Shawn Esfahani was lying in a hospital bed approximately nine months ago suffering the effects of pneumonia and COVID-19.
His oxygen level dropped to a dangerously low level.
“It was a matter of a few hours, to be honest with you, that I could have lived or not,” Esfahani recalled about his stay at Thomas Hospital in Fairhope last December while COVID cases were spiking nationwide.
The 58-year-old, who is a heart attack survivor from his late 30s, but who says he’s in good health, pulled through thanks to his medical care. He was expected to be hospitalized for two months but was able to be discharged within a week.
The harrowing experience looms large in Esfahani’s mind as he oversees perhaps the most lucrative and enticing vaccine incentive program anywhere in Alabama. It also comes at a time when COVID cases are spiking anew.
Esfahani, who is running his incentive program from a Daphne car dealership he owns, is supporting it with private money. But other programs, such as those financed by the public sector, are generating scrutiny. Fairhope became the latest city to offer a publicly funded incentive program on Monday, but only after criticism was hurled at council members for spending tax money on it.
“We are happy to see other government agencies doing this, but we realize it’s a controversial for the state of Alabama,” Esfahani said.
Esfahani, the owner and operator of the SEAM automotive group, ponied up $100,000 to support a 10-week sweepstakes for Mobile and Baldwin County residents only.
The stakes: If you get the jab, you could win $1,000.
The odds, during the first drawing last Monday, were pretty solid: Ten people, vaccinated after the incentive program was announced on July 29, won $1,000. Only 22 names were eligible for the drawing.
“This initiative is really to help our community and accelerate a percentage of low vaccinations into a high one,” said Esfahani, whose automotive group operates four dealerships in Alabama and one in Georgia. The vaccine incentive is being run out of Eastern Shore Toyota in Daphne, near Interstate 10.
The incentive program goes beyond just a financial payout. Thomas Hospital is hosting vaccine clinics at the car dealership as well. During a clinic on Tuesday, close to 100 people showed up for a jab. Those who got a vaccine also became eligible for the financial incentive drawings that will take place on Mondays through October 7.
The car dealership expects the odds to get longer as the program continues.
Esfahani also wants to encourage his employees to get vaccinated, and he’s hosting an educational seminar from 8-9 a.m. on Tuesday with Dr. William Admire from Infirmary Health. The dealership will be closed so employees can gather in the showroom for the presentation.
“My goal is at least 1,000 people getting vaccinated,” said Esfahani. “It’s a small lift, but a good enough lift. By the math alone, we will have saved 20 people’s lives. That is good enough for us to be a part of this.”
Indeed, the verdict remains out on whether Esfahani’s effort will draw in the crowds and be successful. The same can be said of the select few governmental agencies that are utilizing tax money to push hesitant Alabamians to get vaccinated.
Incentives go beyond the local governments in Alabama. Universities, hospitals and some private businesses are doing in-house vaccine incentives for their employees. At Infirmary Health – the largest hospital system in Mobile and Baldwin counties – a $100 vaccine incentive has led to an overall $505,000 payout to employees. More than 65% of employees are vaccinated, and Infirmary Health’s CEO Mark Nix attributes it to the incentive program.
Some statistics are trickling in, but no analysis has occurred on whether they are successful in boosting vaccine rates. Sponsors of vaccine programs believe their efforts are successful, but the evidence has been mostly anecdotal.
Most of the programs are still in their early stages. That’s the case in Gadsden which is the first — and only – city government in Alabama to offer an incentive to all city residents to get vaccinated.
Deborah Gaither, the Gadsden-Etowah emergency management director, told the Gadsden City Council this week that 256 participants were added to the city’s $100 incentive program. The total participants since the program began late last month is 460. It takes 500 residents participating in the program to trigger two drawings for $5,000. The incentive program ends in October.
Etowah County’s vaccination rate is also on the increase, albeit slowly since the program called “Vaccinate Gadsden” was unfurled on July 20. At the time, only 32% of Etowah County residents had received one dose of vaccine while 26.6% were fully vaccinated. As of Thursday, 39.5% of Etowah County residents have at least one dose, while only 27.5% are fully vaccinated, according to the U.S. Centers for Disease Control and Prevention.
