North Carolina's $25 Reward Helped Boost Covid Vaccinations

North Carolina vaccine lottery winner, Shelly Wyramon of Winston-Salem, speaks after Gov. Roy Cooper announced the first winners of the Summer Cash Drawing and Summer Cash 4 College Drawing at the Monday, June. 28, 2021 at the NC Emergency Operations Center in Raleigh. A report released on Monday, Oct. 25, 2021, found that small financial rewards in North Carolina increased some residents' willingness to get a COVID-19 vaccine. Less successful, however, was a $4.5 million statewide lottery program. (Travis Long/The News & Observer via AP)
North Carolina vaccine lottery winner, Shelly Wyramon of Winston-Salem, speaks after Gov. Roy Cooper announced the first winners of the Summer Cash Drawing and Summer Cash 4 College Drawing at the Monday, June. 28, 2021 at the NC Emergency Operations Center in Raleigh. A report released on Monday, Oct. 25, 2021, found that small financial rewards in North Carolina increased some residents' willingness to get a COVID-19 vaccine. Less successful, however, was a $4.5 million statewide lottery program. (Travis Long/The News & Observer via AP)

RALEIGH, N.C. (AP) — What works and what doesn’t when it comes to encouraging people to get vaccinated against COVID-19? A new study in North Carolina shows that offering $25 to people getting their first shot was an important factor, while long odds at a big lottery prize made little difference.

The study released on Monday examined a pilot program offering $25 to residents in four counties. Of the 401 vaccine recipients surveyed, more than two-fifths cited the prepaid cash cards as an important reason they went in for a shot.

Hispanic people, other racial minorities and residents making less than $40,000 a year were more likely than white and wealthier residents to view the cash cards as a key reason to get the vaccine, according to the report published online in JAMA Internal Medicine.

Roughly 1 in 11 respondents said they would not have come in for a COVID-19 shot if the $25 perk was not being offered at participating sites in Mecklenburg, Guilford, Rowan and Rockingham counties. About 1 in 7 people surveyed said they waited to get vaccinated until they learned they could get a cash card or other incentive.

“With hundreds of millions of dollars being spent to accelerate COVID-19 vaccine uptake, these study findings suggest that this strategy for increasing vaccination merits greater investment,” the authors wrote.

The North Carolina Department of Health and Human Services authored the study in collaboration with researchers at North Carolina Central University and the University of North Carolina at Chapel Hill.

After the pilot program ended in June, Gov. Roy Cooper and DHHS Secretary Mandy Cohen decided to offer a $100 financial reward and make the perk more widely available throughout the state.

Less successful, however, was North Carolina's rollout of a $4.5 million lottery package ultimately won by just eight residents. Four kids aged 12 to 17 who got vaccinated each qualified for $125,000 college scholarships, while four adults 18 or older each got $1 million before taxes.

Within the first two weeks of the state announcing the lottery in June, about 118,000 residents got their first shot, but weekly vaccination counts were flat throughout much of June and July before rising in late-July and early-August amid substantial spread of the more contagious delta variant.

“These large but uncertain financial prizes benefit only a few lucky winners and do not broadly address access barriers to vaccination,” the authors wrote, adding that financial rewards should be considered in conjunction with other methods to promote an equitable distribution of shots.

The latest data from the state health department shows eight consecutive weeks of weekly declines in the number of North Carolinians receiving a first dose. While more data is pending, numbers released on Monday show only 19,000 or so residents got their first COVID-19 shot last week, which represents the lowest weekly count to date.

State health officials ended their $100 vaccine reward in August. The incentives section of the NCDHHS website now directs visitors to find a nearby vaccine location.

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Anderson is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.