- Some experts are recommending that the federal government pay people to get a COVID-19 vaccination when it becomes available.
- They say the payments could bring the United States closer to herd immunity more quickly.
- Other experts, however, say paying people would reduce confidence in the vaccine.
The hunt for a COVID-19 vaccine just got a major boost.
Pfizer announced Monday that early findings show its vaccine was more than 90 percent effective in keeping clinical trial volunteers from getting COVID-19.
The vaccine will need more study as well as emergency authorization approval from the Food and Drug Administration (FDA).
Nonetheless, Pfizer says it will have manufactured enough doses to vaccinate as many as 20 million people by the end of the year.
Vaccines usually require years of research and testing. So how do you convince people to take a fast-tracked vaccine?
That could be an uphill battle. In a poll taken in early October, 58 percent of people in the United States said they would get a government-approved COVID-19 vaccine. That was down from 69 percent in August.
In response to that finding, there are now calls for the federal government to consider paying people to be vaccinated against COVID-19.
The benefits of paying
Julian Savulescu, a professor at the Uehiro Centre for Practical Ethics at Oxford University in England, argues that the best way to achieve herd immunity during the COVID-19 pandemic is to get as many people vaccinated as possible.
In an op-ed for the Journal of Medical Ethics, Savulescu suggests that the grave threat to public health as well as a safe and effective vaccine make a strong case for mandatory vaccinations.
But in lieu of making it mandatory, he said the government could pay people to take the shots.
Savulescu said it could be money or what he calls “payment in kind,” such as allowing the vaccinated person to forgo wearing a mask in public.
He said the higher vaccination rate could help people return to work sooner.
Savulescu said we already pay people for some medical procedures.
“Paying people for blood is not unethical, even in the absence of a blood crisis,” he told Healthline.
He believes the plan would be a good fit for people in the United States.
“The U.S. is the heart of capitalism,” he said. “If it is going to work anywhere, it would be the U.S.”
Savulescu isn’t the only one calling for a vaccination payment plan. So is Robert E. Litan, an economist at the Brookings Institution in Washington, D.C.
In an op-ed for the institute, Litan likens it to an adult version of giving candy to a child getting a vaccine.
How much money? His hunch is that the payment would have to be about $1,000 per person. Enough, he says, to assure that the country gets the 80 percent vaccination threshold some experts think is needed for herd immunity.
Litan believes the practice would pay for itself once people could get back to work and the economy gets back on track.
Experts weigh in
The experts interviewed by Healthline were less enthusiastic about a pay incentive for a COVID-19 vaccine.
“Trying to pay people to take the vaccine suggests there’s something wrong with the vaccine,” said Arthur L. Caplan, PhD, a professor of bioethics in the department of population health at the New York University Grossman School of Medicine and the director of the division of medical ethics at NYU Langone.
“It’s not going to address their suspicions and doubts. It’s going to inflame them,” Caplan told Healthline.
“We pay people to be in research projects, so it’s not the payment that bothers me, it’s the context,” he explained. “It’s one thing to pay somebody $1,000 to stay awake during a sleep study. We’re paying you for your inconvenience versus paying you to overcome your fears.”
Caplan also said he’s skeptical you could get enough people to even get close to herd immunity by paying them to take the vaccine.
Nancy E. Kass, ScD, a professor of bioethics and public health in the Johns Hopkins Berman Institute at the Johns Hopkins Bloomberg School of Public Health in Maryland, said she also suspects offering money might increase fears.
“I do worry that it could backfire, that paying people for this vaccination in an environment in which there is already some distrust will increase distrust rather than ameliorate it,” she told Healthline.
Kass said she believes there are alternatives, such as finding messengers — celebrities, athletes, political figures — to vouch for the vaccine in targeted messages.
She also said it may be awhile before there are enough vaccines for the masses. In the interim, there will be lots of examples of people who have taken the vaccine without being harmed.
“Most of us won’t be in tier one. Over time, people will have the opportunity to watch as medical workers, first responders, nursing home workers, teachers… hundreds of thousands take the vaccine,” she explained. “Once it all looks OK, maybe people will relax their shoulders a bit and think it’s OK to get the vaccine.”
And Kass said she suspects that some hospitals, schools, or nursing homes may require people who come onto their premises to be vaccinated.
Altogether, those moves, she believes, would shrink the pool of people you need to convince to take the vaccine.
Next steps
Four vaccines are in late-stage trials in the United States.
Moderna’s vaccine is similar to the one Pfizer is developing.
Pfizer is expected to ask the FDA for emergency authorization in a week or two. However, the company issued only a press release, not data that other scientists can evaluate.
But he also issued a caution.
“You have to go through the hoops, make sure all the i’s are dotted, the t’s crossed about the safety and the regulatory aspects of it. But we could be giving vaccine to people very likely by the end of this year. That is good news,” Fauci said.
Meanwhile, the debate on how to get people to take a COVID-19 vaccine is ongoing.
This past weekend, the New York State Bar approved a resolution urging that state to consider making a vaccine mandatory for all New Yorkers once one becomes available.
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