“Etowah County’s vaccination rate has increase over the past weeks, and from the city’s perspective, it’s encouraging that more of our citizens are getting vaccinated,” said Michael Rodgers, city spokesman. “The Vaccinate Gadsden program has provided an additional incentive that we feel is contributing to that positive trend.”
‘Impact on workforce’
In the hard-hit Alabama Gulf Coast, where hospitals in Mobile and Baldwin counties are overwhelmed with hundreds of COVID patients daily, vaccine incentives are receiving mixed views.
Fairhope, last Monday night, became the latest entity to back a vaccine incentive after the City Council voted 4-1 to roll out a $500 reward all full-time employees who get vaccinated. Of the city’s 350 employees, only 25% are fully vaccinated.
The city was criticized by some for using tax money to do to provide an incentive to the unvaccinated. The money does not come from the Fairhope city budget, but it’s still taxpayer money that is allocated through the city’s $1.9 million portion of the American Rescue Plan Act. Fairhope’s incentive will cost an approximately $300,000.
“For us, obviously, I thought it would make an impact on our workforce,” said Fairhope Mayor Sherry Sullivan. The program will last through November.
“But each city has to evaluate that and determine for themselves,” she added.
Mobile never even debated whether their allocation of ARP money should go toward incentivizing vaccines. Mobile County experienced an average of more than 600 new COVID-19 cases per day last week, and it is also saddled with a low vaccination rate: Only 32% of residents have been fully vaccinated, with over 43% receiving at least one dose, according to CDC data. Those figures are lower than the state’s average of 35% fully vaccinated, lowest in the nation.
James Barber, the chief of staff to Mobile Mayor Sandy Stimpson, said on Tuesday that he did not think a vaccine incentive would work.
“We’ve watched to see if they moved the needle any,” Barber said about incentive programs elsewhere. “But what really helps is peer conversations. People are pretty dug in on whether or not they will take the vaccine or not take the vaccinate.”
Mobile County Health Officer Dr. Bernard Eichold said he believes incentives can be useful.
“If we can use that money to incentivize people to get vaccinated then we should use every tool in the toolbox to get people vaccinated,” said Eichold. Vaccinations, he said, “is the only way to inhibit the community transmission of the virus.”
The Mobile City Council, which endorsed a one-time bonus for city employees — $5,000 for all full-time workers – did not tie any of that money up to vaccine status. According to Mobile City Councilman Joel Daves, the city’s finance committee chairman, the issue of a vaccine incentive never came up during the discussions over the ARP money.
Experts are skeptical that vaccine incentives work, including Dr. Kevin Schulman, a professor of medicine and economics at Stanford University’s School of Medicine and Graduate School of Business. Schulman, during an interview with ABC News last month, said he felt a “small proportion” responds to incentives, and has favored more coordinated marketing programs backed by state governments aimed at apathetic Americans.
Schulman, in comments to AL.com, said he believes the tragedy with the recent wave of virus spread among unvaccinated Americans is that there has not been a comprehensive marketing approach to promoting the vaccine.
“Some, but not all of the unvaccinated, are truly hesitant,” Schulman said. “Some, even at this late date have not cognitively engaged in a purchase decision around the vaccine. There is still time to support the population that we call apathetic … in making the decision to get the vaccine.”
Schulman wrote about the vaccine hesitant in the Journal of the Medical Association, citing a Pew Research Center study from February that showed 30% (3,306 people) of U.S. adults indicated they probably or definitely would not be vaccinated. But another 42% listed “Don’t think I need it” as a major reason behind their decision, according to the report.
He believes there is more to be done on the local level from a marketing standpoint. He also believes that survivors, who have been hospitalized with COVID-19, should help provide a “powerful local message.”
Schulman said that incentives could also help if tailored to the right populations.
Esfahani is hopeful that will be the case at Eastern Shore Toyota. Lives, he said, are at stake.
“I had a sense this delta variant would hit us hard and it did,” said Esfahani. “We are in a critical situation.”