Vaccination nation

[apl68]

Would it help herd immunity if we just paid people to take the vaccine?  The most hardcore antivaxx people will likely break down if offered cold hard cash.

Maybe that needs to be in the stimulus bill.

Yes, and it's a good idea, well worth one hell of a lot of money. We have to beware, however, that when money is on offer for a vaccination, it pays us to claim we are antivaxxers.

Therefore, we'd have to pay everybody. And still a good idea.

It would also be necessary to develop a good way of verifying that people had genuinely been vaccinated.  And precautions would need to be taken against Russian, Chinese, etc. hackers stealing billions of dollars by claiming vaccinations that never took place.  They've already made off with billions of dollars of stimulus relief.

Honestly, I think that paying people to be vaccinated would be a bad precedent.  People should be vaccinated because they understand that it's the thing to do.  If we pay people to be vaccinated for COVID, where will it end?  There are multiple vaccinations (chicken pox, rubella, etc.) that everybody needs to take.  Paying hundreds of dollars apiece for each of them just isn't going to work.

[dismalist]

The reason to pay people to get vaccinated against many diseases is that that not only protects them, but also protects those not vaccinated.

Alternatively, one could fine people who do not get vaccinated. But that won't fly. :-)

[Puget]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

I think what we do need to be doing is talking up what vaccination will allow you to do again-- as it is becoming increasingly clear that it will be pretty safe for vaccinated people to socialize with other vaccinated people (greatly reduced transmission, not just illness), that is a major selling point. I do think it is a mistake for super cautious public health folks to keep saying you can't change your behavior at all even after you are fully vaccinated. Instead, tell people what they can do that is relatively safe IF they are fully vaccinated.

[dismalist]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

I think what we do need to be doing is talking up what vaccination will allow you to do again-- as it is becoming increasingly clear that it will be pretty safe for vaccinated people to socialize with other vaccinated people (greatly reduced transmission, not just illness), that is a major selling point. I do think it is a mistake for super cautious public health folks to keep saying you can't change your behavior at all even after you are fully vaccinated. Instead, tell people what they can do that is relatively safe IF they are fully vaccinated.

There's the Israeli kibbutz story of parents not picking up their children on time even after a fine for lateness was imposed. Well, it was a small fine, so one can then rent child care at a low rate. If the fine were a sufficiently high share of income, this wouldn't be observed.

Same applies to vaccines: Give them enough and they will come! And anyway, it doesn't have to be everybody who is sensitive to price.

The additional point about bribing people to take vaccines, and not just to pick up their kids, is that those who don't take vaccines also benefit. By paying people for getting vaccinated we are merely recognizing that they are doing good for others.

[Liquidambar]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).

Yeah, no way would my father get vaccinated for $500 (or any amount of money).  He would be highly suspicious.

[downer]

Would it help herd immunity if we just paid people to take the vaccine?  The most hardcore antivaxx people will likely break down if offered cold hard cash.

How much $$ are we talking?

$500

That is much cheaper than a few weeks in the ICU on a ventilator.

That would be a good deal for me. Not sure it would be a good deal for the taxpayers.

There's also a question of whether consent to the procedure is free when there is a significant financial incentive. So it might be past the ethics board.

[dismalist]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).

Yeah, no way would my father get vaccinated for $500 (or any amount of money).  He would be highly suspicious.

Would your father pay $500 to NOT get vaccinated? :-)

[spork]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

[. . .]

I will counter with the vaccination RCTs in Bannerjee and Duflo's Poor Economics.

[Liquidambar]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).

Yeah, no way would my father get vaccinated for $500 (or any amount of money).  He would be highly suspicious.

Would your father pay $500 to NOT get vaccinated? :-)

No, he would probably file a lawsuit and stage a protest with lots of signs.

[Puget]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

[. . .]

I will counter with the vaccination RCTs in Bannerjee and Duflo's Poor Economics.

