Ohio is running a lottery to give 5 people $1 million each if they've been vaccinated. It sounds like a crazy idea but I think it's brilliant. Let me explain. 1/9
1. It creates buzz and gets everyone talking about the vaccine. That opens the doors for conversations that will help encourage vaccine hesitant people to get vaccinated. 2/9
2. Lotteries with bigger jackpots draw more people in. A million dollars might seem like a lot of money but it has the potential to massively boost vaccination rates. 3/9
3. This lottery will pay for itself in the short or long run. The money might be better spent elsewhere. But the bottom line is that the pandemic is costing the economy millions. Pouring crazy amounts of money into vaccination programs is optimal. 4/9
4. The lottery can reach those who make vaccination decisions emotionally rather than rationally. It's hard for most people to determine optimal behavior given small probabilities so they just go with their gut. That's one of the barriers to vaccination in the first place. 5/9
5. Having a weekly lottery gives people incentive to get vaccinated sooner. We all know that having a deadline is a good motivator when we're procrastinating. This is the first "vaccination deadline" we've seen. 6/9
6. It incentivizes everyone everywhere to encourage their Ohio-based friends and family to get vaccinated so they have a shot at the prize. Everyone is already entered in the drawing (voter registration database) but you can't collect the prize unless you're vaccinated. 7/9
7. Money is a universal motivator. The lottery decouples getting vaccinated from the specific vaccine-related benefits and reaches people who don't respond to the usual approaches. The expected value of the lottery is too small to be seen as coercive. 8/9
8. The Ohio lottery is innovative! No one has tried this before so there is a chance it won't work very well. But if it succeeds it creates a blueprint for others to try a similar approach. And that means herd immunity is one giant leap closer. 9/9

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More from @ZoeMcLaren

25 Jan
Here's a helpful analogy: We are in a battle against the virus. Each vaccine dose can be used to give armor to the most vulnerable OR to lay a stone in the wall to keep the virus out. 1/4
If doses are limited, it makes sense to start by *only* giving armor to the vulnerable since it offers them a lot of protection from illness and death.

We could try to build the wall first, but the vulnerable wouldn't be protected from the virus until the wall was finished. 2/4
So, while doses & infrastructure are too limited to vaccinate enough less-vulnerable people to control the virus, we must focus on getting the most-vulnerable vaccinated. It's the most effective way to protect them.

Only then should we turn to vaccinating the less vulnerable.3/4
Read 4 tweets
25 Jan
Could throwing some COVID19 vaccine doses in the trash actually help save lives? Buckle up. This thread might break your brain. 1/9
Some argue that it's a net positive for non-prioritized people (e.g. young people) to get leftover COVID19 vaccine doses that would otherwise end up in the trash. Let me try to convince you that this is far less helpful than you think and actually likely costs lives. 2/9
According to the CDC, someone aged 65-74 is 90 times more likely to die from COVID19 than someone 18-29.👇 So vaccinating people 65-74 is *about 90 times more effective* at preventing death than vaccinating someone 18-29. 3/9
Read 9 tweets
23 Jan
I respect @lindy2350's work, but this article draws the misguided conclusion that "declining a Covid-19 shot because you think it should go to someone else won’t help anyone." Let me explain. 1/9
nytimes.com/2021/01/21/opi…
The pandemic has been long and hard on everyone. And I don't want to add to anyone's burden. But the idea that letting other more vulnerable people ahead of you in the queue "won't help anyone" is patently false. It may not fix the system, but it could save someone's life. 2/9
If you are at relatively low-risk *within your priority group* then you have many reasons to believe that your vaccination appointment would go to someone with higher risk. A 65 year old who works from home is at far lower risk than a 65 year old who works in retail. 3/9 Image
Read 9 tweets
23 Jan
@gregggonsalves you are a treasure and I want you to stay healthy. But I also know how much you care about health equity so please forgive me, but I feel compelled to respond. You can take the vaccination appointment, but you may want to consider postponing. Let me explain. 1/10
If you postpone your appointment, the dose will either (1) go to someone at higher risk, (2) go to someone at lower risk, or (3) in rare cases end up in the trash. 2/10
What is your COVID19 risk relative to the rest of your priority group? If you have low exposure risk (e.g. WFH) and have no underlying risk factors for hospitalization or death from COVID19 then you likely fall in the lower range of risk for your group. 3/10
Read 10 tweets
22 Jan
Is it naive to hope that the pandemic will get better now that we have a new President? The truth is that there is a lot of low hanging fruit that the Biden administration is already working on. I predict our trajectory will start to look better soon. Let me explain 1/14
Health information: Better information about relative COVID19 risks of different activities. @CDCDirector Walensky plans to review all guidance for scientific merit and update it as necessary. This will help reduce transmission right away. 2/14
Funding: HHS had been inexplicably holding up funds appropriated by Congress last summer. Under Biden's administration more funds will be allocated to states and health departments to be spent on COVID19 priorities. 3/14
Read 14 tweets
20 Jan
Many people have asked why ACIP's vaccine prioritization recommendations would put a young firefighter in line ahead of 65-year-old. Let me explain. 1/9
ACIP prioritized vaccinations to achieve 2 separate and co-equal goals that most people conflate:(1) Prevention of morbidity/mortality & (2) Preservation of societal functioning. The prioritization order reflects advancing both goals at the same time, interspersing the groups.2/9
"Preservation of societal functioning" is our insurance policy. Mass illness or death among HCW, firefighters or USPS workers could grind society to a halt. Protecting the food supply and delivery services enables others to stay home and stay safe from COVID19. We all benefit.3/9
Read 10 tweets

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