How will we know if NC’s vaccine lottery is working?

North Carolina

RALEIGH, N.C. (WNCN) — The number of North Carolinians getting their first shots has plateaued during the three weeks since the state announced a series of $1 million drawings for vaccinated people.

State officials consider that relative flatlining a victory — because it means those numbers are no longer falling.

“We’ve seen a leveling off of our vaccinations where we were on a downward trajectory,” state Department of Health and Human Services Secretary Dr. Mandy Cohen said this week.

From the lotteries for cash and scholarships to free meals and drinks — even to bringing President Biden to Raleigh to push for vaccinations — there is no shortage of incentives to persuade people to get their shots.

It raises a simple question with a complicated answer: How will we know which of them — if any — are actually working?

Dr. Emily O’Brien, an epidemiologist with the Duke Clinical Research Institute, says the novelty of vaccine incentives make it difficult to gauge success or failure.

“So there isn’t some clear benchmark of success from the past that we’re working with,” she said. “In general … we know some some common principles that are true here. Vaccination is good, more vaccination is better. And so certainly every additional dose is a victory.

“So what we want to see is continued progress. And so every additional dose is a good thing,” she added.

DHHS data show 159,651 people got either their first dose of the two-dose Pfizer or Moderna vaccines or the single-shot Johnson & Johnson product in the three weeks that followed the June 10 announcement of the four drawings for $1 million for vaccinated people 18 and older, and $125,000 scholarships for those between the ages of 12 and 17.

Those vaccinations have been relatively consistent throughout, with between 45,000 and 65,000 of them coming during each Thursday-to-Wednesday week.

A CBS17.com data analysis last month found the lottery could make financial sense for the state if it helps avoid just 125 of the most severe cases of COVID-19 or about two months’ worth of overall cases, based on the state’s Medicaid reimbursement rate.

Are the results we’re seeing now good enough to justify the $4.5 million in federal relief funds — which could be spent elsewhere — the state is offering in prize money?

O’Brien says yes.

“At this point, I think that it’s reasonable to do what we can to get to where we need to be,” she said.

After the first drawings earlier this week, Gov. Roy Cooper said he hoped for a bump after introducing the those winners to “show people that, ‘Yeah, you can win this.’”

“We’ve got to pull out all the stops to get this done,” Cooper said.

But that hasn’t been what’s happened in Ohio, the state whose vaccine lottery was the model for North Carolina’s.

Weekly vaccinations in Ohio climbed 43 percent shortly after the announcement of that state’s lottery — but soon thereafter, those numbers plunged with Gov. Mike DeWine admitting “clearly the impact went down after that second week.”

Louisiana — which has one of the nation’s lowest vaccination rates — saw a 14 percent increase shortly after announcing its lottery.

Dr. David Wohl, an infectious disease specialist at the University of North Carolina School of Medicine, compares the numerous incentives to a “kitchen sink” approach — as in, the cliche of throwing the kitchen sink at a problem.
“Sometimes in medicine, we treat the patient with multiple different medications,” he said. “And we don’t always know which one did the trick. But we’re just glad that the patient recovered.”

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