Anderson High School students were eligible to receive $100 for getting vaccinated against COVID-19. Phoenix school officials are giving away $100 gift certificates. Los Angeles students can win $100 gift cards and free homecoming tickets by getting the jab.
And in the nation’s largest school district, New York City, children as young as 5 could get paid for getting a COVID-19 vaccination, another example of the lengths to which schools are going as they strive for normalcy after nearly two years of pandemic-disrupted education.
The decision to give money and gifts to children to perform tasks that were recommended by most health professionals is controversial. Critics claim it amounts to bribery. It makes perfect sense for schools across the nation if it protects students and staff.
<strong>“A lot of people smarter than us have worked on this. So to me, it was money well spent.”</strong>“Our youth go home every day to their families, to multigenerational households, to grocery stores, to churches, to parks. There’s no way to separate public education from public health,” says Chad Gestson, superintendent of Phoenix Union High School District in Phoenix. “We know that the higher the vaccination rate, the lower the spread, the minimized quarantines and the increased access to campus. That’s been our focus.”
Gestson’s district is offering students a $100 Target gift card if they show proof of vaccination, working toward a goal of getting 85% of students and staff in the district fully vaccinated. He says roughly 10,000 students—about 36% of the district—are fully vaccinated so far. A $200 vaccination incentive was offered to district employees and 83% are now fully vaccinated.
Superintendent of Anderson School District Five, South Carolina, Thomas Wilson offered $100 to high school students if they were vaccinated before Oct. 15. This was in an effort to protect them in a state which had previously banned the use of masks in schools. This law remains in dispute. The program was attended by about 30% of the high school students.
“I looked at it more as a safe-school issue than anything else,” Wilson says. “This is tested. Many people are more intelligent than us and have spent a lot of time on it. So to me, it was money well spent.”
Wilson and Gestson both used federal coronavirus funding to fund the incentive programs in their respective districts.
History of vaccination programs in schools
Wilson thought about expanding the program for younger students but decided not to after facing opposition from parents, who claimed the policy was corrupt and accused the district, of being too aggressive.
Wilson is not in agreement.
“Throughout history, schools have been involved in [vaccinations],” Wilson says, recalling that he got the polio vaccine at school as an elementary-school student. “Our number-one goal is to provide a safe learning environment, and to me, I think this was the safest thing we could do to ensure our kids were safe — to do everything in our power to ensure they didn’t get COVID.”
On Nov. 2, the Centers for Disease Control and Prevention (CDC) recommended the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11, following the Food and Drug Administration’s authorization of the vaccine for that age group. However, youth vaccination rates are still low. While children as young as 12 became eligible for the Pfizer vaccine in May, just 50% of 12- to 17-year-olds in the U.S. are fully vaccinated against COVID-19 — a smaller percentage than any older age group, according to a Mayo Clinic tracker.
New York City announced on Thursday that it would give $100 to children 5 to 11 years of age if they were vaccinated for COVID-19 at any city-run school vaccination site. The incentive was in addition to that offered to adults in July.
“We really want kids to take advantage, families to take advantage of that,” Mayor Bill de Blasio said as vaccination sites opened for children as young as 5 years old. “Everyone could use a little more money around the holidays, but most importantly, we want kids and their families to be safe.”
In Los Angeles, the nation’s second-largest school district is requiring students 12 and older to be vaccinated by Jan. 10 if they want to continue attending in-person classes. Frances Baez, superintendent of the city’s Local District Central, has been making phone calls and home visits to ensure as many students as possible meet that deadline. Half of her district’s students aged 12 or older have received vaccinations.
On Friday, she plans to be door-knocking around the community to spread the word about a vaccination clinic taking place at one of the district’s schools on Monday. If she meets parents who hesitate to vacate their children she will remind them of the learning losses she saw last year as well as the improvements she’s seen in students since they returned to school. Los Angeles students who don’t get vaccinated by January will have to participate in an online learning option, and that worries her.
“If we go the direction of online learning, we’re going to fall back again,” Baez says. “There’s going to be a decline. So I’m using the data to establish the urgency, the importance that face-to-face learning is the best option that helps our students succeed.”
For Gestson, the gift card incentive was a logical first step in a district that wasn’t ready to mandate vaccines for all students. “We weren’t—and aren’t—quite ready yet to move into the requirement phase,” he says. “We wanted to move from encourage to incentivize, and then perhaps at some point, from incentivize to require.”
Are incentive programs effective?
School-based programs mirror incentives offered by colleges, state companies, and corporations. Colleges may require that students be immunized. Others offer the possibility of gift cards, or even a year free tuition for students who do so.
However, research into the effectiveness of these incentives has been mixed. The Center for Health Incentives and Behavioral Economics conducted at least one study that found that statewide programs of incentive did not have an effect on daily vaccination rates. Research showed that North Carolina offered $25 in incentives to adult vaccine recipients. This was contrary to what had been shown by other studies. In fact, vaccination rates fell more at non-incentive clinics.
Emily Largent, an assistant professor of medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine, says “small, guaranteed incentives” tend to work better than big prizes that aren’t guaranteed, like lotteries. Although $100 won’t influence someone opposed to vaccines it can help to ease logistical hurdles to vaccination such as transportation costs and time off work.
“To the extent that offering that small cash incentive helps overcome those barriers, it can be really helpful for getting people who are open to being vaccinated across the line and removing barriers that are in their path,” Largent says.
“You’ve just got to stand your ground and know we’re doing whatever we can to take care of students and children in these schools.”[/time-pullquote]
A piece in the Journal of the American Medical Association in January, Largent analyzed the problems with paying people to be vaccinated against COVID-19 and concluded that such a policy “should be adopted only as a last resort if voluntary vaccine uptake proves insufficient to promote herd immunity within a reasonable period of time.”
Since then, however, there have been many changes. “Uptake has really slowed down,” she says. “I think kids are going to be such an important part of trying to help increase overall community vaccination rates, given what a large percentage of the population they are, and it’s appropriate to be thinking about this.”
“I’m an ethicist. People should do the right things. I think protecting yourself and your community is a really great reason to be vaccinated,” Largent says. “But I’m an ethicist who lives in the real world, and we know that people have financial barriers. Sometimes they’re hesitant. They have concerns, and we should meet people where they’re at. Financial incentives can be part of this multi-pronged approach.”
Wilson says he would recommend the incentive program to other school districts looking to boost vaccination rates, but he warns that it won’t come without controversy.
“You better set your jaw and have alligator skin because they’re gonna come after you,” he says, referring to protesters opposed to vaccines. “But you’ve just got to stand your ground and know we’re doing whatever we can to take care of students and children in these schools.”