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Albertans line-up for a COVID-19 vaccination at an mass immunization clinic in downtown Calgary, May 17, 2021.Jeff McIntosh/The Canadian Press

Canada is spending upwards of $8-billion to purchase COVID-19 vaccines. So what’s wrong with spending a few million, or even tens of millions, to encourage people to get their shots?

In recent days, much attention has been focused on U.S. vaccine lotteries – $1-million prizes, free college tuition, and more all being offered to incentivize Americans to roll up their sleeves.

Canadians have largely looked upon these schemes with skepticism, if not derision. The U.S. has a glut of vaccine – yet, after 34 million COVID-19 cases and 610,000 deaths, they still have to bribe people to get shots.

“In America,” we tell ourselves, “everything is about money.” We take comfort in soothing bromides like “Canadians are more civic-minded.”

But are we really? To date, about 21.5 million Canadians have received at least one vaccine dose, and two million are fully vaccinated with two shots.

Canada turned the tide in May. We can win the pandemic war in June

Drop in COVID-19 vaccine demand could push provinces to explore incentives

About 62 per cent of Canadian adults are partially vaccinated, about the same as the U.S. They’re hitting a wall, and we could be soon, too.

Vaccine hesitancy exists in Canada as well. So how do we encourage people, from the recalcitrant to the mildly hesitant, to get their shots?

We can urge people to close their eyes, roll up their sleeves and think of the Queen (or perhaps the possibility of attending a live sporting or music event), but stern appeals to civic duty can only take us so far.

Incentives work.

Two weeks ago, Ohio launched its Vax-a-Million lottery, with a promise to give a US$1-million prize to a vaccine recipient every week for five weeks, along with some “full ride” college scholarships. Governor Mike DeWine was widely mocked – but vaccine rates jumped 45 per cent in the state.

California followed suit, promising US$116.5-million in inducements for vaccine recipients, including 10 prizes of $1.5-million, 30 prizes of $50,000, and $50 gift cards for two million others. Minnesota took a more modest approach, offering the next 100,000 vaccine recipients prizes ranging from fishing licenses to amusement-park passes.

In Canada, reopening plans are tied to achieving vaccination rates of 70 to 75 per cent. We’re going to have to do something with a little more oomph than airing earnest Health Canada ads to get our vaccination rates up.

Several provinces are considering the lottery approach, but nobody has acted yet. We need to shake off our Canadian allergy to innovation and risk-taking in health care. Imagine the free publicity that’s going to come from the media coverage when one brave politician finally does something a bit bold.

The most common arguments against offering prizes or rewards are that these “bribes” are coercive and could create a precedent.

Offering people what is essentially a lottery ticket is not in any way punitive or inequitable. It’s true that people grossly overestimate their odds of winning, but if we’re going to argue that is inherently dishonest, then we should get rid of lotteries altogether.

We also offer incentives, big and small – ranging from cookies to insurance rebates – to incentivize all kinds of health behaviours, such as blood donation, smoking cessation and adherence to some drugs.

We pay people to participate in clinical trials testing new drugs, so why isn’t it okay to reward some who take these drugs, including vaccines, after they are approved?

Legally, we can make vaccines mandatory in some circumstances (though the case law is a bit mixed on when and where) so how can it be considered more coercive to offer people a little bribe? Instead of fuming over unvaccinated health workers, why don’t we pay them to get their shots?

Of course, offering prizes is not going to sway anti-vaccine naysayers, but there are very few of them. A few zealots tried to argue that offering young people free ice cream after their vaccines was luring children – which is laughable.

Where giving a little enticement will make a difference is the soft middle – the many people who are hesitant for a whole range of reasons, from fear of needles through to “I can’t be bothered.”

The incentives don’t have be big. In England, they offered young women aged 16 to 18 gift certificates worth £45 (about $77) if they would take the HPV vaccine. The small incentive doubled vaccination rates among those contacted for the first time, and quadrupled the rate among those who had previously refused.

Small cost, big payoff.

Widespread vaccination is our chance for a decent summer, and one of the key elements to getting back to a semblance of normal life.

We should be pulling out all the stops. Canada has Lotto Max (this week’s jackpot: $70-million) – so why not Lotto Vax?

Editor’s note: (June 2, 2021): This article has been updated to correct the description of the Ohio lottery prize.

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