The architect of Oregon’s vaccine lottery on using games for social good

The tagline is pretty easy to understand: Get a vaccine, get a chance to win a million bucks.

That was the scheme cooked up by Ashby Monk when Oregon State Treasurer Tobias Reed gave him a call in April.

Monk is the executive and research director at the Stanford Global Projects Center. He’d spent much of his career studying institutional investing before turning his attention to a thornier question: how to motivate people to make smarter long-term personal finance decisions.

On the phone, Reed was looking for creative ways to convince more people to get vaccinated. Oregon’s vaccination rate had been strong for several months, but demand was beginning to taper off as the most vaccine-hungry Oregonians had already scheduled their appointments. The state still had a long way to go to hit its aim of a 70% vaccination rate by July 4, President Joe Biden’s target.

How do you help the vaccine-ambivalent get off the fence and get their shots, quickly?

Monk’s answer was also elegant in its simplicity: make it a game.

Saving to win

Monk said convincing the vaccine-hesitant to sign up for a shot carries a lot of the same challenges he saw when he was researching how to motivate people to begin saving money. In both cases, there are a lot of up-front challenges, and the long-term payoff is hard to visualize.

“Many people are intimidated by personal finance,” he said. “There’s tons of misunderstanding, there’s high cost, you have to put money away.”

With COVID-19, the combination of uncertainty about the vaccine itself, an unwieldy scheduling process and competing obligations for personal time was preventing many individuals from prioritizing their vaccine appointments.

Monk said the one thing that wouldn’t work, though, was telling people what’s best for them.

“There’s a whole world in the personal finance space that’s focused on financial literacy,” Monk said, “which is another way of saying ‘Let’s just try to teach everybody how to behave.’”

Research shows that the approach doesn’t really do much. A 2013 meta-analysis in the journal Management Science found traditional financial literacy programs only result in a 0.1% change in individual financial behaviors.

“You could almost say the takeaway from all these financial literacy programs is they don’t make you worse at personal finance,” Monk said.

Monk found a solution in prize-linked savings accounts. He started a company to motivate people to save money by incentivizing them with the chance to win cash prizes as long as their money stays in the bank. The practice was signed into law by President Barack Obama in 2014, and it has proven to be a success: A recent study from the Kellogg School of Management at Northwestern University found that 110 bank branches with prize-link savings programs saw a 41% increase in new personal savings accounts being opened.

The era of games

“Look: This is the era of games,” Monk recently told OPB’s Weekend Edition.

With the omnipresent rise of smartphones, more and more of our daily decisions are being gamified. Want to eat better or work out faster? There’s an app for that. We use games to sleep better, to track our steps, even to meet new people: Just look at the swipe-culture of online dating.

Monk said the trick is providing people extrinsic motivation to make better decisions based on the hope of an uncertain but potentially huge payoff.

“People play for the chance to change their lives with luck,” Monk said. “It’s like, ‘If I win, the change is just going to be astounding. And I’m not really feeling the cost.’”

In designing Oregon’s vaccine lottery, he pushed the governor’s team to focus on three priorities. First, there needed to be a variable reward prize.

“It’s a type of game prize where not everybody wins,” he said.

That big million dollar prize would motivate people to opt in, even generating a bit of fear of missing out (yes, he used the term “FOMO”). Why play if there’s no big reward?

Second, there needed to be a chance to feel some proximity to the winner. That’s why he urged a smaller $10,000 prize in each of Oregon’s 36 counties.

“We wanted every community and region to have winners so that maybe somebody you know won,” Monk said, “so you could really visualize yourself winning this thing.”

Finally, it needed to be risk-free for participants. Monk acknowledges this is one of the biggest problems for conventional lotteries. “I can find you losers,” he said. “These are people who often struggle to make the money they’re holding in their hand and sadly, it goes away.”

Games of the free

Since Oregon’s announcement, vaccine lottery fever has swept the country. Both California and Washington have announced their own lottery programs to pump up vaccination efforts.

Initial findings suggest the incentive may be working here in Oregon. Daily vaccinations are up in several rural counties: Marion County is reporting a 2.3% increase, Sherman County is up 2.5%, Gilliam County up 2.1% since before the lottery was announced. These are places where previous trends had anticipated a decreasing vaccination rate.

On Friday, Oregon Gov. Kate Brown announced we’re closer than ever to reaching the 70% vaccination threshold that will allow the state’s economy to reopen, and that we’re even running ahead of schedule. The Oregon Health Authority estimates that we will reach that goal by June 21 at the latest.

But Monk said the biggest change might come once governments wrap their heads around how effective games are as a motivator.

“It’s a carrot,” he said. “For those freedom loving folks out there, there’s something here that’s pretty interesting because there’s no mandate, right? It’s about building an incentive and allowing you to choose.”

One of the major tensions in American life this year has been the friction between well-intentioned government regulation and the bristling of individuals and communities who feel their rights are being trampled. Monk hypothesizes there are countless ways governments could create more systems that incentivize people to opt-in to healthier, more productive behaviors, rather then penalizing them for opting out.

“I’d love to see it applied to education, maybe welfare-to-work or personal health. What if instead of a healthcare mandate there were healthcare prizes?”

Listen to Ashby Monk’s full conversation with OPB Weekend Edition host John Notarianni using the audio player above