Was Vax-a-Million a successful incentive? New study raises questions

COLUMBUS — Less than a week after the announcement of Ohio’s then-unorthodox vaccine lottery, Gov. Mike DeWine’s administration claimed Vax-a-Million was a success.

Two weeks after the last winner was crowned, health experts say otherwise.

A study published by the Journal of the American Medical Association performed by the Boston University School of Medicine that relied on data from the Centers for Disease Control and Prevention concluded that claims that the Vax-a-Million lottery program increased vaccination rates failed to consider other factors, like an expansion of shots to those age 12 to 15.

Eligibility opened to include this group just one day after the contest was announced.

“The study did not find evidence that a lottery-based incentive in Ohio was associated with increased rates of adult COVID-19 vaccinations,” the study concluded.

Rather, “the analyses suggest that the rate of decline in vaccinations slowed to a greater extent in the U.S. than in Ohio after the May 12 lottery announcement.”

DeWine administration response

“We believe the study is flawed,” said DeWine’s press secretary Dan Tierney in an email.

He noted state data tracks vaccinations based on the start date of first doses. The Boston University analysis “seems to base its analysis” on the date a vaccination was reported to the Centers for Disease Control and Prevention.

“We believe the Ohio data based upon first dose start date is the most accurate measure if you are doing a study on if an event caused you to get a vaccine within specific days of that event, and that data clearly shows a significant increase after the Vax-a-Million announcement,” Tierney wrote.

Indeed, the report admits, “The findings are limited by the accuracy of US Centers for Disease Control and Prevention vaccine administration data ...”

Tierney provided the following data, which appears to indicate the majority (62 percent), but not all, of the increase, is attributable to increased age eligibility:

All ages:

• Week 1 compared to base: 106 percent increase
• Week 2 compared to base: 53 percent increase

16-plus:

• Week 1 compared to base: 44 percent increase
• Week 2 compared to base: 15 percent increase

Tierney also pointed to a Washington Post analysis, which supports DeWine’s claims.

Author Philip Bump said the contest “had the intended effect” based on the seven-day average number of Ohioans getting their first shots after the announcement.

He also claims the data in Ohio diverged from national vaccination trends at this point.

However, the article notes: “It’s useful to consider the broader context here. That uptick in cases recently appears to be real, but it’s also only a subtle reversal of the state’s downward trend.”

A look at the data

DeWine announced the contest on May 12. The announcement resulted in a bump in vaccine uptake, but it was minimal compared to the excitement surrounding the vaccine in February and March.

Here’s a look at new first doses administered weekly:

• March 28 to April 3: 461,345 new first doses;
• April 4 to April 10: 409,281 new first doses;
• April 11 to 17: 289,076 new first doses;
• April 18 to April 24: 203,274 new first doses;
• April 25 to May 1: 155,312 new first doses;
• May 2 to May 8: 121,994 new first doses;
• May 9 to May 15: 136,704 new first doses;
• May 16 to May 22: 188,474 new first doses;
• May 23 to May 29: 137,220 new first doses;
• May 30 to June 5: 91,333 new first doses;
• June 6 to June 12: 66,744 new first doses;
• June 13 to June 19: 57,766 new first doses
• June 20 to June 26: 45,413 new first doses;
• June 27 to July 3: 44,480 new first doses.

Were the winners swayed?

Of the 10 Vax-a-Million winners — five Vax-a-Millionaires and five recipients of the full-ride scholarship — most had already gotten vaccinated before the contest was announced.

For example, the state’s fourth winner Suzanne Ward said, “I didn’t have any hesitation when my age group came up.”

But for young winners like 13-year-old Sydney Daum, the announcement of the contest sped up her family’s timeline for getting their daughter the shot.

They had planned to wait until the beginning of the school year, but once Vax-a-Million was announced, her parents decided to get Sydney vaccinated immediately.

Jonathan Carlyle, the Toledo man chosen in the state’s second drawing, reported he was among the vaccine hesitant when the contest was announced and hadn’t gotten the jab.

“I was putting it off a lot because I was working a lot at the time. But I knew I wanted to get it,” he said. “When y’all announced the Vax-a-Million, I said, ‘Yes, I need to do this now.’”

Other vaccine incentives

Despite being roundly criticized on the internet, DeWine was emulated by many after launching Vax-a-Million May 12. States, cities, counties and companies have followed his lead and offered cash for residents and employees to get the shot.

Here are a few examples:

• Maryland announced its VaxCash program on May 20 and has since doled out $2 million to 40 winners.
• Michiganders can win up to $2 million as part of the state’s Shot to Win program, which was announced July 1.
• Illinois Gov. J.B. Pritzker created a vaccine lottery for state employees who have the chance to win prizes from $5,000 to $10,000 as well as sports tickets and airline vouchers.
• Dubuque County, Iowa launched a $10,000 lottery program
• Cleveland-Cliffs is offering all vaccinated employees $1,500 if at least 75 percent of employees get vaccinated. If 85 percent or more get the shot, the prize could increase to $3,000.

What’s next?

Two weeks after the Vax-a-Million contest wrapped, the state vaccination rate has barely budged. It continues to hover at about 48 percent — lower than the national rate of 55 percent.

The rates are even lower for people of color, said Ohio Ohio House Minority Leader Emilia Strong Sykes, D-Akron.

Only 22 percent of Ohioans on Medicaid, 32 percent of Black Ohioans and 28 percent of Latinx Ohioans have been vaccinated.

“Vax-a-Million further exposed what we already knew – that we’ve got our work cut out for us, and it will take more than monetary incentives to get the job done,” Sykes said. “We need to target campaigns at higher-risk populations, reduce vaccine hesitancy and boost vaccination rates for the most vulnerable Ohioans.”

Dr. Allan Walkey, one of the authors of the Boston University study, said the data backs that up: monetary incentives are unlikely to impact vaccine hesitancy.

“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.

— News from Center Square Ohio was used in this report.

This story was originally published July 9, 2021 at 3:52 AM.