In the year since there has been a multitude of campaigns and initiatives designed to increase vaccine participation. Krispy Kreme gave out free donuts, D.C. Marijuana Justice offered a free joint. One notable format is being entered into a raffle once vaccinated with prizes including everything from cruises to guns. But do these tactics work? A recent study from the Journal of the American Medical Association (JAMA) assessed the effectiveness of lottery-based incentives to get the COVID-19 vaccine. Looking at programs with cash prizes operating between mid-May and mid-July 2021, researchers looked at daily vaccination rates in these locations and how they compared to states without similar incentives. Across the board, there was no significant association between the lottery and higher vaccination administrations. The research team had previously found the same results for Ohio but expanded this study to include data from 15 other states with cash prizes. Overall the recent study showed an increase in 190 vaccines per 100,000 people in the 28 days post-lottery, compared to what was expected without the lottery incentive.
Understand the Remaining Resistance
A year after vaccines started to become available, there is still a great deal of resistance that initiatives like cash prizes are not solving. As of January 18, 2022, 75% of people had at least one dose, 63% were fully vaccinated, and 39% received a booster in the United States. “Reasons for this are multiple, but I think are still being driven by significant misinformation that has been circulated via social media and even some news outlets,” says Dr. MeiLan K Han, professor of medicine in the Division of Pulmonary and Critical Care at the University of Michigan and the author of Breathing Lessons: A Doctor’s Guide to Lung Health. She still sees a lot of vaccine hesitancy due to fear of allergic reactions, concern about mRNA technology, and infertility. “Perhaps some don’t realize the virus itself is made of RNA, and you will have millions of cells with foreign, viral DNA if you do become infected,” adds Han. Another hesitation comes from worry about who is represented in vaccine studies. Dr. Denise Powell, a pediatric resident physician, says she is often asked about the race and ethnicity of participants. “It’s important because underrepresentation and expanding the breadth of health information is an issue that we have had to continually hone in on throughout medical history, especially given a longstanding issue of disparities in medicine,” she explains. Powell credits these discussions with helping to create a movement of “healthcare providers finding different outlets to educate themselves, each other, and the general public about vaccine history and concepts.” One such organization, The Conversation, created a space for nonjudgemental, open discussion about the pandemic and vaccines. Similarly, Han worries about reaching people such as African Americans, Hispanics and Latinos, and American Indian/Alaska Natives — all of whom are more likely to be hospitalized with COVID than white people. To this end, she is working with the National Institutes of Health Community Engagement Alliance (CEAL) Against COVID-19 Disparities to determine the best methods for emphasizing the importance and safety of vaccines to these communities.
Addressing Vaccination Concerns
This far into the pandemic, and with so many people vaccinated without side effects, it can be frustrating to have to reiterate the importance of getting one continually. For medical professionals, there is no one size fits all solution to encouraging someone to become vaccinated. However, there are a few techniques they regularly try. For Dr. Michael Genovese, a board-certified psychiatrist and the chief medical officer of Acadia Healthcare, the most important points to keep in mind are validating concerns and maintaining clinical responses. Instead of saying, ’that’s ridiculous,’ he tells the patient that they’re not alone in their hesitancy but then outlines clear, factual information from journals and other trusted medical organizations. If the conversation turns political with someone stating their apprehension to the ‘goverment telling them what to do,’ for instance, he’ll respond along the lines of, ‘I get that, but here’s why I still think it’s a good idea medically no matter who says what.’ “I feel like I undermine any credibility I have as a physician if I veer outside of my lane in these discussions,” says Genovese. “If I have a respectful conversation with someone and keep it to ‘just the facts’ the person feels respected and can maintain their sense of agency and come to their own conclusion.” Han agrees that presenting the facts to vaccine-resistant individuals is critical. She will also make sure to point out that getting vaccinated protects not only themself but also loved ones. When all else fails, Han engages the patient’s vaccinated family members who are aware of the benefits—a strategy she has seen work. “If such a family member or close friend exists, having them talk to the vaccine-hesitant individual can actually convince them,” says Han. Another point Powell emphasizes is not forcing an immediate decision. She tells patients that if they need time, she is available to answer any questions or address any concerns as they arise.
What Changed The Mind of Former Anti-Vaxxers
So, what has really worked for people initially against the vaccine? For some people, seeing a loved one or someone close by become sick changes their minds. Such was the case for Thomas Jepsen, who spent most of 2021 firmly against receiving a vaccination. “I was previously skeptical about the usual things anti-vaxxers are,” says Jepsen. “It felt unsafe to go around injecting ourselves with medication every six months. I think I got my news coverage from a very select group of news outlets.” However, the fear he felt once a family member became seriously ill due to COVID made everything feel much more real. He has since received the vaccine and plans to get the booster once six months have passed. Looking at the hard data around the COVID vaccine has also helped. “I used to be anti-vax due to the fear instilled by my family, friends, and of course, social media,” says Jenny Jacobs, who explains that her anxiety got the better of her. “However, I’ve come to a realization that these are just mere probabilities, and no scientific or medical data has been officially released to support long-term side effects. With this in mind, I’ve decided to focus on what’s certain, the fact that these vaccines developed by scientists and medical professionals have been concluded to be a great defense against the virus.” Jacobs has since received the initial vaccine and a booster shot. There’s no way to know what will convince anyone to get the vaccine. Whether it’s data, an experience, or loved ones’ wishes. However, it’s clear that more people need to get the vaccine for the pandemic to end finally. As Jepsen candidly admits: “I simply want the same as everyone else. I want to be done with Covid. My prior beliefs of not getting the vaccine unfortunately only helped prolong the period of time we’ll be dealing with the pandemic.” The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
