Vaccine Lotteries: They Work!

To try and encourage vaccination during the on-going COVID pandemic, there have been many public and private incentives offered. For example, free doughnuts. Or offering $200 to state employees in Arkansas (taxable income, of course!).

But when the governor of Ohio announced on May 12, 2021 that they would be offering a $1 million lottery prize, with 5 winners, it took the incentive game to a new level (college scholarships were also a prize for 5 winners under 18).

So do the lotteries “work”? Do they get more people vaccinated? And even if they do “work,” does it pass a cost benefit test? Many expressed concern that, even if more people get vaccinated, that this is a lot of money to spend in uncertain budget times.

A new working paper by Andrew Barber and Jeremy West attempts to answer these questions. And they do so using synthetic control, one of the better methods social scientists have for attempting to identify causal relationships (which can be tricky).

What do they find? First, vaccine lotteries do work! They estimate that vaccination rates increased by 1.5% in Ohio because of the lottery. This amount is above and beyond the increase that would have been expected without the lottery (by comparing Ohio to other states that didn’t use a lottery — this is what the synthetic control method does).

But does it pass a cost-benefit test?

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Laboratories of Democracy in Pandemic

You’ve probably heard the phrase that US states are often “laboratories of democracy.” The phrase comes from a Supreme Court case. It’s well known enough that it has a short Wikipedia page. The basic idea is simple: states can try out different policies. If it works, other states can copy it. If it doesn’t work, it only hurts that state.

The 2020-21 pandemic has provided a number of possibilities for the “states as laboratories” concept. Here’s three big ones I can think of (please add more in the comments!):

  1. Do states that impose stricter pandemic policies (“lockdowns”) have better or worse outcomes? This could be about health, the economy, both, or some other outcome.
  2. Do states that end unemployment benefits sooner have quicker labor market recoveries? Or are these not the main drag on the labor market?
  3. Do states that offer incentives for vaccination have higher vaccination rates? And what sort of incentives work best?

These are all good questions, but let me throw some cold water on this whole concept: we might not be able to learn anything from these “experiments”! The primary reason: the treatments aren’t randomly assigned. States choose to implement them.

Let’s think through the potential problems with each of these three areas:

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