Thread by @anicalaw

I want to share some of our work, hot off the press @JAMAcurrent: Lottery-Based Incentive in Ohio and COVID-19 Vaccination Rates ja.ma/2SO8Iac

A couple weeks after Ohio launched their lottery for vaccinated Ohioans, many news outlets noted a spike in Ohio vaccination rates and declared the lottery a success: npr.org/2021/05/30/100… @andy_chow

Shortly thereafter, many states jumped on the lottery bandwagon: nytimes.com/2021/05/28/us/… @stanfordc

But – here’s the key – was the spike in vaccine rates in Ohio really due to the lottery, or something else (like the expansion of vaccines to adolescents at almost exactly the same time)?

This matters, because if lotteries really work, we should be doing lotteries in every state. If the spike isn’t from the lottery, we should be using all of that money/resources on other (more effective) ways to increase vaccine uptake.

To tell if the spike in Ohio vaccines was related to the lottery, we compared trends in Ohio vaccination to trends in the rest of the US (via controlled autoregressive interrupted time series analysis, censoring states starting lotteries on lottery announcement date).

We found the rest of the US (w/o lotteries) ALSO had a spike in vaccine rates at the same time. Ohio's rise in vax rates, despite its $5million+ lottery, *wasn't different than what was already happening in the rest of the country*. Maybe related to adolescent vaccine expansion?

Vaccine uptake matters (get yours if you haven’t already) – but we need to be smart about how we go about encouraging uptake. If vaccine hesitancy is due to strong fears/beliefs about the vaccine, a lottery nudge may not do the trick.

We may need broader, more multi-faceted approaches featuring a deeper dialogue. This isn’t going to be simple, but at this stage of the epidemic, the “frontline” has shifted from our EDs/ICUs to our primary care doctors/general practitioners. How can we better support them?

As heard in this episode of The Daily nytimes.com/2021/05/10/pod… these conversations require patience, empathy, and perseverance @mikiebarb. We have so far to go.

Daily US Vax progress here:

https://twitter.com/vax_progress/status/1410963986032517121?s=20

This has been a team effort by @WalkeyAllan and @NickABosch. We’re ICU physicians who took care of some of the sickest COVID cases. We’re also researchers @BUMedicine @thebmc @BUPulmonary focused on improving delivery of healthcare.