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A Nation that Runs on Bribes: Civics Lessons from our Vaccine Rollout

Summary:
By Lambert Strether of Corrente Bloomberg’s headline is forthright: “Bribing People to Get Vaccines Just Might Be Working in U.S.” In this short post, I’ll try to tease out some of the civics lessons of the vaccine rollout — normalizing bribery among them. I don’t mean to moralize; after all, I supported Operation Warp Speed, even though it would obviously empower Big Pharma, because “given the givens” it was the best way to get “jabs into arms” as rapidly as possible (and possibly we could disempower Big Pharma after the fact). Similarly, if bribery is what it takes to vaccinate as many (willing) people as possible, then so be it. That said, if we start bribing citizens to get vaccinated, what else are we going to end up needing to bribe them to do? The bribes — or, as Bloomberg also

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By Lambert Strether of Corrente

Bloomberg’s headline is forthright: “Bribing People to Get Vaccines Just Might Be Working in U.S.” In this short post, I’ll try to tease out some of the civics lessons of the vaccine rollout — normalizing bribery among them. I don’t mean to moralize; after all, I supported Operation Warp Speed, even though it would obviously empower Big Pharma, because “given the givens” it was the best way to get “jabs into arms” as rapidly as possible (and possibly we could disempower Big Pharma after the fact). Similarly, if bribery is what it takes to vaccinate as many (willing) people as possible, then so be it. That said, if we start bribing citizens to get vaccinated, what else are we going to end up needing to bribe them to do?

The bribes — or, as Bloomberg also calls them, “incentives” — take various forms:

President Joe Biden’s announcement last week that Anheuser-Busch InBev would give away beer was the latest bid to bribe hesitant Americans to get vaccinated. Other public officials have dangled empanadas, guns and even cold, hard cash.

As the administration aims to get at least one shot into 70% of Americans by the Fourth of July, the gimmicks appear to be working.

Vaccinations surged in the past month among the young people typically targeted by the campaigns. About 44% of 18-24 year olds have now received at least one shot, up from 34% a month earlier.

Bloomberg doesn’t mention it, but both Ohio and Manitoba offer scholarships, which, moralizing huffily, strikes me as a state taking a more high-minded view of its citizens than offering beer. That said, since the bribes target youth, the civics lesson for the next generation of citizens is that government really works by quid pro quo. Bloomberg goes on:

One key to the incentives’ effectiveness is that they’ve been bespoke, said Austin Hall, a psychiatrist at the University of North Carolina who has worked to ease hesitancy among patients with severe mental illness.

“The more diverse the incentives that are offered, I think that we can capture that many more people,” Hall said.

AFAIK, mobile vaccine units (like those in Maine), workplace-focused solutions (like vaccinating everyone in a plant), or, for those essential workers with scheduling issues, vaccination on demand[1], are not the norm. Instead, you go to a large venue like a stadiums or a school, line up, and get vaccinated in your turn. So the civics lesson here, for the youth, is that government does not take your working life into account when delivering services. When you hear the word “diverse,” class is always silenced. So, not “bespoke” that way.

Now, to be fair to Bloomberg, they immediately give an example of a vaccination drive that doesn’t involve bribery:

In Chelsea, a predominantly young and Latino city near Boston that has been one of Massachusetts’ virus hotspots, health officials organized a vaccination party in late May attended by 120 people, replete with music and Latin American food like empanadas and pupusas. They’re planning a follow-up so that attendees can get second shots.

The parties reflect widespread efforts, from door-to-door visits to mobile vans, that have boosted Chelsea’s partial vaccination rate to roughly the state average. The city is working with local nonprofits to encourage vaccination, catching young people wherever possible, said City Manager Tom Ambrosino.

Personally, I wouldn’t throw lotteries and block parties into the bucket labeled “incentives,” “bespoke” or not, because the cash nexus isn’t the same thing as community building. More importantly, the civics lesson here is that government services are “bespoke,” and not delivered universally or in a standardized way. (On the one hand, it’s clear that trust is important for vaccine uptake, trust is in short supply, and trust may be most easily found in a highly granular way; Black barbershops, for example. On the other hand, delivering services through their dense and partly billionaire-funded “bailey” of NGOs is what liberal Democrats would do.) To contrast the universal vs. the bespoke approach, we can look at the vaccine rollout of the Sabin “sugar cube” vaccine for polio. From the University of Cincinatti:

On three consecutive Sundays — “Sabin Sundays” — in 1960, millions of families lined up at churches and schools across the country to swallow a spoonful of pink syrup or a sugar cube treated with a life-saving polio vaccine, developed by [University of Cincinatti] researcher Albert Sabin.

And in more detail, from the Weirton, WV Daily Times:

[T]he first Sabin vaccine would be distributed through a “S.O.S.,” or a “Sabin On Sunday” program aimed at successfully eradicating polio.

The date in our region was Sunday, Dec. 2, 1962, at 35 clinics throughout the seven-county area. Each site would have two physicians, two nurses and at least 16 volunteers on hand for the distribution. Drs. Sanford Press and Jonathan Yobbaggy were chairmen of the Jefferson County drive. The vaccine would be stored in the freezers of the Jefferson County Home on Sunset Boulevard until it was transported to the sites the day of the S.O.S.

The Kroger Co., through its stores in the seven-county region, provided the needed sugar cubes upon which the vaccine was administered. Participants were asked for a 25-cent donation, if possible, for the vaccine.

Throughout November 1962, promotional materials were distributed through the media explaining the Sabin vaccine. The Type I distribution would be administered to anyone 6 weeks or older on a sugar cube, and was recommended to be taken by anyone who had already received the earlier Salk vaccine. Dr. John W. Young, the county health commissioner, issued several newspaper stories, in addition to Press and all the medical societies of the seven counties. Volunteers were assembled by Drs. Earl Rosenblum, Carl Goll and Paul W. Ruksha.

The Wintersville Citizen newspaper reported that nearly 6,000 people took the vaccine at the Wintersville clinic from 11 a.m. to 5 p.m. on that Sunday, one of the largest clinics attended, with more than 30 volunteers working that day. A second clinic was held a month later, and a third clinic was needed.

A make-up clinic was held for all of Jefferson County on Dec. 8, 1962, at the City Building with another 1,163 taking the vaccine, for a total number of 51,052 having received the Sabin vaccine by the end of 1962 in Jefferson County.

The S.O.S. Clinic for Type 2 of the Sabin vaccine was held Jan. 20, 1963, and more than 50,000 received the second vaccine in Jefferson County. The third S.O.S. Clinic was in March and a similar number received the final vaccine.

Granted, 1962 was a different era. Nevertheless, polio was eradicated (that is, vaccine equity was achieved). The civics lesson for our own rollout, as distinct from “Sabin on Sundays” is that national mobilization is not a thing. I can’t recall any discussion at all of a similar approach in 2020 or 2021.

So let’s review. The civics lessons from our vaccine rollout — and these are common to the Biden Administration and the Former Guy — are as follows:

1) Government works by quid pro quo;

2) Government does not take your working life into account when delivering services;

3) The delivery of government services is not universal bespoke;

4) National mobilization is not a thing.

Now let’s do climate!

NOTES

[1] New York Times: “‘What might help this situation,’ added Mr. Grayson, ‘is if it was like Domino’s Pizza and you could call someone and say, ‘Can I get my shot?’ And they come give it to you.'”

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