Recently there has been a lot of discussion of using incentives or penalties to improve the vaccination rates for COVID-19. Hesitancy is a big concern and getting vaccines into enough people to create some level of Herd Immunity rapidly given the variants is very important. While incentives for COVID vaccines are a relatively new topic, this has been an ongoing issue for decades in the wellness/wellbeing industry.  Do we use a Carrot or a Stick?

It has become clear over this time that:

1. Each person is different and responds to incentives/penalties differently
2. Certain incentives that incorporate Behavioral Economic principles are better than those that don’t
3. Over time the goal is to move from extrinsic motivation to intrinsic motivation to make these changes sustainable, and
4. A heavy-handed approach or use of penalties is often a ham-fisted one creating more problems and backlash for companies than it is worth.

For these reasons and others, most have recommended using some sort of incentives at the beginning to generate greater vaccination rates and we have seen many companies do just that, offering additional hours of pay, bonuses, or time off for their employees who choose to get vaccinated.

A recent Viewpoint in JAMA entitled Incentivizing Vaccination Uptake The “Green Pass” Proposal in Israel by Rachel Wilf-Miron, MD, MPH; Vicki Myers, PhD; and Mor Saban, PhD discusses what Israel has done and some of the pros and cons of their “Green Pass”. It’s a good review and definitely worth reading.

As an employer, before diving into this debate, it is also very important to understand the EEOC and other federal rules that impact the use of incentives and penalties in health improvement programs.

When ready, take a look at the evidence associated with the various strategies to encourage the COVID vaccine or other healthy behaviors, and in most cases, a Carrot is better than a Stick.