Good reasons to vaccinate: mandatory or payment for risk?

Savulescu, Julian

doi:10.1136/medethics-2020-106821

Cited by 144 publications

(119 citation statements)

References 22 publications

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“…It might also turn out that people are unwilling to take the second dose of a two-dose vaccine, or not accept refresher doses, which would further complicate the situation and might require subtle intertemporal strategy choice. Before making any vaccination mandatory, people could also be paid or incentivized in other ways to accept it [43]. If, as we hope, people take the external effects of their action into account, and a sufficiently high number of people get vaccinated as a result, mandatory vaccination won't be necessary.…”

Section: Plos Onementioning

confidence: 99%

Attitudes on voluntary and mandatory vaccination against COVID-19: Evidence from Germany

2021

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Several vaccines against COVID-19 have now been developed and are already being rolled out around the world. The decision whether or not to get vaccinated has so far been left to the individual citizens. However, there are good reasons, both in theory as well as in practice, to believe that the willingness to get vaccinated might not be sufficiently high to achieve herd immunity. A policy of mandatory vaccination could ensure high levels of vaccination coverage, but its legitimacy is doubtful. We investigate the willingness to get vaccinated and the reasons for an acceptance (or rejection) of a policy of mandatory vaccination against COVID-19 in June and July 2020 in Germany based on a representative real time survey, a random sub-sample (SOEP-CoV) of the German Socio-Economic Panel (SOEP). Our results show that about 70 percent of adults in Germany would voluntarily get vaccinated against the coronavirus if a vaccine without side effects was available. About half of residents of Germany are in favor, and half against, a policy of mandatory vaccination. The approval rate for mandatory vaccination is significantly higher among those who would get vaccinated voluntarily (around 60 percent) than among those who would not get vaccinated voluntarily (27 percent). The individual willingness to get vaccinated and acceptance of a policy of mandatory vaccination correlates systematically with socio-demographic and psychological characteristics of the respondents. We conclude that as far as people’s declared intentions are concerned, herd immunity could be reached without a policy of mandatory vaccination, but that such a policy might be found acceptable too, were it to become necessary.

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Section: Plos Onementioning

confidence: 99%

Attitudes on voluntary and mandatory vaccination against COVID-19: Evidence from Germany

2021

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“… 3 4 Various interventions have been discussed to counter COVID-19 vaccine hesitancy specifically and increase vaccination intentions, including mandatory regulations 5 and educational campaigns to highlight the contributions of individual vaccination to herd immunity and to fight conspiracies. 6 Recently, Julian Savulescu 7 advocated for monetary vaccination incentives. He argued that paying people to be vaccinated against COVID-19 is ethically just (because it is risk-neutral: being paid for an approved, marketed, otherwise unpaid-for vaccination does not increase risk) and economically reasonable (because the financial benefits of higher vaccination rates should outweigh payment costs).…”

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confidence: 99%

Money is not everything: experimental evidence that payments do not increase willingness to be vaccinated against COVID-19

et al. 2021

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Rapid, large-scale uptake of new vaccines against COVID-19 will be crucial to decrease infections and end the pandemic. In a recent article in this journal, Julian Savulescu argued in favour of monetary incentives to convince more people to be vaccinated once the vaccine becomes available. To evaluate the potential of his suggestion, we conducted an experiment investigating the impact of payments and the communication of individual and prosocial benefits of high vaccination rates on vaccination intentions. Our results revealed that none of these interventions or their combinations increased willingness to be vaccinated shortly after a vaccine becomes available. Consequently, decision makers should be cautious about introducing monetary incentives and instead focus on interventions that increase confidence in vaccine safety first, as this has shown to be an especially important factor regarding the demand for the new COVID-19 vaccines.

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“…50 Julian Savulescu recently argued that in the case of a novel vaccine about which we have limited long-term safety data, the most appropriate way to incentivise community-wide vaccination might be to compensate individuals for the risk they incur. 51 He argues that such a policy avoids coercion and increases peoples' choices. In healthcare settings, incentives might include free meals, professional registration, parking and bonuses.…”

Section: Clinical Ethicsmentioning

confidence: 99%

Spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for front-line healthcare workers

Bradfield

Giubilini

2021

J Med Ethics

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Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This ‘conditional’ policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large.

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Good reasons to vaccinate: mandatory or payment for risk?

Abstract: vaccine-mandatory-or-paymentmodel/]. I would like to thank an anonymous reviewer for very many helpful and constructive comments. I would also like to thank Alberto Giubilini for his help.

Cited by 144 publications

References 22 publications

Attitudes on voluntary and mandatory vaccination against COVID-19: Evidence from Germany

Attitudes on voluntary and mandatory vaccination against COVID-19: Evidence from Germany

Money is not everything: experimental evidence that payments do not increase willingness to be vaccinated against COVID-19

Spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for front-line healthcare workers

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