The United States has employed a variety of incentive programs and access initiatives to encourage COVID-19 vaccination. These efforts range from large-scale state-run lotteries offering cash prizes and scholarships to targeted programs ensuring free vaccine access for uninsured and underinsured individuals. The strategies have evolved, particularly after the end of the federal public health emergency, which shifted the primary mechanism for free vaccinations from direct federal distribution to insurance-based coverage and specific assistance programs for vulnerable populations. This article details the types of incentives offered, the structure of access programs, and the current landscape for obtaining a no-cost COVID-19 vaccine.
State-Level Vaccine Lottery and Incentive Programs
Multiple states have launched promotional campaigns, often referred to as vaccine lotteries, to boost vaccination rates. These programs typically offer cash prizes, scholarships, or gift cards to residents who have received at least one dose of a COVID-19 vaccine.
Ohio’s Vax-a-Million campaign is frequently cited as one of the most debated and successful state-level incentives. The program offered drawings for five $1 million awards for vaccinated adults and five four-year scholarships to an Ohio state school for residents aged 12 to 17. The scholarships covered room, board, tuition, and books. An Associated Press analysis indicated that vaccinations in Ohio increased by 33 percent after the vaccine lottery was announced. Following the announcement, the state’s city editor for the Richland Source news organization stated he would sign up for the lottery, noting, “I’ve already got the shot, so if they say go to this website and fill this out ... I’d be dumb not to.”
Other states have implemented similar programs with varying prize structures. California’s Vax for the Win program featured the largest prize pool in the nation at $116.5 million. This included 10 prizes of $1.5 million each and $50 gift cards for the next 2 million residents who became vaccinated by a target date of June 15. The program aimed to incentivize approximately 12 million unvaccinated Californians.
Colorado’s Comeback Cash vaccine lottery offered five $1 million prizes and 25 $50,000 college scholarships for teenagers. Drawings were held on specific dates in June and July 2021. In each drawing, one $1 million winner and five scholarship recipients were randomly selected.
Massachusetts introduced the VaxMillions Giveaway, funded by the American Rescue Plan Act. The Massachusetts Lottery held weekly drawings for cash prizes and scholarships, starting the week of July 26 and ending on August 27. The program offered five $1 million prizes for residents aged 18 and above and five $300,000 college scholarships for teens aged 12 to 17. Governor Charlie Baker stated, “We're hopeful that this giveaway will give another reason/opportunity for people to choose to get vaccinated here in the Commonwealth.” Registration began on July 1 and continued until August 20. The state was working toward a goal of 4.1 million fully vaccinated residents by early June, having reached 4 million by June 15.
Other jurisdictions have also offered incentives. Polk County, Iowa, awarded five $50,000 prizes and 90 $1,000 prizes, with a $5,000 scholarship available for 12- to 17-year-olds. In Philadelphia, the Philly Vax Sweepstakes offered 36 vaccinated residents a chance to win up to $50,000.
Non-Cash and Employer Incentives
Beyond lotteries, incentives have included tangible freebies and employer-sponsored benefits. These offers are designed to appeal to individuals motivated by immediate rewards rather than large cash prizes.
A range of freebies has been offered in exchange for vaccination, including free doughnuts, a complimentary beer, tickets to an amusement park, no-cost hunting licenses, childcare, gift cards, and a chance at free flights. These incentives were often part of partnerships between the White House and various businesses and organizations.
Employers have also played a significant role in incentivizing vaccination. Many companies have provided their employees with paid time off, gift cards, or cash bonuses for getting vaccinated. According to an ethics and health policy expert, the variety of incentives is beneficial, as “everybody wants something different.” The expert noted that a diverse range of options, from free food to cash, could encourage people with different motivations, particularly younger individuals or those less concerned about public health benefits. However, the same expert cautioned that incentives may not be effective for those who are fundamentally wary of vaccines, as there are multiple reasons for vaccine hesitancy that incentives cannot address.
Free Access Programs for Uninsured and Underinsured Individuals
Following the end of the federal public health emergency in the spring of 2023, the U.S. government ceased purchasing and distributing vaccines for free to all individuals. While most insured Americans can receive the COVID-19 vaccine at no cost through their private insurance, Medicare, or Medicaid plans, a significant population remains uninsured or underinsured. Estimates indicate there are between 25 million and 30 million uninsured adults, plus additional adults whose insurance does not cover all vaccine costs. For these individuals, paying out-of-pocket for an updated COVID vaccine is a substantial financial burden, particularly as uninsured adults are disproportionately low-income and people of color.
To address this gap, the CDC’s Bridge Access Program provides free COVID-19 vaccines to adults without health insurance and adults whose insurance does not cover all vaccine costs. This program is critical for ensuring continued access for vulnerable populations.
How to Access Free Vaccines Through the Bridge Access Program
Approved providers for the Bridge Access Program include major pharmacies like Walgreens and CVS, pharmacies within the eTrueNorth network, select local healthcare providers, and HRSA-supported Health Centers.
To find an approved provider and schedule a free vaccination: 1. Visit vaccines.gov. 2. Enter your zip code. 3. Select the vaccine you prefer. 4. Check the “Bridge Access Program participant” box. 5. Select a preferred location and make an appointment. 6. Upon arrival, confirm that the vaccine should be covered under the CDC’s Bridge Access Program based on your insurance status.
Community organizations, such as the National Urban League, have also been instrumental in providing access. They established pop-up vaccine clinics in Urban League offices, churches, schools, community centers, housing complexes, senior centers, local colleges and universities, farmers markets, and street fairs. These efforts resulted in over 850 vaccine events and clinics, administering more than 120,000 doses to community members.
Despite these programs, awareness remains a challenge. After the public health emergency ended, many uninsured and underinsured Americans became unaware of how to access free vaccines, leading some to delay updated shots due to fear of being charged. This has left vulnerable populations unprotected during ongoing COVID-19 surges.
Conclusion
The landscape of COVID-19 vaccine access and incentives has shifted significantly since the initial rollout. State-level lottery programs, which offered cash prizes and scholarships, were effective in boosting vaccination rates in specific regions, as evidenced by data from Ohio and other states. A wide array of non-cash incentives, from free products to employer benefits, provided additional motivation for diverse groups of individuals.
However, with the end of federal vaccine procurement, the focus for free access has moved to insurance-based coverage and targeted programs for the uninsured. The CDC’s Bridge Access Program is the primary mechanism for providing no-cost vaccines to adults without insurance or with inadequate coverage. While these resources exist, ongoing efforts are needed to ensure that vulnerable populations are aware of and can easily access these free vaccination services. Consumers seeking a free COVID-19 vaccine should verify their eligibility for the Bridge Access Program and utilize resources like vaccines.gov to locate participating providers.