COMMENTARY

Are Free Beer and Donuts the Way to Get More People Vaccinated?

Arthur L. Caplan, PhD

Disclosures

July 12, 2021

This transcript has been edited for clarity.

I'm Art Caplan. I'm at the Division of Medical Ethics at the New York University School of Medicine. Vaccines — how do we get people to use them? How do we get people to engage in healthier behavior more generally?

Some people say, "Let them eat donuts." That philosophy has stirred up a lot of debate about the use of incentives to get people to vaccinate, and it certainly touches on other ideas about trying to encourage people to adopt healthier lifestyles.

If you looked at the vaccine issue, there are all kinds of clever ideas. Krispy Kreme, the donut company, has said if you come in with proof of vaccination, we'll give you a free donut. Many people got mad and said that donuts are not healthy.

My attitude is to calm down. I don't think you have to accept the donut. Even if it's a donut a week for a year, I don't think that's going to be the key to obesity in America. I'm not against that promotion.

Beer companies have offered free beer. Some bars and restaurants are encouraging vaccination by saying you get a free drink, which is clearly targeting younger people who they hope might get vaccinated. The New York Yankees and New York Mets said if you come to the game and you agree to get vaccinated, you get a free ticket and they'll vaccinate you at the stadium. There are many different ideas swirling around incentives.

I've also heard that in some prisons, prisoners are being offered $20 to get vaccinated. I know in one prison near where I am in Connecticut, prisoners were offered $20 and everybody who got the offer got vaccinated. To offer $20 to a person who earns 20 cents a day is a large amount of money. They jumped forward and all prisoners were vaccinated when that offer was made.

I don't have any problem with incentivizing vaccination behavior, or for that matter, trying to get people at work to lose weight, to spend a half an hour on a bike, or to get them to control their hypertension. I think incentives can be great.

There may be an issue around who knows about these activities. If you're doing it in the workplace, maybe you don't really want your boss to know whether you're exercising or whether you're compliant. That might be a privacy issue.

Most of the vaccine issues are not going to be reporting anything about whether you took the donut, took the beer, or got the free ticket. I don't think we have a privacy issue on the vaccine side.

What's more likely to be the case is whether the incentive is enough to really move the needle. Some data suggest that small rewards like food may be able to get people to change their behavior a little bit.

More data demonstrate that unless you're paying large amounts, such as $500 per month, people don't change their habits. They don't really want to exercise more. It's difficult to get on the treadmill and to monitor their diet, so they don't do it.

It's not the incentive that bothers me. It's whether it's going to have any chance at working. I don't think we should shy away from trying to incentivize people to do the right thing for themselves and their community. It's cute and admittedly somewhat good public relations when you're getting on the right side of vaccination.

I think the right side of vaccination is where we want our sports teams, our Broadway shows, our restaurants, our bars, and our concerts to be. If you get better seating because you got vaccinated, that's great. Whether it's going to really move you to get vaccinated because you're going to be up in the front row, I don't think we know for sure.

I'm Art Caplan at the Division of Medical Ethics at New York University. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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