Are Vaccine Lotteries a Good Thing?
On May 27th, Ohio Governor Mike DeWine proudly announced the first winners of the state’s Vax-a-Million lottery. Twenty-two year-old Abbigail Bugenske won $1 million and Joseph Costello, an eighth-grader, won a four-year college scholarship. The only requirement for Ohioans to qualify was having received at least a first-shot COVID vaccine. It was smiles all around at this event and in similar ones in many other states as vaccine lottery winners have been announced.
As public policy, it seems nothing here could be amiss. These campaigns are designed to encourage people to get vaccinated - a clear public health goal. The funding in Ohio and many other states is being taken from federal COVID relief funds, not from state coffers. Winners are certainly delighted, and there’s lots of excitement about the lottery drawings – not to mention that politicians love the attention and good feelings.
Yet thinking more deeply, questions arise. What evidence did anyone have that such lotteries work? While many state officials point to increased rates of vaccination since the lotteries have been launched, it’s hard to know whether the increase is due to lots of people getting their second shots, the recent opening of vaccinations to children 12 and older, the fact the some lotteries began right after the Memorial Day weekend during which few got vaccinated, ongoing outreach to hard-to-reach populations or the lotteries themselves. Some evidence is emerging that the “lottery effect” on vaccination rates has been short-lived even where it appears to have had initial success.
A more central question: what unanticipated side effects or opportunity costs result from vaccine lotteries? If they have done some good, that doesn’t mean they have done no harm.
Our republican form of government relies on what the founders called “civic virtue” - what we might call “civic responsibility.” It’s the notion that citizens’ moral behavior builds and buttresses self-government – that our rights require us to accept responsibilities. In this context, is offering money to people to do what they ought to do anyway to protect themselves and their fellow citizens a good practice? What do we contribute to the ethical development of young people when we, in essence, bribe them to demonstrate civic responsibility – or communicate that the luck of the lottery draw not hard work determines if your government rewards you? Since eligibility for these lotteries requires only having gotten the vaccine, irrespective of when, some winners didn’t have to do anything; they were already vaccinated (as was the case with Abbigail Bugenske). In some states, those vaccinated by DOD or VA hospitals were not even eligible (this is belatedly being addressed) since they weren’t in state databases, in essence penalizing those who actually did serve the public good.
Another question: what else might have been done with the millions dedicated to rewarding a small handful of people? Might the funds have been better allocated for outreach to poor, rural or low-vaccination-rate areas to increase vaccinations there? Should the funds have been used for educational materials and campaigns to counter common fears and misperceptions about vaccination? In a Kaiser Family Foundation poll, for example, 54 percent of adults subscribe to - or say they’re not sure about - one or more of the following: you can get COVID from the vaccine, it contains fetal cells, can cause infertility, can change your DNA and that you don’t need to get vaccinated if you’ve had the virus.
Might the funds have been used, as another example, to pay fully vaccinated people to meet and talk with those with such concerns to encourage them to get their shots? Such a program done by hiring vaccinated teens would have given them an instructive experience in public health, the chance to meet and learn about the lives of their fellow citizens and a sense of achievement and positive feelings associated with doing important work.
Some have also raised the question of why so much money is being dedicated to these lotteries when other pressing state needs exist in such areas as education, health care, infrastructure and poverty relief.
When government leaders adopt policies and engage in public acts, they signal what values count in civil society. Public health through vaccination is certainly a laudable value, but lotteries that require no demonstration of civic responsibility communicate less commendable values.
In an interview with CNN’s Chris Cuomo, Abbigail Bugenske said she plans to keep her job as a GE engineer; she has no intention of leaving it. She said she is looking to buy a used car not a Lamborghini, has contributed some of her winnings to charities and hopes, as restrictions are lifted, to communicate to others the importance of getting vaccinated. The values she thus communicated show the kind of civic virtue our society needs. The more difficult question is whether the lotteries themselves foster that same civic virtue.
Photo Credit: WBNS TV, Channel 10
