This time last year, Wynfred Russell was a strong believer in providing incentives to marginalized communities to get them to take the COVID-19 vaccine.
Today, a year after the vaccine was released, he’s less enthusiastic about this strategy.
“I’m in for a struggle because of what I saw,” said Russell, who serves as director of African Health Equality in Jobs, Education and Resources (ACER) and a city councilman in Brooklyn Park. “Motivation has become a double-edged sword.”
Vaccine incentives are essentially financial rewards or perks intended to induce those wishing to get the vaccines. They have worked successfully to increase vaccination numbers against other diseases, such as polio vaccines for children in Ghana, according to a peer-reviewed scientific study published earlier this year. Last summer, the federal government and states across the country decided to use this approach to curb COVID-19.
Minnesota began offering the COVID-19 vaccine incentives last May, as the number of people getting their first vaccinations began to decline. During June, the Minnesota Department of Health offered non-vaccinated people $25 Visa gift cards, free hunting licenses, state park tickets, or state fair tickets. Once August comes, the incentive to get $100 gift cards has increased.
As the Delta wave led to a resurgence of new infections, Governor Tim Walz went even further by offering $200 gift cards to children ages 12-17. The state also gave families the opportunity to enter children into the lottery in exchange for five college scholarships worth $100,000.
Currently, the state runs a $200 flight coupon lottery for vaccinated people in Minneapolis-St. Poole International Airport. The state also provides $100 on-site incentives at community vaccine events and community health clinics targeting underserved populations, including booster shots.
But as of this writing, approximately 1.5 million eligible Minnesota residents remain unvaccinated. The Delta Wave continues to hit the state and hospitals continue to overwhelm patients – most of whom are not immune – suffering from the virus.
Just over 100,000 of the 3.7 million Minnesota residents who received at least one dose of the COVID-19 vaccine have collected incentives this year, according to MDH. The Sahan Journal reached out to experts working on vaccine equity, and heard mixed reviews about how incentives work.
On the plus side, practitioners and health officials say the incentives have led to more Minnesota receiving over the past several months. At the same time, a large segment of the population remains skeptical about the vaccine, and the idea of incentives only increases their skepticism.
“I give it a net positive with an asterisk,” said Tito Wilson, who runs Wilson’s Image Barbers & Stylists in the Jordan neighborhood of north Minneapolis. Wilson’s business organizes weekly community vaccination events, which have given him the opportunity to listen to countless clients.
“If people don’t believe in a vaccine, but are willing to do it for $50, that speaks to a whole host of problems that need to be addressed,” Wilson said.
State officials indicate that incentives for COVID-19 vaccines will run through 2022.
“We continue to identify other opportunities to encourage Minnesota residents to get their vaccine and we thank them for doing so,” said Erin McHenry, a spokeswoman for the Minnesota Department of Health.
Incentives to persuade skeptics are not bribes
The state paid for the stimulus throughout 2021 mostly with federal coronavirus relief money. The state benefited from $16.3 million in federal relief money during the summer, and another $12.2 million in federal funds for the “Children Deserve a Bullet” campaign during the fall.
To pay for on-site incentives at community vaccine events and community health clinics, the state used $4 million in federal COVID-19 stimulus funds and $400,000 from private foundations.
Years before the outbreak of the COVID-19 pandemic, Russell ran a polio vaccination campaign in Nigeria for the Bill & Melinda Gates Foundation, which gave 3 million injections. Sharing free supplies such as groceries and medicine has been credited as key to the success of this programme.
But to him, the incentives for a COVID-19 vaccine seem more complex. “There are people who say, ‘If it’s safe and sound, why would you bribe us to get vaccinated?'” Russell said. “This caused a lot of people to stop.”
This dynamic could be especially true in communities of color, said Dr. Shaun Enifor, a retired pediatric anesthesiologist.
“Some people are offended by the stimulus, especially when it targets disadvantaged communities,” Ennevor said. “Like, why is this necessary?”
This puts people like Russell and Ennevor, both black and working year-round at community vaccination events, is in a position to convince some people that incentives are not bribes.
When he receives questions like these, Enifor said he responds that the decision came from politicians and policymakers who decided that incentives would be an effective way to get more people into the shots. He adds that they did not necessarily come from the recommendations of scientists or health experts.
High fade with a shot to the side
Since the summer, Wilson’s Image has been holding weekly vaccine events through a partnership with the state Department of Health and several other health organizations. At the time, Wilson estimates that 600 to 1,000 people were vaccinated in his barbershop.
On a recent Friday morning, when a winter storm loomed, a handful of people walked into Wilson’s barbershop. Donnie Hathaway’s “This Christmas” was shown in the background as a crew of health professionals occupied tables where customers could sign up for the shot. Enifor handled the syringe’s supply, while a nurse was taking people into a back room to vaccinate them.
Getting shots in the community was especially important to Lily Thomas, a registered nurse helping with the event. Thomas works at Twin Cities area hospital – she didn’t want to name which one. As of that week, 89 people at the facility have been hospitalized with COVID-19. Thomas said that out of 89, three have been vaccinated.
“We are in capacity,” she said.
As for whether incentives vaccinate more people, Thomas said she often encounters three types of people. First, people who are already hesitant can become more skeptical.
“I hear it from the community,” Thomas said, “Why would they give us money to get the vaccine?” ”
“And then you have some who say, ‘Okay, they give it, I’m going to go get the vaccine. And then you have some who say, “I don’t care what you all do, I don’t get it.”
Mandez Ransom, a lead barber at Wilson Image, said the incentives seem to work best for people who are just visiting the barbershop. Ransom, a burly man with long dreadlocks, describes typical conversation, as he pulls an e-cigarette on a short break outside:
“Do you want a vaccine?”
“I’m not sure.”
“Okay, well, here are all the health benefits, and on top of that you’ll get $50.”
“Fifty dollars? OK.”
“A lot of friends have contracted the virus and they are fine”
Ransom himself felt skeptical of the vaccine for months after the shot became widely available to the public. He feels like he has a good immune system: Vidya doesn’t get sick often, and when he does, he likes to treat himself with home remedies. He added that a lot of friends had contracted the virus and turned out to be fine.
“Besides that, it’s just a fact that people of color, we don’t have that confidence there in vaccines and healthcare,” he said.
The incentives didn’t change his mind about getting the shot. Instead, it mostly came from his mother, who works in healthcare and has consistently urged Ransom to get vaccinated.
“After a while, with the spread and all these variables, I felt I’d rather not risk it,” he said.
Ransom got his first shot in August.
Wilson said the community’s knowledge of his barbershop could provide an environment for similar conversations — which he attributed as the biggest factor behind the hundreds of vaccinations being offered at his company.
“We are an African American barbershop,” he said. The nurses and doctors who administer the injections are also African-American. So there is some comfort there.”
On this day, most of the people vaccinated at Wilson’s Image would come to get their boosters. Among them was Matthew Urban, who has lived in the neighborhood and has been cutting his hair here for a decade. He chose to donate his $50 stimulus, and he felt it best goes to the people who need it.
“This is the way it should be,” Urban said.