Interesting-- do you know the actual paper citations per chance? I'd be interested to check them out.
I don't doubt that it might work if the main barrier is just that people don't want to bother, or don't want to take the time to do it. Where I suspect it would backfire is with people who are actually vaccine hesitant, which seems to be the main problem in the US. I'm ready to change that hypothesis if there is data suggesting otherwise though!

[dismalist]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).

Yeah, no way would my father get vaccinated for $500 (or any amount of money).  He would be highly suspicious.

Would your father pay $500 to NOT get vaccinated? :-)

No, he would probably file a lawsuit and stage a protest with lots of signs.

Well, yeah. How much would one be willing to pay for the lawsuit and for organizing the protest? It must be some finite number. We pay someone that, and s/he takes the pill! :-)

[pgher]

My BIL says a bunch of guys he works with are concerned about the vaccine's impact on fertility. No amount of money would wipe that out. I'm not sure facts would either.

[spork]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

[. . .]

I will counter with the vaccination RCTs in Bannerjee and Duflo's Poor Economics.

Interesting-- do you know the actual paper citations per chance? I'd be interested to check them out.
I don't doubt that it might work if the main barrier is just that people don't want to bother, or don't want to take the time to do it. Where I suspect it would backfire is with people who are actually vaccine hesitant, which seems to be the main problem in the US. I'm ready to change that hypothesis if there is data suggesting otherwise though!

Ch. 3 is about health care, with references to, among others, Richard Thaler. One piece of literature specific to immunization that is cited:

https://www.bmj.com/content/340/bmj.c2220.

In general people in the USA are not very rational, and I think irrationality here is increasing over time. The era of U.S. world dominance is over. At this point we're just living off the carcass of what was created several decades ago.

[Caracal]

My state opened it up to essential workers and my state university sent out something saying we are all in that category, so I now have an appointment for Friday.

[Puget]

Behavioral economics research suggests paying people might backfire. If you're offering money to get someone to do something, they are likely to conclude that it must be something that they wouldn't otherwise want to do, so you might actually increase resistance (especially among the hard-core anti-vaxxers who would see it as yet another conspiracy).  Ironically, the fact that vaccines are currently hard to get may be driving up demand for the same reason-- anything scarce must be worth having. Not rational on either count, but humans aren't.

[. . .]

I will counter with the vaccination RCTs in Bannerjee and Duflo's Poor Economics.

Interesting-- do you know the actual paper citations per chance? I'd be interested to check them out.
I don't doubt that it might work if the main barrier is just that people don't want to bother, or don't want to take the time to do it. Where I suspect it would backfire is with people who are actually vaccine hesitant, which seems to be the main problem in the US. I'm ready to change that hypothesis if there is data suggesting otherwise though!

Ch. 3 is about health care, with references to, among others, Richard Thaler. One piece of literature specific to immunization that is cited:

https://www.bmj.com/content/340/bmj.c2220.

In general people in the USA are not very rational, and I think irrationality here is increasing over time. The era of U.S. world dominance is over. At this point we're just living off the carcass of what was created several decades ago.

OK thanks-- as I suspected, that was research in rural India, so the reasons people are not getting vaccinated are quite distinct from vaccine hesitancy in the current US context.

As I noted above, incentives work when people aren't opposed to doing something, but just aren't motivated to do so or perceive a cost (actual or opportunity) to doing so. So as in this study, could be a good tool for getting poor farmers to get routine vaccinations that are otherwise not high on their priority list in an already difficulty existence.

However, in the current US context, although a subset of healthy young adults who don't see COVID as a threat might respond well to incentives, those who are vaccine hesitant because they have fears or believe conspiracy theories about the vaccines are likely to see incentives as confirmation that there is something wrong with the vaccines -- see you have to pay people to take them!

In short, I think this is a good reminder that interventions can't necessarily be translated from one context to another, and that we need to look beyond behaviors that are similar on the surface (low vaccine uptake) to determine why people are engaging in those behaviors.

Not meant as a personal gripe at spork, just a general point, and pitch for including some psychologists and not just economists in policy ;-)