After a rocky start, Canada is vaccinating people at an increasing pace. While we are still well behind many other countries, the pressure is on to have individuals line up for the jab as quickly as circumstances permit.
However, there is a level of hesitancy about the shot that must be addressed. Multiple strategies need to be employed. One that needs further thought is rewarding people for getting vaccinated.
Many people are eager for inoculation’s protections. But for society as a whole to enjoy as much shielding as possible, we must strive for herd immunity, with up to 80 to 90 per cent being vaccinated. There is some evidence of decline in resistance, especially in England and the United States. Yet there remain many troubling indications of hesitancy to take the jab in this country and elsewhere, including the U.K. and the U.S. There are many reasons for this indecision. Part of the story is the history of discrimination toward Indigenous and Black people that has led to concern that a disproportionate number are suspicious of this remedy. There are other pockets of hesitancy among the general population as well. Twenty-five per cent of those over 80 in Ontario have not received the vaccine or even made arrangements to get it: reasons range from language barriers to worries about interactions with prescribed medications. The fears about the safety of AstraZeneca have not helped matters.
There are a number of prescriptions to counter this indecision. A nonstarter seems to be mandatory vaccination: too difficult to enforce and at odds with a longstanding right to refuse medical treatment. (But there is some pressure to require employees to be vaccinated in some workplaces.)
One straightforward response is to make the vaccine easier to access: bring it to the elderly and disabled. More generally, education is seen as the most positive way to persuade people that vaccination is right for them. This campaign of persuasion is being conducted in a number of ways to address the different needs of various groups and communities, including deploying “norm entrepreneurs“: influencers with large public profiles who could help people decide to be inoculated by being vaccinated in public while urging others to get the jab. One example, from the U.S., is a charming video of Dolly Parton gently coaxing folks to take the jab.
But the campaign cannot be limited to education. There may be consequences for failing to be inoculated that will make people decide that taking the jab is the thing to do after all. One such consequence may be the failure to have a vaccine passport/certificate: documents that are reliable evidence that an individual has been fully vaccinated. There is widespread agreement that they could be necessary for foreign travel. They may be relevant for activities within the country (going to restaurants, theatres, etc.), though the prospect of this latter use has generated controversy. The possibility that activities may be curtailed may be enough to persuade some of the hesitant to decide to be inoculated.
There is one more way: we could pay people. A debatable strategy but one that needs to be fully considered. To start, let’s remind ourselves that payments/subsidies have long been used to shape behaviour. The government provides incentives for lots of basics: owning a home (no capital gains tax); saving for an education (tax breaks on educational funds); saving and investing, especially for retirement (RRSPs/TFSAs). The private sector has its own programs, from paying employees not to smoke to underwriting exercise programs.
How much to pay is a matter of conjecture but it would have to be enough, by itself, to incentivize the doubters to take the jab.
Not surprisingly, this proposal has run into a lot of opposition. It’ll cost too much. We shouldn’t pay people to do the right thing for themselves and for the common good. If they have to pay us to take it there must be something wrong with it.
A more modest form of financial compensation focuses on providing employees with time off with pay (say three hours). These programs are already underway in some large corporations in the U.S. and by law in New York State and in Saskatchewan.
Krispy Kreme has its own, unique incentive strategy: The company will give everyone who presents proof of vaccination a doughnut every day for the rest of 2021. (Those not vaccinated, including the unwilling, can get a free doughnut but only on Mondays from March 29 to April 24). Encouraging people to eat doughnuts is a nonstarter from a nutritional perspective. But if, in fact, these sweet caloric treats move some people to get the shot they may, in this one instance, serve a noble purpose.
There are valid concerns about using rewards as part of the campaign to persuade people to get the jab. But they have to be weighed against the prospect of those who refuse to do so getting and giving COVID-19. The significant costs associated with those who become seriously ill and of a society continuing to struggle against the plague because herd immunity is unattainable are sobering. The pandemic battle is far from over. All reasonable strategies to have people vaccinated and to conquer the contagion must be considered.