Covid-19: The pros and cons of incentivising vaccination

The World Health Organization has said making routine childhood vaccines mandatory is among the best methods to boost coverage.

With countries all over the world aiming to return normality to everyday life, governments in some countries had pulled out all the stops by incentivising vaccine drives. From the chance to win a Tesla in Hong Kong to an iPhone in Prague, the incentives came in all shapes and sizes. In Hong Kong, vaccine lottery prizes also included $1.4 million apartments, diamond-encrusted Rolex watches, and gold bars. However, some countries also made it mandatory to get vaccinated to keep jobs.

Now, the governments’ vaccine pushes are tending more towards the latter as the Delta variant has renewed fears of another round of lockdowns, than the incentive programmes provided earlier.

Incentivising vaccines
At the beginning of the vaccination programme, stickers for Instagram posts were the only prize. Now, the likes of Hong Kong have turned into a roulette with incentives such as a swanky apartment, a Tesla, a $100,000 shopping spree. Vladimir Putin, on the other hand, is handing over snowmobiles in Russia.

In West Virginia, United States, getting a vaccine can land one a lifetime hunting licence as well as custom rifles. Alabama is offering vaccinated people the chance to drive on a racetrack. President Joe Biden has himself gone on record asking states to offer the newly vaccinated $100 to address flagging vaccination. New York City will pay $100 to anyone getting the vaccine at city-run sites for their first dose, Mayor Bill de Blasio announced. Earlier, the city had announced a ‘Vax and Scratch’ programme where lottery tickets, otherwise sold for $20, were handed out for free.

For those aged between 12 and 17 in Ohio, the state is offering the chance to enter a contest for a four-year scholarship, including room-and-board, tuition, and books to any state university or college. Those above 18 have the chance to walk away with prizes worth a whopping $1 million. The likes of Illinois, Colorado, Maine, Delaware, and Minnesota have also launched similar schemes.

In Europe, Israel issues a ‘Green Pass’, a ticket to hotels, restaurants, and gyms, upon vaccination. In Serbia, President Aleksandar Vučić has also announced cash incentives to boost the country’s vaccination rate.

In India, a foundation in Chennai is offering the chance to be a part of lucky draws for prizes including washing machines, gold coins, blenders, and motorcycles. The administration in Sheohar district of Bihar is also adopting the model to overcome hesitancy. A village in Arunachal is giving away free rice to those who take the vaccine.

Taking action
having tried the incentive routes, governments are now putting into action stricter measures to boost vaccination rates as Covid-19 caseload additions rise due to rapidly spreading mutations. France passed a law last week that would require citizens to furnish a “health pass” — proof of vaccination or a negative RT-PCR report — to enter bars, restaurants, and for long-distance travel. Greece, which faces the risk of its crucial tourism sector shutting down because of rapidly rising cases, has barred the unvaccinated from entering bars, cafes, indoor restaurants, and movie theatres. It has made it compulsory for workers in elderly homes to get jabbed by August 16 or face suspension.

Italy, which made vaccines mandatory for healthcare workers in April, has announced that there would be similar restrictions on indoor venues for non-vaccinated citizens. Across counties in the European Union, 42 per cent have been fully vaccinated.

New York has announced the public hospital employees would need to furnish proof of vaccination, failing which they will have to submit weekly test reports. Several private and public employers, including those in New York City and California, have asked workers to get vaccinated or face mandatory testing.

United Airlines is among companies asking for proof of vaccination from new joinees. The crew of the Broadway show Hamilton announced in May that all members of the cast and crew must be inoculated. The Chronicle of Higher Education reported at least 600 US colleges — both public and private — require their students and staff members to show proof of vaccination.

Do these methods work?
Vaccinations rose two-fold in Hong Kong since the private-sector incentives were rolled out. On the other hand, there was no evidence that Ohio’s vaccine lottery had increased vaccination uptake, according to a study. However, it did suggest that the rates in Ohio had slowed less than in the rest of the country.

Experts also mostly believe that incentivising vaccines was worth trying.

However, France’s new legislation had a dramatic effect: 926,000 people — a record — booked appointments via DocotLib, the medical booking site, last Monday. That figure went up to 2.6 million — 62 per cent below the age of 35 years — as on Thursday.

Similarly, a Euromedia Research poll in La Stampa newspaper found that 68 per cent Italians would favour allowing only vaccinated people to enter hotels, cinemas, restaurants, planes, and trains. A similar percentage would support the removal of health care staff members who are not fully vaccinated by mid-September.

Incentives vs disincentives
Compulsory vaccines or incentivising shots both remain controversial ideas.

Julian Savulescu, who teaches at Oxford Universty’s Uehiro Centre for Practical Ethics, wrote that while ‘anti-vaxxers’ might never change their stance, incentives could persuade others to get the jab.

However, other experts cautioned against financial incentives. According to Keith Neal, an emeritus professor at Nottingham University, paying people to get themselves inoculated would set a dangerous precedent.

The World Health Organization has said making routine childhood vaccines mandatory is among the best methods to boost coverage. However, policies that either make mandatory or incentivise vaccines for adults are rare and, as in France when President Emmanuel Macron said people needed to get vaccinated to visit restaurants or bars or even travel, are often met with resistance.