Lottery Incentives Don't Increase COVID-19 Vaccination Rates

Carolyn Crist

July 06, 2021

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Lottery-based incentives such as cash and prizes don't appear to increase COVID-19 vaccination rates, according to a new research letter published in the Journal of the American Medical Association.

In particular, researchers found that Ohio's "Vax-a-Million" campaign wasn't associated with an increase in vaccinations. In May, Ohio Gov. Mike DeWine announced five $1 million cash prizes would go to vaccinated residents, and several states created similar programs to increase vaccination rates.

"State-based lotteries are of limited value in increasing vaccine uptake," Allan Walkey, MD, one of the study authors and a professor of medicine at Boston University School of Medicine, said in a statement.

"Therefore, the resources devoted to vaccine lotteries may be more successfully invested in programs that target underlying reasons for vaccine hesitancy and low vaccine uptake," he said.

Walkey and colleagues used CDC data to evaluate trends in vaccination rates among adults. They compared vaccination rates before and after the Ohio lottery with other states that didn't have vaccine incentive programs.

Between April 15 and June 9, the daily vaccination rates among adults declined from 485 per 100,000 people to 101 per 100,000 people in Ohio and from 700 per 100,000 people to 97 per 100,000 people in states without lottery programs. Daily vaccination rates declined in both Ohio and the U.S. throughout May, and even after the Ohio lottery announcement, adult vaccination rates didn't increase significantly.

Overall, the research team found that lottery-based incentive programs weren't associated with an increase in COVID-19 vaccinations and that other factors likely led to additional vaccinations, such as expanded eligibility for shots. For instance, the Ohio lottery program was announced on May 12, just days after the FDA expanded the emergency use authorization for the Pfizer vaccine to ages 12-15.

"Prior evaluations of the Ohio vaccine incentive lottery did not account for other changes in COVID-19 vaccination rates in the United States, such as those that may have been due to expansion of vaccination to ages 12-15," Walkey said.

Walkey and colleagues said they hope the findings will lead to a shift in focus by moving away from ineffective lotteries and toward other programs that may reduce vaccine hesitancy and increase vaccinations.


JAMA: "Lottery-Based Incentive in Ohio and COVID-19 Vaccination Rates."

Boston University School of Medicine, "Lottery-Based Incentives Do Not Increase COVID-19 Vaccination Rates."