In order to encourage people who have not yet received a coronavirus vaccine, City Council voted Thursday to approve the use of $1 million to buy grocery gift cards as a financial incentive.

The funding, part of a federal grant from the Centers for Disease Control and Prevention, will buy 10,000 gift cards from H-E-B, each worth $100, said Claude Jacob, director of the San Antonio Metropolitan Health District. Metro Health hopes to begin distributing the gift cards by the end of September, but no firm start date has been established.

According to Metro Health’s most recent numbers, 70% of the eligible population in Bexar County has been fully vaccinated, Jacob said, while 86.5% has received at least one dose. Those figures do not include children younger than 12, as no vaccine has been approved for that population.

Only people who started the vaccination process after July 31 will be eligible, Jacob said. The H-E-B gift cards will also have purchase limits; they cannot be used to buy weapons, ammunition, alcohol, tobacco products, or lottery tickets.

Though most city council members welcomed the program with enthusiasm, Councilman Manny Pelaez (D8) expressed his hesitation at what he said was an ethical dilemma. He cited a medical journal article that presented the idea of paying people to get vaccinated as “problematic” due to high unemployment rates. People staunchly opposed to getting a vaccine may feel they don’t have a choice to turn down a $100 gift card if they aren’t financially stable, Pelaez said.

“I feel like voting for this would be taking a patronizing stance and send the wrong message to people who don’t trust vaccines,” he said. “I’m not talking about the lunatics, I’m talking about people who just have a general distrust of government and big pharma and all that. I feel like it smacks of paternalism and it treats adults like children.”

Offering payment for a vaccine might also strengthen the idea that getting the shot is risky, Pelaez said.

“I think that a better way to approach this is to build trust and respect these folks, and sitting down with them and working harder and overcoming their objections and listening to their concerns,” he said.

Councilwoman Ana Sandoval (D7) said she understood Pelaez’s points, but that the damage the pandemic has wrought and will continue to cause forces the city to use all the tools at its disposal. Not all unvaccinated residents are firmly opposed to getting the shot; the incentive program is there to nudge people who may have never considered getting a vaccine, she said. 

“They may have had other reasons,” she said. “Some of it was lack of trust, but some of them just said, ‘I simply never got around to it.’ When you give people $100, they may actually get around to doing something for their health.”

She added that financial incentives have been shown to not only encourage short-term changes to health behavior but longer-term changes as well.

“I’m also hopeful that this incentive program will make it more likely that members of the community who didn’t get other types of vaccines or do other types of health-protective behavior” will do so, she said.

Pelaez was the lone no vote on the council. Mayor Ron Nirenberg recused himself, as his wife Erika Prosper works at H-E-B as its senior director of customer insights.

Metro Health intends to give the gift cards to people who get their final vaccination at a Metro Health pop-up clinic. Details on the program’s logistics have yet to be finalized, but Jacob urged people to not delay getting vaccinated.

Gift card recipients must provide their name, date of birth, address, the type of vaccine and date administered, he said.

“This variant punishes the procrastinators,” he said. “We’re reminding folks that we’re still in this global pandemic. It’s been a long year and a half. So at the end of the day, we have an opportunity to make it a little easier for folks to make that decision for themselves.”

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Jackie Wang

Jackie Wang is the local government reporter at the San Antonio Report.