As Ohio’s Vax-a-Million incentive comes to a close with lackluster results, experts are looking at other tactics to encourage COVID-19 vaccination and push the population closer to herd immunity.
A Penn Medicine research study published in the New England Journal of Medicine found that beyond financial incentives, there are two main effective methods:
- Restrict people's choices. For example, requiring vaccines in order to attend live music or sporting events, or airlines that require proof of vaccination to fly.
- Make vaccination mandatory. This would include the methods that some workplace and colleges are using now which require people to prove they are vaccinated before returning in person.
But those more restrictive, punitive methods may not be popular in American society, said Northern Kentucky University professor of sports business and event management Joe Cobbs, and should be the last choice.
"In our society, where we have a high value on freedom and individuality, we would rather have somebody do it because they make the choice to do it instead of us trying to force them into doing it,” Cobbs said. "What you lose when you punish somebody or force them through punitive measures is you lose that potential for them to feel good about the decision that they've made."
He said the key is to be able to use influential voices that crowds tend to follow, like a respected leader who can change what is viewed as acceptable or normal. Cobb used an example from a 1989 Bengals game when coach Sam Wyche got fans to stop throwing trash on the field by telling them, “You don’t live in Cleveland, you live in Cincinnati.”
"He was sending that message as a highly respected leader of people who identify with the Bengals that it wasn't acceptable to behave in the way they were currently behaving,” Cobbs said. "It's most effective when the members doing the motivation are influencers in the group."
Cobb also said that in addition to influential voices, lowering barriers and making the vaccine accessible is key as well.
Dr. Stephen Feagins, chief clinical officer at Mercy Health, agrees. He said the vaccine is readily available and doesn’t want to see hesitancy conflated with lack of access.
"We still see folks coming into the emergency department being offered vaccines and go ‘yeah, I didn't know you could just get it anywhere.’ Well yes you can,” Feagins said.
He said he worries that COVID-19 strains such as the delta variant will infect unvaccinated people and people who think they've built natural immunity by catching COVID-19 once already.
"We know that having had COVID in the past is not going to protect you against the delta strain, it's a new strain," Feagins said. "The vaccine will. Every one of these COVID deaths could be prevented by vaccine."
Feagins said the challenge lies in talking to people and worries that groups of unvaccinated people may influence other people to do the same.
In populations where there is a high vaccination rate, like the 90% rate in nursing homes, COVID-19 has been virtually eliminated. Unfortunately, that’s not the case everywhere.
"I'm concerned that in many areas there may be entire families that remain unvaccinated, entire pockets of a neighborhood or community that sort of remain unvaccinated,” Feagins said. "It's like anything else, if all you hear and see are people who don't get vaccinated, that's what you kind of believe."