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Can water ice, booze, and cash encourage the unvaccinated and ambivalent to get shots? Philly-area officials are finding out.

"Whatever we have to do to get this last group of people," said one official, "we need to do it.”

The Rita's Water Ice mascot "gets vaccinated" at the Neshaminy Mall in Bensalem on Thursday, May 20, 2021.
The Rita's Water Ice mascot "gets vaccinated" at the Neshaminy Mall in Bensalem on Thursday, May 20, 2021.Read moreALEJANDRO A. ALVAREZ / Staff Photographer

Get a coronavirus vaccine in Bucks County and treat yourself to a free water ice. Get a shot in New Jersey and chase it with complimentary beer or wine. In South Philadelphia, jabs last weekend came with tacos, and in Fairmount Park, some people have gotten $20 for getting their second shots — if they bring a friend for a first.

As vaccine demand drops and the country claws its way toward mass immunity, vaccine providers and public health officials are getting creative, luring folks in with food, booze, one-of-a-kind experiences, and even cold hard cash.

New Jersey has led the region with an incentive program that has attracted thousands in less than a month. Delaware this week made vaccinated people eligible to win $302,000. Philadelphia has already partnered with the Sixers, Eagles, Flyers, and Wawa to bring mascots, free game tickets, and complimentary coffee to clinics, a city spokesperson said, and is planning additional incentives.

The recent influx of incentives serves as yet another sign of the challenges the vaccination effort faces six months into the rollout. In Philadelphia, more than half of city residents have not gotten a shot, and Council President Darrell L. Clarke said Thursday the city needed to “act creatively and aggressively.” City Councilmember Cindy Bass introduced two bills that would give residents who get vaccinated a $50 credit toward their gas or water bill or a $50 gift certificate from the city.

But Pennsylvania state officials have not set up incentive programs, saying people should be motivated by the promise of immunity and the guarantee that the state will lift its mask mandate when 70% of adults are fully vaccinated.

» READ MORE: Vaccinations have hit a key threshold across Pa., but still lag in Philly and some rural counties

“Incentive programs broadly are still being contemplated,” Acting Health Secretary Alison Beam said Thursday. But “at this stage, we’ve seen such great success,” with the state on track to reach that 70% mark and lift the mandate by the end of June, incentives don’t seem necessary, she said.

‘A win-win’

Since people don’t specify why they’re getting vaccinated, it’s difficult to gauge how many people the prizes are bringing in the door. And providers say they don’t entice everyone, including those who are definitively opposed to getting a vaccine.

However, Philadelphia’s incentive efforts “have elicited an uptick in the number of people that have come out to those clinics,” said health department spokesperson James Garrow.

The city is partnering with the Sixers to give out free playoff T-shirts and one autographed item at Johnson & Johnson clinics at the Convention Center through Wednesday, Garrow said, and officials are reaching out to businesses about future incentives, not only for the newly vaccinated but for all residents who have gotten shots.

“Everyone who has contributed to Philadelphia getting closer to reopening and getting back to doing the things that we love deserves a thank you,” he said. “And if we can have that thank you to encourage folks to get back into restaurants and business districts, that’s a win-win.”

The incentive bills introduced in City Council could help close the racial gap in vaccine uptake, Bass and Clarke said upon introducing the legislation. The bills would have to go through a committee hearing, get approved by the full council, and be signed by Mayor Jim Kenney before the program could begin.

» READ MORE: Esperanza has been a success at vaccinating Latinos, but Black Philadelphians still lag behind

“These numbers are consistently skewed with people of color not even remotely close to where they need to be,” Clarke said, “so whatever we have to do to get this last group of people, we need to do it.”

Creating urgency

There’s evidence to support incentives. A randomized survey conducted last month by the UCLA COVID-19 Health and Politics Project found that a third of the unvaccinated population could be persuaded to get a shot with a cash payment. The incentive of being able to relax mask-wearing — as Pennsylvania has promised — and social distancing also was effective, particularly among Republicans.

