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Conditional cash lotteries increase COVID-19 vaccination rates

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  • Barber, Andrew
  • West, Jeremy

Abstract

Conditional cash lotteries (CCLs) provide people with opportunities to win monetary prizes only if they make specific behavioral changes. We conduct a case study of Ohio's Vax-A-Million initiative, the first CCL targeting COVID-19 vaccinations. Forming a synthetic control from other states, we find that Ohios incentive scheme increases the vaccinated share of state population by 1.5 percent (0.7 pp), costing sixty-eight dollars per person persuaded to vaccinate. We show this causes significant reductions in COVID-19, preventing at least one infection for every six vaccinations that the lottery had successfully encouraged. These findings are promising for similar CCL public health initiatives.

Suggested Citation

  • Barber, Andrew & West, Jeremy, 2022. "Conditional cash lotteries increase COVID-19 vaccination rates," Santa Cruz Department of Economics, Working Paper Series qt1062k4v8, Department of Economics, UC Santa Cruz.
    • Handle: RePEc:cdl:ucscec:qt1062k4v8
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    References listed on IDEAS

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    Cited by:

    1. Orhan Erdem & Sukran Erdem & Kelly Monson, 2023. "Children, vaccines, and financial incentives," International Journal of Health Economics and Management, Springer, vol. 23(4), pages 537-552, December.
    2. Arnab K. Basu & Nancy H. Chau & Oleg Firsin, 2025. "Social Connections and COVID19 Vaccination," Health Economics, John Wiley & Sons, Ltd., vol. 34(6), pages 1188-1213, June.
    3. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2023. "When reality bites: Local deaths and vaccine take-up," European Economic Review, Elsevier, vol. 156(C).
    4. Reddinger, J. Lucas & Charness, Gary & Levine, David, 2024. "Vaccination as personal public-good provision," Journal of Economic Behavior & Organization, Elsevier, vol. 224(C), pages 481-499.
    5. Thuilliez, Josselin & Touré, Nouhoum, 2024. "Opinions and vaccination during an epidemic," Journal of Mathematical Economics, Elsevier, vol. 111(C).
    6. Fu, Wei & Wang, Li-San & Chou, Shin-Yi, 2024. "A single dose for me, A wealth of protection for us: The public health cost of individualism in the rollout of COVID-19 vaccine," Social Science & Medicine, Elsevier, vol. 348(C).
    7. Kato, Hiroki & Sasaki, Shusaku & Ohtake, Fumio, 2024. "Adding nudge-based reminders to financial incentives for promoting antibody testing and vaccination to prevent the spread of rubella," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 113(C).
    8. Nguyen, Manh-Hung & Hoang, Viet-Ngu & Nghiem, Son & Nguyen, Lan Anh, 2024. "The Dynamic and Heterogeneous Effects of COVID-19 Vaccination Mandates in the USA," TSE Working Papers 24-1598, Toulouse School of Economics (TSE).
    9. Epstein, Gil S. & Heizler, Odelia & Israeli, Osnat, 2025. "Herd behavior and the intention to vaccinate against COVID-19," European Economic Review, Elsevier, vol. 175(C).
    10. Eiji Yamamura & Yoshiro Tsutsui & Fumio Ohtake, 2023. "Would Monetary Incentives to COVID-19 vaccination reduce motivation?," Papers 2311.11828, arXiv.org.
    11. Jonathan Cook & Noah Newberger & Sami Smalling, 2024. "COVID vaccination and social norms," Contemporary Economic Policy, Western Economic Association International, vol. 42(4), pages 660-682, October.
    12. Shusaku Sasaki & Takahiro Kubo & Shodai Kitano, 2024. "Prosocial and Financial Incentives for Biodiversity Conservation: A Field Experiment Using a Smartphone App," Papers 2402.18047, arXiv.org.
    13. Serrano-Alarcón, Manuel & Mckee, Martin & Palumbo, Leonardo & Salvi, Cristiana & Johansen, Anne & Stuckler, David, 2024. "How to increase COVID-19 vaccination among a population with persistently suboptimal vaccine uptake? Evidence from the North Macedonia mobile vaccination and public health advice caravan," Health Policy, Elsevier, vol. 139(C).
    14. Josselin Thuilliez & Nouhoum Touré, 2024. "Opinions and vaccination during an epidemic," Post-Print hal-04490900, HAL.
    15. repec:osf:socarx:emj6v_v1 is not listed on IDEAS
    16. Josselin Thuilliez & Nouhoum Touré, 2024. "Opinions and vaccination during an epidemic," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) hal-04490900, HAL.
    17. Manh‐Hung Nguyen & Viet‐Ngu Hoang & Son Nghiem & Lan Anh Nguyen, 2025. "The Dynamic and Heterogeneous Effects of COVID‐19 Vaccination Mandates in the USA," Health Economics, John Wiley & Sons, Ltd., vol. 34(3), pages 518-536, March.
    18. Sasaki, Shusaku & Kubo, Takahiro & Kitano, Shodai, 2025. "Prosocial and financial incentives for biodiversity conservation: A field experiment using a smartphone app," Ecological Economics, Elsevier, vol. 230(C).

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