Equality by lot

According to the article “Mastering the art of persuasion during a pandemic” in the journal Nature (OUTLOOK, 26 October 2022):

After the first COVID-19 vaccines were rolled out in the United States, local and state officials invested millions in the idea that waving money at people would convince them to get the jabs. Leaders tried straight cash incentives, whereby people collected a set sum for getting vaccinated, as well as lotteries, in which vaccinated people were entered into a draw to win a cash prize.

But the concept often flopped. One study (3) that gauged the effectiveness of vaccine lotteries found that vaccination rates were not significantly higher in lottery states than in non-lottery ones. Guaranteed cash payouts were somewhat more likely to encourage vaccination, a meta-analysis showed (4). Still, the evidence on incentive-based persuasion “is pretty disheartening in general”, Milkman says.

She is now studying a twist on the lottery strategy that might deliver more value for money — a regret lottery. This involves telling people that their name has been entered into a draw to win a large amount of money, but if their name is pulled from the hat and they have not been vaccinated then they will have to decline the reward. When Milkman and her team tried this in Philadelphia (5), vaccine rates in the area increased slightly compared with those in other, similar areas that did not have a regret lottery. “The one data point we have looks promising,” Milkman says, but further research is needed to confirm the finding.

References from the original:

(3) Law, A. C. et al. JAMA Intern Med. 182, 235–237 (2022).

(4) Brewer, N. T. et al. Lancet Reg. Health Am. 8, 100205 (2022).

(5) Milkman, K. L. et al. Nature Hum. Behav. https://doi.org/10.1038/s41562-022-01437-0 (2022).

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