DeWine’s Gamble Pays Off

Key Takeaways

• A leader has three ways to make people do things: mandate, persuade or incentivize.
• People respond to incentives.
• Sometimes a leader has to incentivize people to do something even if they should already want to do that thing.

At first glance, the Ohio Vaxamillion lottery may look like a dumb idea. Governor Mike DeWine’s program has been heavily criticized by Democrats and Republicans, who view the lottery as a gimmick and a waste of resources. However, as silly and gimmicky as it seems, the lottery is actually more cost-effective than it might seem, and we should not be surprised at its success given the research on incentivizing behavior. Even as vaccination rates in many parts of the country have declined, Ohio saw a 53% increase after Vaxamillion was announced.

The problem is fairly straightforward: In May, Ohio’s rate of COVID-19 vaccinations (like the rest of the country) started to decline. The state’s mask mandate expired on June 2, we are nowhere near herd immunity and infection rates among unvaccinated adults remain high. The governor needed a strategy to speed up vaccinations.

Getting people to do something involves changing behavior. So, a leader can either force people to do it, persuade people to do it by convincing them it is in their best interest or offer an incentive to encourage them to do it.

To make people do something, a government can make it legally required for its citizens. And a vaccine mandate would have been the cheapest solution. We have had enormous success in this country with vaccine mandates in public schools, for example. However, the prospects of getting a COVID-19 vaccine mandate in the current political environment are quite poor. Sadly, anti-vaccine beliefs have spread in many places in Ohio.

Those beliefs also, unfortunately, limit the value of persuasion. In general, there is skepticism about the effectiveness of advertising. Emerging evidence suggests that attitudes about the vaccine may be polarized on party lines, which would make it even less likely that advertising will have an effect. Plus, with COVID-19, the active spread of misinformation makes it difficult for good public health information to change minds.

And, indeed, it does not seem like the governor is trying to change minds.

In a New York Times op-ed, Governor DeWine explained his reasoning behind the lottery: He argued that while most Ohioans were eager to get the COVID-19 vaccine and some were adamantly opposed, “There was a third group that did not have strong feelings about the vaccine. Many people were just not in a hurry.”

The goal of the lottery, then, was to push this third group to get vaccinated quickly. With a mandate not feasible, and persuasion not likely to work, Governor DeWine has chosen a strategy of incentivizing.

But paying all Ohioans enough money to get them to get a vaccine would be prohibitively expensive, so the state has chosen a method that is reminiscent of researchers’ approach to the recruitment problem. We often have limited budgets for recruitment and, sadly, few people want to participate in an experiment just to help advance scientific knowledge.

Research shows that participants respond to tangible incentives more than appeals to the collective good or community unity. And lotteries are more cost effective than offering guaranteed payments, which often have to be quite high in order to encourage participation. In this case, it is cheaper to offer the possibility of $1 million to all Ohioans than it would be to try to pay all 11.69 million of us to get vaccinated.

The Vaxamillion program (and the copycats it has inspired) are premised on getting people who want a vaccine to make it a priority and get the shot. Lottery winner Jonathan Carlyle admitted “As soon as I heard that [about the lottery] I was like, ‘Yes, I need to go do this now.’” Prior to the lottery he had been putting it off because he had not found time around his work schedule.

This is a very common problem. We all have work, school, childcare, life and it is often hard to prioritize things even when we know they are important. If you are not in a high-risk group, you might want the COVID vaccine in the same way that you want a flu shot. It becomes a thing that you get when it is convenient, and you remember to do it. However, if everyone does that then the vaccination rate declines, and the virus continues to spread.

It is a little silly that miniscule odds of winning a lottery add incentive to getting free medicine that will end a pandemic. But leaders must recognize that not everyone will automatically agree with them about what should be done or what should be a priority. If you can’t impose a heavy-handed mandate, and people won’t listen to your argument, they may need a substantive benefit to make the “correct” choice.

The governor deserves credit for being willing to act quickly and take a risk on a silly idea. A lottery motivates people to get vaccinated faster, which will save lives.

Get the shot!