In Wisconsin, a $100 vaccine incentive seems to work. Nationwide, incentive results are a tossup.

MADISON, Wis. — A week after Gov. Tony Evers promised a $100 rewards card to anyone in Wisconsin getting their first COVID-19 vaccine, the 7-day average of shots administered rose to its highest since late June.

From free beer to cash prizes, COVID-19 vaccine incentives have emerged throughout the country as part of a nationwide push to get more Americans vaccinated, with mixed results. For Wisconsinites, the promise of a $100 rewards card likely helped contribute to over 65,000 Wisconsin residents receiving their first dose in the 13 days after Evers’ “Get vaccinated, get $100” program was announced.

The results had state officials happy enough to keep the incentive going past the originally-announced end date, from September 6 to the new cutoff of September 19.

“This is for sure the high-water mark of the last several weeks,” Secretary-designee Karen Timberlake with Wisconsin’s Department of Health Services told News 3 Investigates. “We’re very pleased with the results so far.”

The rise in vaccine incentives follows President Biden’s recommendation that states, territories and local government officials should use federal American Rescue Plan dollars to encourage citizens to take the vaccine with $100 incentives. With the current number of first doses in Wisconsin equaling about $6.5 million in incentives to pay out, the $100 cards will come from the state’s pool of ARPA funds. Incentives are in part targeted for the vaccine-hesitant, but also those who may face extra barriers to getting the shot.

“They have to hire a babysitter, or they have transportation challenges, or they have to take time off of work because they don’t work in a place that gives them sick time,” Timberlake explained.

Yet, as Evers has extended the incentive program to last for two more weeks, the effectiveness of vaccine incentives from a national standpoint remains unclear. In addition, health policy experts point to pros and cons–and at times, ethical concerns associated with health incentives.

Justin Sydnor, a UW-Madison School of Business professor with expertise in behavioral economics and health care, said incentives might cause individuals who are already hesitant about receiving the vaccine to further escalate their concerns.

“There are some reasons to worry that incentives could backfire in some of these situations,” Sydnor said. “Sometimes when you’re offering an incentive it signals that the thing you’re trying to incentivize might not be that appealing, and so that is a slight concern.”

Nationwide, incentive effectiveness varies

An analysis of data from various types of incentives from other states yields a mixed bag of results, particularly based on the incentive’s type. Examples are plenty in Wisconsin: a chance to win Bucks tickets for Game 6 of the NBA Finals only prompted 19 people to get their shot; later, hundreds got one in exchange for a free cream puff at the Wisconsin State Fair.

In Minnesota, the state offered a $100 gift card vaccination incentive that provided the model for Wisconsin’s program. The program was also extended due to its apparent success, with Minnesota’s 7-day-average rising from 2,675 last month to about 4,955 by the end of August. That’s prompted some old-fashioned rivalry between the states.

“We looked hard at Minnesota which had a similar incentive program,” Timberlake said. Are we beating their results? “There’s always that Wisconsin-Minnesota rivalry, so we’d love to be ahead of them on this.”

Vaccine incentive efforts appeared effective in New Jersey as well, where people getting a first dose also got a free beer in May. A week into the incentive program, the state saw a 7-day-average increase from about 66,000 on May 4 to about 75,000 shots a day a week later.

But a similar free-beer incentive in Connecticut had a much different result, where the 7-day average of new vaccine doses dropped from over 40,000 on the day of the announcement, April 26, to about 33,000 on May 11. 

It can be difficult to determine whether vaccine incentives are effective because states don’t know what the vaccination rates would have looked like without them. Additionally, other variables can skew the data as well.

For example, Gov. Gavin Newsom in California offered a series of incentives including free Six Flags tickets, $50 gift cards, and the chance to win big cash. After his “Vax for the Win” lottery program announcement, he claimed a 22% increase in doses week-after-week. But health experts in California say the results aren’t as clear; a drop in vaccinations over Memorial Day Weekend and another wave of shots after Pfizer’s emergency authorization for children aged 12-15 could have prompted a 22% increase as well, rather than being exclusively an incentive result. 

In a news conference two weeks ago, Evers said he was at first skeptical about the success rate of incentive programs, but decided to move forward with the program after witnessing the success of Michigan’s vaccine lottery efforts. However, the effectiveness of this particular lottery program also offered mixed results.

When Michigan’s million dollar lottery incentive was announced, millions of residents signed up. At the time, the state’s vaccination rate was 61.82%. However, the state reported that the vaccination rate only rose to 62% for individuals 16 or older the next week. 

This number indicates that most of the near 1.4 million Michigan residents who signed up for the lottery had already been vaccinated prior to the announcement, suggesting that the announcement did not encourage many unvaccinated individuals to get vaccinated, according to WOOD-TV

Health policy experts: There’s pros and cons

Though the success rate of vaccine incentives may be hard to determine, health experts say government officials should use whatever tools are available to encourage people to get the shot. 

According to Thomas Oliver, A UW-Madison Population Health Sciences Professor and expert on health policy, the social costs of an unvaccinated population pose a greater risk than the financial cost of a vaccine incentive program.

“The cost we face socially and individually if we get sick— all of the healthcare costs, all of the stress on all of our other services, people can’t go to work, they lose income…there’s a lot of costs that are out there for the sickness,” Oliver said.

“I think the government is being very responsible in adding this as one more thing to try to tip the scale on the side of getting vaccinated for people who have found it difficult to justify or take the time to go get it.”

Yet, Oliver explained that vaccine incentives can cause some reason for ethical concerns. 

“The problem with the financial reward is that it sends a very strange message that we need to bribe you as opposed to people feeling good about themselves doing it,” Oliver said. “If you accept the $100 bribe, you’re probably not going to feel that great, like you did something for others.”

This can also cause those who received the shot prior to vaccine incentive programs to feel slighted in some ways, according to Oliver. 

 “It makes the rest of us who willingly went and got the vaccine think, ‘Why should somebody else get 100 bucks for waiting so long, creating a more dangerous situation for themselves and for others, now get rewarded for procrastinating, blowing it off, or basically opposing it? And now all of a sudden they’re gonna get a reward?” Oliver said. “So I think that’s damaging to the social fabric.”

The state had their own response for fully-vaccinated individuals who resent their exclusion from the $100 card program.

“The great news for them is they have been protected against COVID-19 this whole time,” Timberlake said. “We want to say a great big ‘Thank You’ to the 3 million people across Wisconsin who are fully vaccinated against COVID-19.”

How to sign up

In order to get the reward, residents will need to register by filling out a form online or calling 844-684-1064. Information will be used to verify that residents got their first dose between Aug. 20 and Sept. 19.

The payments will come in the form of a $100 bank reward gift card. Cards will be mailed to participants’ addresses and may take up to six weeks to arrive.

Proof of insurance, I.D., or citizenship isn’t required. Wisconsinites ages 12 and older are eligible.