Show a vaccine card, get a sweet deal
Doughnuts, incentives are OK, ethicists say
Hesitant to get a COVID-19 vaccine? Would a free doughnut change your mind? If that’s too sugary for you, how about an Amazon gift card? Or maybe a tax break?
When Krispy Kreme recently offered free doughnuts to Americans who get vaccinated, it marked a new chapter in the national conversation about how to convince people to get jabbed – and quickly – so that the country can put an end to the pandemic.
So don’t be surprised if other businesses offer freebies, too, while local and state governments begin offering even more substantive incentives, such as gift cards, to people who might otherwise resist the shots.
The possibility raises ethical questions about when it’s acceptable to offer goodies to people to make a health care decision, especially when the handout could negatively affect the person’s wellness.
But advocates, including business ethicists, health experts and behavioral economists, say it’s a small price to pay for the greater good of saving lives and helping the economy.
“I thought it was cool,” said Valerie Bennett, a soon-to-be college student in Roanoke, Virginia, who recently got the one-shot Johnson & Johnson vaccine and a free Krispy Kreme doughnuts for doing so. “They’re trying to support the community and help us get healthier. But they’re businesses – they have to make money, and they need people to be coming through.”
The situation also calls attention to what motivates Americans to get vaccinated or to resist vaccination. For some, it’s fear of COVID-19, or fear of potential side effects. For others, it’s social pressure. And for certain workers, it’s fear of losing a job if they can’t show up due to illness.
Soon after making its announcement, Krispy Kreme faced a backlash on social media from some critics who say doughnuts contribute to America’s obesity epidemic and should not be of
fered alongside something that is genuinely critical to your health.
Peter Jaworski, who teaches business ethics at Georgetown University, said he likes the idea of the Krispy Kreme giveaway, but that moderation would’ve been ideal.
“In principle, it’s a good move,” he said. But “if you’re doing it for a public health reason, you’ve got to recognize that giving people a doughnut a day might not be consistent with the message about caring about health.”
Yet, if doughnutlike incentives catch on, vaccine hesitancy could fall as the movement adds additional motivation to get the shots, advocates said.
“It will depend on the company, but generally speaking, it can be a positive thing,” said Bunny Ellerin, director of the Healthcare and Pharmaceutical Management Program at Columbia Business School. “It’s positive reinforcement.”
More rewards to vaccinate are likely on their way.
Blackhawk Network, a company that sells gift cards and advises employers on how to design and deliver wellness incentives to their workers, has had conversations with state and local governments that are making plans to offer freebies to people who get their shots, said Theresa McEndree, global head of marketing.
In some cases, they may use money provided by the federal government to fund those efforts, she said.
President Joe Biden in March signed a $1.9 trillion bill providing $1,400 stimulus checks to most Americans, and about $350 billion in funds to help states address the COVID-19 crisis.
“If you look at the COVID stimulus packages, a lot of that was handed over to local and state governments to distribute the vaccine as they saw fit,” McEndree said. “And some governments are looking at incentives as part of that strategy.”
Many employers – ranging from grocery chains like Trader Joe’s, Aldi and Lidl, to retailers like Dollar General, Olive Garden and McDonald’s – have announced incentives like extra pay or paid time off.
Offering incentives to the public, however, is a new frontier in the vaccine rollout.
Research suggests Americans would embrace it. A survey Blackhawk Network conducted in January of about 2,100 adults found that more than twothirds would get vaccinated in exchange for a financial incentive, including onethird who would do it for less than $100.
“The most proven form of that is going to be a gift card or a prepaid card,” McEndree said. “It’s about providing an additional extrinsic motivator.”
It would not be without precedent to offer incentives for people to get shots.
Some health care insurers provide incentives to their members to get influenza vaccinations every year, in part because it protects members and in part because they’ll save on health care costs if the person avoids hospitalization or treatment due to getting the flu.
For example, Priority Health, which insures more than 1 million Michiganders, recently sent $10 Amazon gift cards to members who got a free flu shot during the fall or winter.
“Offering a small incentive to encourage people to change their behavior is the right thing to do, certainly for us but also for them,” said Nate Foco, vice president of marketing and customer experience at Priority Health.
That said, Priority Health is not providing gift cards for its members to get COVID-19 vaccines – at least not yet. Their first priority is to educate people on the basics.
Foco said the insurer has been focusing on using data to send tailored messages to people urging them to get vaccinated and providing information on how to do so.
“People don’t know where to go, people don’t know what to listen to,” Foco said. “So we target a subset of our membership with clear and concise information about the vaccine.”
