Opinion

Vaccine hesitancy? Follow Krispy Kreme’s lead and give people a reward

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. 

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18 Comments
  • Eva says:

    As usual, very interesting reading!! Food for thought. (Krispy Kreme would certainly me an incentive for me to be vaccinated!!!)

    • Bill bogart says:

      Eva
      Thanks for the comment.
      The Krispy Kreme example was provocative. Handing out donuts could be patronizing. But maybe offering a cup of coffee and a donut while discussing persons’ situation and why they may be hesitant might be appropriate and effective.
      You are obviously a fan of these Krispy Kreme! :)
      Bill

  • Edward HC Graydon says:

    Personally I have found the rhetoric around the need to be vaccinated outrageous, condescending and unbearable repetative . It seems more a sales job on the public regardless of country or where you happen to reside . I have never sensed any altruism from Canadian prim minister Justine Trudeau ! In fact I sensed he was selling a bigger issue and the pandemic was a means to an end.

    ” I believe this to be true” I cannot believe a man who stated in the very early stages of the pandemic “We must prepare for at least a few years or more of lock downs” While his health minister Teresa Tam stated “ I have no problem with ankle bracelets ,in order to monitor Canadians” This was stated back in 2019! What kind of approach to governence does this instil into Canadians but one of fear ! The fact that Blood clots and the death rate associated with them is quite high and taking into account that each Vaccine now seems to have the same side effects being Blood clots I think the risks of vaccination for some that fear dying from blood clots to be real.

    When the Ontario government shuts down all surgery’s and all none medical emergencies making access to medical treatment difficult ! It will be harder to treat those that do in fact develop blood clots as a side effect of taking the vaccine. Blood clot death is very fast and access to treatment is essential should you get one but good luck on that during covid and the current state of medical care in Canada .

    • Bill Bogart says:

      Edward –
      Whatever you make of Canadian government officials I hope you’ll make your own decision to get vaccinated for your own sake and those you hold dear.
      COVID is not fundamentally about politics but about health. Don’t give it. Don’t get it
      Best wishes
      Bill

      • Edward HC Graydon says:

        WHO does not back vaccination passports for now – spokeswomanThe World Health Organization does not back requiring vaccination passports for travel due to uncertainty over whether inoculation prevents transmission of the virus, as well as equity concerns, a spokeswoman said on Tuesday.

        “We as WHO are saying at this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” WHO spokeswoman Margaret Harris said.

        “There are all those other questions, apart from the question of discrimination against the people who are not able to have the vaccine for one reason or another,” she told a U.N. news briefing.

  • Randy Filinski says:

    I find this article very unsettling for many reasons.

    1. We have a press Corp and selected “experts” who are interviewed daily and have caused a hesitancy in the public even with supply constraints. This includes healthcare workers that I interact with.
    2. We have created the myth of “get a shot and wait four months” but stay totally isolated and all will be fine.
    3. We are struggling to redeploy essential workers (nurses, allied healthcare workers) to critical covid floors with the same mentality with their first shot but wait for four months for the second.
    4. My neighborhood is full of people wanting the vaccine (high risk postal code) and yet, have no idea how to proceed.

    So, let’s scrap incentives for now and identify the real priorities first for those who will take the shot and create vaccine ambassadors with these people (workers and the public) and use their voice to carry forward into the areas of hesitancy.

    To me, this is not about a donut or an incentive but using human compassion and empathy in a very trying time. Help those who can, then help others to get to herd mentality and lead by example.

    • Bill Bogart says:

      Thank you for your thoughtful and clearly laid out comment.
      I certainly agree with your views about compassion and empathy.
      I did try to make clear that addressing vaccine hesitancy requires multiple strategies. Rewards may be one. But, yes, how they are used, where and when, needs careful consideration. Allowing people time off of work with no loss of benefits may be one fairly straightforward initiative. The Krispy Kreme venture calls for close examination
      Bill

      • Edward H C Graydon says:

        WHO does not back vaccination passports for now – spokeswomanThe World Health Organization does not back requiring vaccination passports for travel due to uncertainty over whether inoculation prevents transmission of the virus, as well as equity concerns, a spokeswoman said on Tuesday.

        “We as WHO are saying at this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” WHO spokeswoman Margaret Harris said.

        “There are all those other questions, apart from the question of discrimination against the people who are not able to have the vaccine for one reason or another,” she told a U.N. news briefing.

    • Margaret says:

      I support Randy’s thinking that we “scrap incentives for now” and make more of an effort to simplify the process to get the shot. Many of the people I connect with, who are in their late 50s and up, are interested and willing but aren’t computer savvy or are unsure of how to register. Randy’s idea of creating vaccine ambassadors is one way and widespread promotion of phone lines is another. As you may know from years of September newspaper stories about student school suspensions, many parents don’t get around to getting their kiddos the annual vaccinations that are mandatory to allow kids to go to school. So perhaps public health can share lessons learned in reaching out to encourage and assist parents.

      • Sue McKeown says:

        Everyone I know late 50s and up possesses enough computer literacy to find a vaccination site or knows someone who can help her/him. Sheesh. We are not dinosaurs.

      • Bill Bogart says:

        Margaret
        Thanks for the comment.
        Thinking about comparisons to have kids vaccinated for schooling could be very useful.
        I was careful to say that rewards, if used, should be one of many strategies to promote vaccinations. We need to consider all reasonable possibilities.
        Bill

      • Bill Bogart says:

        Sue
        Thanks for your comment.
        We may not be dinosaurs but is giving someone a helping hand to encourage vaccinations such a bad thing? Each time we get vaccinated we protect ourslves – and others
        Bill

    • Edward H C Graydon says:

      WHO does not back vaccination passports for now – spokeswomanThe World Health Organization does not back requiring vaccination passports for travel due to uncertainty over whether inoculation prevents transmission of the virus, as well as equity concerns, a spokeswoman said on Tuesday.

      “We as WHO are saying at this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” WHO spokeswoman Margaret Harris said.

      “There are all those other questions, apart from the question of discrimination against the people who are not able to have the vaccine for one reason or another,” she told a U.N. news briefing.

      • Bill bogart says:

        Hi
        Thanks for this further comment.
        My article wasn’t really about vaccine passports/certificates. I commented that, if they are used, their employment might provide an incentive to get vaccinated for those otherwise hesitant.
        I don’t understand the reservation because of equity. The solution there is to ensure that *everyone* who wants to be vaccinated can be. For this who can’t be for recognized reasons there could be an exemption in terms of certificates/ passports.
        Bill

  • Larry W. Chambers says:

    Do nurses in Ontario receive pay for being vaccinated for COVID?

    • Bill Bogart says:

      Don’t think so. But they may need to be paid more given their crucial role, especially during COVID. B

    • Edward HC Graydon says:

      The issue is that the WHO does not believe it has been shown that the vaccine stops transmission or prevents the spread hence the reason many would rather forgo the cheap pastry as a prize of inoculation .

      The eats Krispy Cream ? And who would be tempted by such a low ball offer?

    • Edward HC Graydon says:

      The issue is that the WHO does not believe it has been shown that the vaccine stops transmission or prevents the spread hence the reason many would rather forgo the cheap pastry as a prize of inoculation .

      Who eats Krispy Cream ? And who would be tempted by such a low ball offer?

Author

W.A. Bogart

Contributor

W.A. Bogart is a Distinguished Professor of Law (retired), University of Windsor, and author of Off the Street: Legalizing Drugs and Regulating Obesity? Government, Society, and Questions of Health.