As of April 27, 2021, 141 million Americans have received at least one dose of a COVID vaccine and 95.9 million are fully vaccinated, according to The Washington Post. These rates differ greatly by state and demographic.

We are witnessing a growing number of people who fit in a gray space of immunization, in which they aren’t against getting vaccinated for COVID-19 and yet, they haven’t received their first shots. Clumped into this group are also those who did get the first dose, but have lagged for the second.

The largest two clusters of unvaccinated people: conservative, rural white people that believe that any COVID precautions (including the vaccine) infringe on their freedom and people of color, whose hesitancy stems from a history of medical betrayal. While these groups (especially the latter) certainly warrant attention, I’d like to focus on a different population: those who are not opposed, but aren’t very motivated to get vaccinated. College students, twentysomethings, and additional folks that fit this description feel that they don’t have enough of a reason to make a vaccine appointment and then take time from work/school/life to go to an immunization site and get the shot. I say “shot” and not “shots” because these people need the one-dose. If it’s hard to prompt someone to get a first dose, the second dose is unlikely (helping to explain the drop-off of 2nd-dose recipients).

With the current widespread availability of vaccines in the U.S. for ages 16 and over, most people who were eager and willing have already been immunized. The vaccine-reluctant, then, need to be targeted, with their carrots identified. History is repeating itself on this one. In the late 1950s, this same age group held out on getting the polio vaccine, believing they weren’t susceptible enough to the virus to make it worth the shots. As I wrote about in my article for The Washington Post, the Ad Council initiated a mass public health campaign addressing this hole in the herd immunity.

How do we motivate the vaccine-reluctant during our current pandemic? We need a combination of targeted campaigns with messages that appeal to this age group, combined with incentives. Creative motivators have already sprung up: free donuts from Krispy Kreme, beer from Sam Adams and a number of breweries in New Jersey, on-campus vaccine site raffles, and employer-specific bonuses of vacation time or cash, to name a few. West Virginia Governor Jim Justice has promised savings bonds of $100 for those 18-35 who get the vaccine. In D.C., the organization Marijuana Justice gave out free joints at vaccination centers on April 20th, much like the Michigan-based “Pots for Shots” campaign. Such incentives have and will help close the gap of the vaccine-reluctant.

However, it’s not enough. What we need are vaccine requirements for various activities and places. To be pandemic-responsible, concerts, music festivals, and other large-gathering attendees should have to provide proof of vaccination — a notion that is being considered for Burning Man and other events scheduled for later this year. Additionally, college campuses need to mandate COVID vaccines for students, faculty, and staff. According to The Chronicle of Higher Education, 209 colleges will mandate vaccines. Most of these institutions are private and located in blue states. Mandatory COVID vaccination fits with existing immunization requirements (MMR, varicella, meningitis) and still allows for religious exemptions. Widespread college and university COVID vaccine mandates will (obviously) incentivize the difficult-to-reach population, normalizing this immunization for young adults. This approach also reinforces the necessity of mass vaccination as vital to public health — not as a person choice.

We need drastic action to even begin to dream of herd immunity, if that is a possibility. Motivating the super-spreader group to get vaccinated should be a top priority. Since emotional appeals may not reach the vaccine-reluctant, it’s time to create incentives and requirements that push them to get vaccinated. A free beer and the return to campus life?