Research backs cash payment as one way to lift vaccine rate

A leading researcher has backed a Labor proposal to pay people $300 if they are fully vaccinated by December 1 as the federal government says the idea is “insulting” to people who are doing the right thing to protect their health.

Queensland University of Technology professor Adrian Barnett said cash incentives were more powerful than other factors, such as lotteries or an explanation of health benefits, in encouraging people to take a step toward vaccination.

Federal Labor has proposed paying people $300 to get vaccinated.Credit: AP

“Overall, across a range of countries, it looks like giving people cash close to the time that you want them to do something works the best,” he said.

“And there does seem to be a dose response as well, so the more cash you give, the more likely people are to change their behaviour.”

Professor Barnett released a study last week with colleague Raymond Duch from Oxford University and other researchers from Oxford and the Vienna University of Economics and Business showing that cash was the best incentive in a randomised trial of people who might get a vaccine against COVID-19.

That came days before Labor leader Anthony Albanese proposed the $300 payment, which would cost $6 billion to cover the adult population of Australia, and the federal government released sections of an internal report that favoured potential “freedom incentives” over cash.

Professor Barnett said Australia had years of experience in offering positive and punitive incentives for health behaviour, ranging from the tax benefits offered for those who pay for private health insurance to the “no jab, no pay” penalties for those who do not vaccinate their children.

Asked about the Labor policy, he said, “I like the proposal. Based on our research it seems like good policy to me”.

Professor Barnett said it was difficult to estimate the right amount of money to change behaviour but the economic gains were likely to offset the spending because of the cost of shutdowns, border closures and social restrictions.

His study, published by Medrxiv last week, asked 1,628 people to show their interest in being vaccinated after being told of three incentives: the health benefits, a lottery with a financial prize and a cash voucher.

While 14 per cent asked for more information on the vaccine after being told of the lottery, 16 per cent responded to the health benefits and the largest group, 22 per cent, responded to the cash voucher. The response was similar across age, gender and race.

The study, which was done in the United States because of the time required to do a similar study in other countries, was based on the offer of a $US100 voucher.

“We know the dose of the vaccine that works. We don’t know the dose of cash that would work,” Professor Barnett said.

“You could up the dose of the cash and you might find that you get a higher figure, but that depends on the number the government is willing to tolerate.”

“The thing to bear in mind is that it would very likely pay for itself. Anything in the region we’re talking about, from $100 to $300, if we got a big chunk of people to get vaccinated and get life back to normal that would very likely pay for itself very quickly.”

Professor Barnett said real-world programs showed the impact of financial incentives such as payments in some countries for people who give up smoking, but he said negative incentives could also be effective.

“Given the state we’re in at the moment and given the massive costs of the lockdowns and life not being back to normal, I suspect the government will end up trying both in order to get the rate up to that herd immunity percentage that we need,” he said.

Professor Barnett has a doctorate in mathematics, is the president of the Statistical Society of Australia and worked at pharmaceutical company SmithKline Beecham earlier in his career.

The Labor policy would pay the $300 to all those who have two doses of a COVID-19 vaccine by December 1, including those already vaccinated, and would cost $6 billion if it covered all adult Australians.

Finance Minister Simon Birmingham rejected the Labor idea on Tuesday morning on the grounds it was “insulting” to people who had already been vaccinated and was unnecessary to reach the target.

The government is relying on advice from the Behavioural Economics Team of the federal government, part of the Department of Prime Minister and Cabinet, that the primary consideration should be incentives that enhance the benefits of the vaccine or increase the costs of not being inoculated.

“Evidence from overseas has shown larger financial incentives and lotteries have generated a lot of publicity but have had little to no impact on longer term vaccination rates. This approach is unlikely to drive vaccine uptake in Australia,” it said.

But the government has refused to release the full report from the economic team and has instead released selected quotes from its findings.

French President Emmanuel Macron has passed laws to require a “digital pass” showing people have had two doses of a vaccine if they want to go to a concert, restaurant or public event.

United States President Joe Biden has taken a different approach by proposing a $US100 payment to people who get vaccinated.

Professor Anthony Scott, head of the economics research program at the Melbourne Institute at the University of Melbourne, said many studies worldwide showed cash incentives generally worked.

“The evidence suggests that cash payments are good for short, one-off behavioural change such as a visit to get vaccinated,” he said.

“The evidence on lotteries is not as strong.”

Asked about Labor’s $300 payment, he said, “That sounds expensive if it’s going to go to everybody who gets vaccinated, but I think the advantage with that is that it is pretty clear and is one single message.”

Professor Scott said the incentives generally worked for people who were undecided but were unlikely to sway people with strong views, such as those opposed to vaccination.

“The $300 sounds like a fair bit of money for most people and would have an impact, but only on those groups who are unsure - it would get people vaccinated more quickly,” he said.

“If you’re paying people who have already been vaccinated in the past, then it’s kind of money down the drain in a way. You need to focus on those people who are unsure.”