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Abstract

When the US expanded COVID-19 vaccine eligibility to all adults, many state governments developed cash incentive programs to motivate individuals to get vaccinated. Using a differences-in-differences method, I examine the effects of Illinois’ lottery incentive (low odds/high payout) and Wisconsin’s fixed incentive (high odds/low payout) on county first-dose vaccination rates in 2021. I find that (1) neither incentive produced a significant improvement from baseline vaccination trends on average, (2) the impact of each varied systematically along the lines of a county’s partisan majority, ruralness, unemployment rate, and median household income, and (3) the incentives’ disaggregated impacts were statistically significant but small relative to unvaccinated population that had to be mobilized at the time for meaningful progress toward herd immunity. I suggest that policy solutions addressing COVID-19 vaccine hesitancy must directly engage the complex and differentiated barriers to vaccine access, and that financial incentives cannot reliably improve vaccine intention at scale.

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