Should people get paid to get the coronavirus vaccine? Experts are torn

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Tackling vaccine hesitancy amid fight to end COVID-19
WATCH: Tackling vaccine hesitancy amid fight to end COVID-19 – Dec 2, 2020

Health Canada officially approved Pfizer’s coronavirus vaccine Wednesday, and the first inoculations could begin as early as next week.

Although a vaccine has been given a green light, it does not mean everyone will want to get it.

According to Ipsos polling carried out for Global News between Oct. 23 and 26, just 54 per cent of the Canadian public is willing to take a vaccine as soon as they can.

That’s not just in Canada. Polling from south of the border shows a majority of Americans saying they would be uncomfortable being among the first to receive the coronavirus vaccine, and a sizable minority said they will pass on getting vaccinated, according to Pew Research.

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In the wake of the vaccine hesitancy, and as coronavirus numbers continue to climb and overwhelm hospitals, some economists have proposed a solution to help create herd immunity (the percentage of the population that needs to be vaccinated in order to reach widespread immunity): Pay people to get the coronavirus vaccine.

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The idea was first floated in August when economist Robert Litan, a Brookings Institution non-resident senior fellow, wrote about an incentive to get more people to get the vaccine: pay US$1,000 a shot.

He called it the “adult” version of the doctor handing out candy to children.

But the plan could cost the American people about $275 billion. And in Canada, the cost would be around $30 billion, he said.

“But it could save lives and a lot of that will be earned back because the economy is up and running again,” Litan told Global News.

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How it works

It is still unknown what percentage of the population is required to be vaccinated to have herd immunity to COVID-19. Some experts have said about 60 to 70 per cent of the country needs to get the shot, depending on the efficiency of the vaccine.

Litan said the 70 per cent number will change depending on the vaccine’s efficiency. For his example, he used an 80 per cent immunization rate, taking into account that a number of vaccines will likely be used.

“We all want to get rid of masks and social distancing, and have businesses fully come back. So how do you get these numbers up from 50 to 60 per cent of the population who will get a vaccine up to the 80 per cent range.”

There are a number of ways to do this, he said. Nations could use a public education campaign and get politicians and celebrities to get a shot in order to show its safety. There is also the idea of making it mandatory.

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But many countries, like Canada, have reiterated they do not plan to make vaccine mandatory.

Litan argued that if all else fails, paying people to get the vaccine is a “Plan B” idea.

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He said it would be a “one-time” payment and the person could only receive it if both shots were taken (in the case of the Pfizer vaccine).

“I picked the price $1,000 out of the air. $100 did not seem like enough to persuade someone who does not want to get a shot to get vaccinated. But if you have a family of four, that’s $4,000.”

Asked about the billions of dollars in costs associated with the plan, especially for nations like Canada that already are in massive debt due to the pandemic, Litan said “the cost is worth it.”

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“If the coronavirus sticks around for years to come because herd immunity isn’t reached, then the economy does not go back to normal … You are operating for a long period of time at a suboptimal level. This is a way to get back to full employment quickly and it could even partly pay for itself.”

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The financial incentive was also brought up in the United Kingdom, where the general public has started to receive the Pfizer vaccine after regulators approved it last week.

Arguing that governments should consider a “pay for risk” approach to encourage their populations to have COVID-19 shots when they become available, Julian Savulescu, a professor at the Uehiro Centre for Practical Ethics at Oxford University, said it would allow people to make an informed choice.

“Anti-vaxxers may never be convinced to change their stance, but incentivizing vaccination may persuade others who might not have done so to get the jab,” he wrote in an article in the British Medical Journal (BMJ).

“The advantage of payment for risk is that people are choosing voluntarily to take it on. As long as we are accurate in conveying … the risks and benefits of a vaccine, then it is up to individuals to judge whether they are worth payment.”

Criticism of the financial incentive

But other experts cautioned strongly against offering financial incentives.

“Paying people to get vaccinated would set a very dangerous precedent,” Keith Neal, an emeritus professor of infectious disease epidemiology at Nottingham University, told Reuters.

“Social media falsehoods would have a field day suggesting it can’t be safe if you need to be paid to have it.”

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Ana Santos Rutschman, a professor at the Center for Health Law Studies of Saint Louis University, agreed.

She argued that if governments start paying people to get the COVID-19 vaccine, then social media may turn around that messaging and “weaponize it.”

“People may say, ‘By the way, this is so bad that the government has to pay us to take it. You really should not get vaccinated.’ Anti-vaxxers are very loud on social media, and they could use this messaging and do the opposite of what you want to achieve,” she said.

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Rutschman said another concern is that the idea is inherently “paternalistic” and assumes that low-income populations, who are disproportionately Black or Hispanic in the U.S., are easily persuaded by money.

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She added that the financial incentive will likely also not change the minds of “anti-vaxxers” and a public education approach, like celebrities and politicians receiving the vaccine, is the best method.

What about in Canada?

Global News reached out to multiple provinces and the federal government about pairing financial incentives with the COVID-19 vaccine.

A spokesperson for federal Health Minister Patty Hajdu said that “once authorized, every Canadian will have access to a safe and effective vaccine, free of charge, beginning with the most vulnerable.”

In Manitoba, where cases are among the highest in the country, a spokesperson told Global News the idea “is not being considered at this time.”

And Alberta, where the province just announced sweeping new restrictions to slow the spread of the virus, a spokesperson said, “That is not something being considered by Alberta Health at this time. We will strongly encourage all Albertans to get vaccinated when it is available to them.”

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Talk of coronavirus ‘immunity passports’ in Ontario

Could it work?

Litan said this has never been done before on this scale, so it’s difficult to know if it will work.

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But there is an example out of Australia showing financial incentives have persuaded people to get vaccinated.

The country’s controversial “No Jab, No Pay” bill, introduced in January 2016, strips families of benefits if they don’t get vaccinated.

Australians risk losing their Child Care Benefit and the Child Care Rebate, which help cover child-care costs, and part of their Family Tax Benefit (similar to the Canada Child Benefit) if they don’t keep their children’s vaccinations up to date.

Since its inception, it’s caused an uptick in the number of people getting shots.

However, a recent study showed the policy was associated with a spike in vaccination in lower socio-economic status areas in Australia, but not among wealthier Australians.

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