» READ MORE: Vaccination rates keep rising in some Philly suburbs, as others plateau, facing access and hesitancy challenges

Officials have been tapping into these motivators. West Virginia Gov. Jim Justice is giving $100 savings bonds to 16- to 35-year-olds who get shots, and Ohio Gov. Mike DeWine has been giving vaccinated residents a chance to win $1 million and full-ride college scholarships. New York City is doling out free or discounted tickets to famous attractions, and Chicago will hold a series of concerts this summer for vaccinated residents only.

Few predicted so many Americans would need to be persuaded to get protection from a virus that upended lives and has killed millions worldwide. As other countries wait desperately for vaccines, the U.S. is using everything from free doughnuts and beer to scholarship money, vacation packages, and Super Bowl tickets to increase vaccination rates.

» READ MORE: ‘The challenge to come’: Vaccinations are open, but demand is down, turning Pa. and Philly’s focus to fighting hesitancy

Incentives can work for those who aren’t “completely resistant” to it, said Bucks County commissioner Diane Ellis-Marseglia, who proposed the county use an incentive after talking with some unvaccinated residents in their 20s and 30s.

“In the back of their mind, they know they’re going to get it, but they’re seeing no urgency for it,” she said.

To lure them, the county partnered with Bensalem-based Rita’s Italian Ice to offer vaccine recipients coupons. For people who say they’re waiting to get the shot, county health director David Damsker said, just a small incentive can “get them off the fence.”

Not effective everywhere

Some Pennsylvania health-care providers said they are hearing people wouldn’t be swayed by incentives.

A Lehigh Valley Health Network spokesperson said they want patients to decide “based on their personal preference.”

In central Pennsylvania, WellSpan Health found incentives effective in its mobile vaccination efforts at shelters, but has focused more on making it easier to get vaccinated and addressing hesitancy to combat dropping demand. Similarly, a spokesperson for the University of Pittsburgh Medical Center said it is focusing on smaller clinics and community initiatives, using “an education, encouragement, and ease-of-access approach.”

» READ MORE: Grassroots efforts take on vaccine barriers across the Philly region

In rural Bradford County, Guthrie Clinic informally surveyed the 28% of its 6,000 staffers who have not been vaccinated and asked if paid time off would persuade them. The answer was no, said Michael Scalzone, chief quality officer.

Guthrie determined the broader community, where more than 70% of residents haven’t gotten a shot, wouldn’t be persuaded so easily either.

» READ MORE: As Americans scramble to get vaccinated, many rural, conservative Pennsylvanians feel no urgency

“Externally, I think we still are in a position where the majority of people who are declining are less likely to be influenced by relatively small gifts or tokens,” he said. “I think they have more philosophical hesitancy with this vaccine.”

Looking ahead

Incentives have had great success in New Jersey, where, like Pennsylvania, a 70% adult vaccination rate is within reach.

When demand slowed there, the state’s top officials collected data on unvaccinated residents and crafted a series of incentives, said Daniel Bryan, a senior adviser to Gov. Phil Murphy. They determined that while a small number of unvaccinated people had decided not to get a shot, about a quarter were planning to, and a larger percentage was undecided.

So Murphy announced in early May that dozens of breweries and wineries across the state would offer free beverages to the newly vaccinated, and all inoculated adult residents could enter to win a dinner with the governor and first lady Tammy Murphy. And every New Jerseyan who has gotten at least one shot by July 4 can also get a free season pass to its 51 state parks.

The Operation Jersey Summer programs have snagged thousands of participants since they were launched earlier this month, Bryan said, according to reports from brewery and winery owners, and more than 13,000 people have entered to win the dinner with the Murphys. The incentives also generated buzz, he said.

“Is the offer of a free beer going to convince someone who has already said they’re not getting the vaccine? Probably no,” Bryan said. “But if the answer is, ‘I hadn’t made it a priority, and now I can go around to a few different breweries and try their beer,’ that’s a different scenario.”

There’s no question that the incentives are working, Bryan said. Asked if they’d consider offering new perks in June, when the free-drinks program ends, he said, “We would kind of consider anything.”

Damsker of Bucks County said he’d welcome something similar from Pennsylvania.

“If Pennsylvania were to do a million- or two-million-dollar lottery, that would be great,” he said. “It’s not going to hurt.”

Staff writer Laura McCrystal contributed to this article.