Still, he left open the possibility that Priority Health will eventually provide some form of incentive for holdouts to get their COVID-19 shots down the line.
That’s what McEndree said she’s expecting. For now, there’s little reason for governments to provide incentives to people to get vaccinated since supplies, eligibility and appointments remain limited in many cases, although the situation is improving.
But businesses that appeal to general consumers may not wait. Krispy Kreme already took a shot of its own by offering a free doughnut a day to anyone who shows their vaccination card. Uber and Lyft are offering free rides to vaccination sites to some customers. And Staples is offering to laminate vaccination cards for free.
More companies are expected to make offers, said Camilla Yanushevsky, a CFRA Research analyst who tracks retailers. One of the latest to join the fray was Samuel Adams, which offered free beer to a limited number of people who show proof on social media of their vaccination.
“As you see one company taking a step like Krispy Kreme, other companies start thinking about it as well, so it might have a domino effect over time,” she said.
For Denver area resident Debbie Nelson, who recently got her first dose of the Pfizer vaccine, a free doughnut from Krispy Kreme wasn’t the reason she got vaccinated. She was going to do that anyway.
But she also wasn’t going to turn it down.
“I don’t eat doughnuts very often,” she said. “But my grand-nieces and nephews get a doughnut after they get a shot, so I thought, why not treat myself after I got my vaccine?”
While Krispy Kreme’s offer resonated with Nelson, some companies might be hesitant to offer incentives if they could risk turning off people who are themselves hesitant to get vaccinated. Research has shown that nearly one-third of Americans are not committed to getting their shots.
“They may alienate a certain customer base that doesn’t want or is fearful of vaccinations, and I think that’s the concern,” Yanushevsky said of retailers.
McEndree, the Blackhawk Network executive, rejected criticism of Krispy Kreme’s offer as cynical.
“I think it’s nice that they’re that they’re trying to do their part,” she said. “It would be weird if Krispy Kreme was offering a kale smoothie.”
Many Americans view the decision about getting vaccinated as a “social responsibility,” while others are viewing it as a “personal choice” – and for that second group, an offer like a free doughnut could prove effective, said Jason Doctor, a health policy expert and behavioral economist at the University of Southern California.
For rural Americans, in particular, whom research has shown are less likely to get vaccinated, an offer like Krispy Kreme’s would demonstrate that they don’t have to change their social identity to get their shots, Doctor said.
Making the doughnut free and not, say, discounted is especially critical to making the offer effective, even if Krispy Kreme could ultimately benefit from the extra foot traffic, Doctor said.
“There’s this idea that if it’s free, they’re offering it to me to protect me,” he said. “It’s possible to feel more of a duty to follow through, reciprocate and go with what they’re trying to encourage people to do.”
Nelson, the Denver-area resident, said multiple doughnuts is probably too much. But overall, she thinks it’s a good idea if it helps people who are on the fence about the vaccine to embrace the poke.
“I’m the kind of the person they hate when they do special offers like that because I went through the drive-thru, got my one doughnut and left,” said Nelson, who works in the career and technical education field. But “I’ll go back when I got my second vaccine, and maybe I’ll buy a drink just to thank them.”
Bennett, the Roanoke college student, was always going to get vaccinated. But when she found out about the Krispy Kreme offer, she decided to drive to her local shop to get her free doughnut after her J&J vaccination.
Upon arrival, she discovered it had recently closed. Since she had her heart set on getting a treat, she drove another 25 minutes to get the free doughnut.
“I spent a lot more on gas than I would’ve spent on a doughnut,” she said, but “because I drove so far for the doughnut, I did end up getting six, so I think it was a good business practice.”
Doctor, the behavioral economist from USC, likes the Krispy Kreme offer, saying the upside outweighs the downside. But he expressed concern about the possibility of governments providing incentives, especially given significant distrust of the government among a large slice of Americans.
“The chief concern is that payment by the government could signal that ‘getting vaccinated is risky so we will compensate you for it,’ ” Doctor said in a follow-up interview by email. “This could drive people away. Krispy Kreme is a little different because they are viewing it as a social responsibility initiative. So the perceived motive is, ‘Krispy Kreme is trying to help.’ ”
Others, however, say government incentives could turn out well.
Jaworski, the business ethics professor at Georgetown, said incentives could be crucial to achieving herd immunity.
“The government could give tax breaks to people who get a vaccine. I’d be a supporter of that,” he said. “I would worry about the backfire effect, but on net, I think probably there wouldn’t be one, and it would probably encourage people to do it.”