23. A stupid big lottery or a big stupid lottery?

Vaccinating the stragglers

Welcome back to Giving to Strangers. Every issue I explore what matters in social good and offer sane, relevant donation advice. Giving to Strangers is written by me, Anya Marchenko.

One of Ohio’s lottery winners is an Amazon delivery driver who says he was “procrastinating” on getting the vaccine, as he is busy at work and taking care of three kids with his girlfriend.

Last week, Ohio native Jonathan Carlyle got an unexpected call from Ohio governor Mike DeWine while delivering packages for Amazon. Jonathan was busy finishing up his shift, so the governor had to leave a voicemail. The governor was calling to let him know that he had won $1 million as part of a lottery, one of two state programs in the country incentivizing people to get vaccinated.

Jonathan spoke to Cincinnati’s The Enquirer about the lottery inducing him to get vaccinated:

“I was putting it off a lot because I was working all the time, and I just kept putting it off and off and off, but I knew I needed to get it and I wanted to get it,” Carlyle said. “When y'all announced the Vax-a-Million, as soon as I heard that, I was like ‘Yes, I need to go do this now.’”

Why lotteries?

Vaccination rates have been hovering around ~50% in the United States for the last month.

This was expected — many predicted that after an initial surge, there would be a slowdown in vaccination rates, as people procrastinate, are vaccine hesitant, refuse to get vaccinated, or still can’t access vaccines.

But now, how do we get the unvaccinated half vaccinated?

Some states are coming up with creative methods. California and Ohio have announced a lottery in the last few weeks to reward people who get vaccinated, with pots of $15 and $5 million, respectively. While all Californians who have received at least one dose of the vaccine are automatically entered, in Ohio the lottery is opt-in. And over 3.3 million Ohioans have already entered themselves into the drawing.

Why organize a lottery instead of just sending everyone a check when they get vaccinated? Well, that’s not such a bad idea either. But for California to send its 24.6 million adults $200 each would cost $4.9 billion, likely prohibitively expensive.1 A lottery induces people to get vaccinated who aren’t even going to get the money, meaning a better bang for the buck for states.

And the hype seems to be working. At least some of these 3.3 million Ohioans who entered are new people who signed up to a vaccine. According to Ohio’s Department of Health, in the two weeks after the Vax-a-Million announcement, the number of shots administered per week rose an average of 77%. In other words, around 140,000 more people got a shot as compared to the week before the announcement.

There is clear excitement about vaccine lotteries, but the jackpots are still relatively small. The size of the payout and the (un)likelihood of winning is probably not enough to incentivize many more people, especially those who are more afraid, hostile, busy, or uncertain. To get to 70% herd immunity, we need to change more minds.

A stupid big lottery

Steven Levitt — my former boss, author of Freakonomics, host of the podcast People I Mostly Admire, and University of Chicago economist — recently gave a phenomenal answer to his on his show (also check out Levitt Giving to Strangers interview about the best ways to do good, here).

A listener asked Levitt whether we should have lotteries to reward people who are vaccinated, even though it feels kind of icky to some.

Levitt’s answer? A resolute yes.

When COVID-19 first started, Levitt, Paul Romer, and Jeff Severts argued that we should pay people to get tested. At the time, mass testing was our best hope for flattening the curve. Testing was inconvenient, and many people didn’t see the need to get a test if they didn’t have COVID symptoms, leaving many ‘silent spreaders’. Levitt, Romer, and Severts suggested that since the socially beneficial action (getting a test) is kind of a pain in the butt, let’s pay people to do it. Nobody listened. But if they had, would the pandemic be over sooner, saving lives down the line?

Fast forward, and America in the same situation with vaccines.

To incentivize more vaccinations, Levitt argues that states or the federal government should not only have lotteries, but that the jackpot should be very, very big. So big that every family in America is talking about it at the dinner table, so big that it’s on the front page of the newspapers, so big that Twitter is losing its mind over it.

Got a number in your head? Now, make it bigger.

Levitt says that we should make the vaccine jackpots stupid big, like $15 or even $50 billion (the biggest jackpot ever was $1.6 billion in 2016, and that was just for funsies, so definitely bigger than that).

Once you announce this big jackpot, automatically enter all Americans, not just those who are vaccinated. Give people time to scramble and sign up for shots if they haven’t already. Then, pick 100,000 or 1 million or whatever Americans to win. Publish the names of winners publicly. If you have at least one shot and you’re picked, congrats! you get the money.

But if you didn’t get vaccinated? You don’t get the money. But all your friends and family will start calling you to congratulate you on your newfound fortune, and you have to break the news — embarrassingly — that you didn’t get vaccinated. (Government can even pick the lottery winners in waves so that people learn from these sore lottery losers.)

If this sounds coercive or just mean, maybe. But there’s a myriad of ways in which we design public policy to incentivize people to do things they wouldn’t otherwise do because they’re good for the rest of us. And shame is a key way that society keeps its members “in line” and conforming to an action that is socially good. Often this gets a bad rap, but those emotions can also be used for good (see this recent experiment that found social pressure was a key ingredient in increasing mask wearing in Bangladesh).

If you’re worried about the cost of this lottery, consider that America’s economy has or will shrink by an estimated $7.6 trillion due to the COVID-19 pandemic (aka, the value of lost GDP). And the cost of the lottery would be less than 1% of the cost of other efforts to combat the pandemic such as the CARES act (which cost $1.8 trillion).

Not only are the costs of a big lottery (relatively) small, but the benefits are bigger than you think. For one, the lottery acts as a cash transfer from the government to the American own people, kind of like a stimulus check, meaning the money would circulate within the American economy and drive growth. Second, an additional person getting vaccinated not only protects the person vaccinated, but also everybody around them — increasing the benefits even further.

Will the government do this? Probably not. But it’s worth recognizing and supporting creative policy ideas and policymakers when they arise, while also pushing thinking even further outside the box.

What strangers should you donate to?

While this post has been about vaccination in America, the virus is more dire globally, as more than ten thousand people a day die from COVID-19 around the world.

The Rockefeller Foundation has recently called for urgent action on vaccine equity, as more than 80 percent of COVID-19 vaccine doses have been administered in high- and upper-middle-income countries, while only 14 percent of South Americans, 4.8 percent of Asians, and 1.2 percent of Africans have been vaccinated. I therefore remind you that you can donate directly to COVAX to buy vaccines for poor countries.

This link will take you to the website of Gavi, the vaccine alliance, one of the governing bodies of COVAX. And the donation will go to COVAX fee-free:

Donate to COVAX

Quotes

I love quotes, so each newsletter I share some of the quotes I’ve written down over the last two weeks.

When you’re having a moral feeling, self-congratulation is never far behind. You are setting your emotion in a bed of ethical language, and you are admiring yourself doing it. We are governed by emotion, emotion around which we arrange language. The transmission of our virtue feels extremely important, and weirdly exciting.

The Paris Review - What Do We Do with the Art of Monstrous Men?

The murkiness as we exist alongside each other calls each other forward. I don’t want to forget that I am here; at any given moment we are, each of us, next to any other capable of both the best and worst our democracy has to offer

— Claudia Rankine in her 2020 book, Just Us

There are no refugees, only fellow citizens whose rights we have failed to acknowledge

— Teju Cole

If you can see your path laid out in front of you step by step, you know it’s not your path. Your own path you make with every step you take. That’s why it’s your path.

— Joseph Campbell, American author & scholar

1

Though maybe not with California’s $75 billion budget surplus