer, seltzer or nonalcoholic beverage if the country reaches 70% goal by July 4. To get the $5 virtual credit for a beverage, people will have to upload a photo of themselves to the company’s websites of their ‘favorite place to grab a beer’ along with basic personal information. The White House said it has been encouraging other corporate programs, including CVS giving away cruises, tickets to the Super Bowl and cash prizes to people who are vaccinated, and Major League Baseball teams offering on-site vaccinations at games and free tickets to those who get vaccinated.”

Donut makers, of course, have received lavish attention for their vaccine-related giveaways (see cartoon above), while the transport services Uber and Lyft have gotten praise for their programs to offer donor-supported rides for those who need them to get vaccinated.

And states like Maryland, Ohio, Washington, and California, meantime, are piling on cash prizes in vaccination lotteries. The Golden State kicked its program off by awarding 15 $50,000 prizes to winners who qualified by getting their shots. Maryland says it will pay out $2 million in a series of prizes, multiple of which will be $40,000, with one $400,000 winner (the prizes come from state lottery funds and patient privacy rules are getting adhered to by health officials administering shots).

The fractures over vaccination

Will the vaccination campaign hit its goal? It may, but in a potentially distressing fashion, with stark geographic, economic, and partisan divides, experts say.

The Washington Post reported this about the area around the nation’s capital:

“The greater Washington region will almost definitely meet President Biden’s goal of 70% of adults being at least partially vaccinated against the coronavirus by July 4 — with Maryland already there, and D.C. and Virginia close behind. But pockets of hesitancy, including among Whites in rural Virginia and black and Latino residents in parts of Maryland, mean some communities may not reach the milestone for months, if ever.”

CNBC News reported these states have crossed the 70% threshold: “California and Maryland most recently reported crossing the milestone, joining Vermont, Hawaii, Massachusetts, Connecticut, Maine, New Jersey, Rhode Island, New Mexico, Pennsylvania and New Hampshire.”

ABC News reported these states are near the key mark: New York, 68.1%; Virginia, 67.5%; Washington state, 69.5%. But the network also said this: “Alabama, Louisiana, Mississippi, Tennessee, West Virginia, and Wyoming still have less than 50% of their adult population vaccinated with at least one Covid vaccine dose” as of May 2.

Health disparities and partisanship

The gap in vaccination, as with other important public health aspects of the battle against the pandemic, has laid bare — yet again — big disparities in health care, based on geography. The independent, nonpartisan Commonwealth Fund provides state-by-state data on these inequities, which are glaring in the South and largely rural areas of the country. The fund, in understated language, described the risky lack of vaccination in swaths of the nation this way:

“What accounts for the recent changing pace of vaccination? Several factors are likely at play, but when we compare the patterns of vaccination to the Commonwealth Fund’s annual State Scorecard rankings, it is hard to miss that states that have previously performed well on measures of access and patient engagement are seeing higher rates of vaccine administration, while lower-performing states are progressing more slowly.”

The news site Politico, which hews to its mission of seeing all matters in political terms, had its own take on vaccination disparities, reporting this under the headline, “The partisan divide in vaccinations is starker than you realize”:

“All but one of the 39 congressional districts where at least 60% of residents have received a coronavirus shot are represented by Democrats, according to a Harvard University analysis that presents one of the most detailed looks yet at the partisan split behind the nation’s diverging vaccination drive. By contrast, Republicans represent all but two of the 30 districts where fewer than one-third of residents have received a shot.”

Politico reported, quoting experts from the Kaiser Family Foundation, that communities of color have lagged in getting coronavirus shots — mostly due to access issues, not necessarily for partisan reasons. Blacks and Latinos struggle to find shot providers, to get time off from work to get vaccinated, and they worry about vaccines’ cost, though the inoculations are free. Federal efforts to reach under-served communities are slowly working.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by an array of awful circumstances and things, including:

• dangerous drugs
• risky and defective products
• abuse and neglect in nursing homes and other long-term care facilities
• and car, motorcycle, and truck crashes.

In these cases, a crowd of problem people and institutions — these can include doctors, hospitals, insurers, regulators, and politicians — may press victims to move on, settle up, and they fast forget the lonely agony of the suffering. It can, however, take a long time for patients to recover from terrible illness or injury. Harms can last a lifetime. Patients may need medical services, as well as financial and other support for months or years. They also need closure and justice for wrongs done, as well as the sense that they may be able to help others avoid the problems that afflicted them.

We are not done with the coronavirus and the huge trauma it has inflicted on us all. Please get vaccinated. All medical interventions carry risk. But vaccines’ benefits long have been shown to far outweigh their harms.

By the way, don’t toss away those face coverings just yet. They may be a good thing to wear in closed, crowded, and poorly ventilated spots, especially as there’s no way to know for now who has gotten vaccinated and who has not. Masks may not be needed outdoors, and they’re less important for the vaccinated.