Opinion: Sticks work better than carrots to increase covid vaccinations, so use more sticks
“On Wednesday, New York Mayor Bill de Blasio (D) announced a vaccine mandate for city workers. The news prompted a fresh — and predictable — round of hand-wringing about a potential mass exodus of public employees who would rather give up their jobs than get the jab.
“We’re going to lose half of our cops and half of our fire department if this goes through,” an elected official in Brooklyn fretted, “and then what?”
Spoiler alert: Gotham isn’t going to lose half its police officers and firefighters.
The experience of the nine months since vaccines became widely available is simple. Carrots — benefits such as gift cards and giveaways and lotteries — sound great. Bribing people to take the vaccine — or to put it more politely, incentivizing them — sounds better than forcing them. But it hasn’t worked — at least not nearly well enough — and the audience on whom it might work has now been vaccinated.
What has produced results, and has the promise of doing much more to reduce the population of the unvaccinated, are mandates. They inevitably invite a game of chicken. People complain; they threaten to quit. Then, for the most part, they cave. Corporate chieftains and elected officials need to call these bluffs, even if it requires taking on public employee unions and terminating a few hundred people here and there to drive home the point: Saying no has a price.
A peer-reviewed study published by the Journal of the American Medical Association shows that the state-run lotteries that doled out millions in prizes failed to coax people into getting vaccinated. Nineteen states experimented with this approach, but researchers found “no statistically significant association” between the announcement of a lottery and the number of vaccinations.
In contrast, evidence shows mandates, well, move the needle. In New York, 77 percent of the state’s health-care workers were fully vaccinated in mid-August, when a mandate was imposed. Now that number is up to more than 90 percent. The state’s largest provider, Northwell Health, said it fired 1,400 anti-vaccine employees — which sounds like an enormous number but is less than 2 percent of its workforce.
Novant Health, a North Carolina-based hospital system, announced in September that 375 of its 35,000 employees had been suspended and would be fired if they didn’t get the vaccine within five days. Guess what happened next? The threat of termination prompted 200 of the 375 to get the jab. The results have been similar across the private sector, from airlines to food processors.
It made sense to try carrots first. But this pandemic has killed more than 728,000 Americans and the average daily death toll continues to exceed 1,500. Only 57.1 percent of eligible Americans are fully vaccinated. It looks as though the worst of the delta variant might be behind us, thankfully, but the country remains vulnerable to a twindemic of covid-19 and flu spikes this winter.
These fights are playing out across the United States. In Los Angeles, faced with the threat of losing their jobs, 99 percent of classroom teachers got vaccinatedby the deadline or received an exemption. In Chicago, Mayor Lori Lightfoot (D) is in a standoff with the police union over a mandate. The head football coach at Washington State University was laid off this week for refusing to comply with Democratic Gov. Jay Inslee’s vaccination requirement for public employees. So were some police officers. But headlines and viral videos obscure the degree to which almost everyone did as directed.
Six weeks ago, President Biden announced that the federal government will order businesses with more than 100 employees to require that workers be immunized or face weekly testing. Along with an executive order for federal contractors, this would cover about two-thirds of the country’s workforce. “We’ve been patient, but our patience is wearing thin,” Biden said on Sept. 9.
But the Occupational Safety and Health Administration has not yet issued the regulations that would put this into effect. A White House spokesman declined to comment Thursday on when the rule will be released but said there’s no reason businesses need to wait to impose their own requirements. This is dangerously circular: Many businesses are waiting for the cover of a federal mandate to order their employees to get vaccinated.
Make no mistake, administering such strong medicine takes courage. That’s why so many politicians have hesitated, obstructed and banned mandates. It’s easy for elected officials to dangle free stuff in front of constituents. That’s never going to cost them politically. But don’t call it leadership. Using carrots is politically expedient, but wielding sticks is what’s needed to finally put this pandemic behind us.“
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