PUBLIC HEALTH professionals are looking for ways to increase Covid-19 vaccination uptake. Despite the numerous disruptions from the ongoing pandemic, a huge proportion of people are still reluctant to take the vaccine. Never in the history of public health have we seen such draw back from a safe and efficient vaccine that could help to bring the pandemic under control.
New evidence is showing that in many instances, those who are severely hospitalised and are dying of Covid-19 are those who have not been vaccinated. Some people who are hesitant are asking, why should they take the vaccine when they can still become infected with the virus. The answer is simple. If you are vaccinated and you get infected, the vaccine has proven to reduce severe infection and hospitalisation thus preventing the chances of dying from the virus.
Incentives to encourage people to take the vaccine are useful in situations where behaviour changes can reduce future health expenditures. In the case of Covid-19 vaccination, the positive return on incentives may be considerable. The pandemic is causing direct and indirect financial loss. Families are losing breadwinners; heath systems must pay more to care of severely sick persons and other sectors such as tourism our main financial earner are being impacted.
Incentives can shift even intractable health behaviours, such as cigarette smoking and physical inactivity, though people may revert to those behaviours when the incentives end. Incentives are thus particularly effective in changing one-time behaviours — such as obtaining cancer screening and vaccinations. In the case of Covid-19 vaccination incentivizing persons for a one-time behaviour change may be beneficial as it can increase vaccination rate and a faster move towards herd immunity and a return to normal.
Given flagging vaccination rates and the societal imperative to end the pandemic, financial incentives hold appeal, especially if an incentive-based program were focused on groups with persistently low vaccination rates. Some people who are reluctant to be vaccinated might opt to get the vaccine “because of the incentive,” thereby overcoming inertia or resistance from their peer group.
Even if incentives can produce a short-term bump in vaccination, however, multiple strategies will be necessary to increase population immunity. Campaigns will have to identify sources of resistance, including safety concerns, and communicate transparently to build public trust.
Incentives must also be given to those who have taken the vaccines. Although taking the vaccines is a way to protect one’s self, people who are vaccinated must see some benefit from doing so. Vaccinated persons cannot be treated like the unvaccinated. Persons who are vaccinated should be afforded shorter quarantine time, if any at all and should be allowed a bit more freedom. If people cannot see a difference, they will most likely ask what the difference is in taking or not taking the vaccine.
Incentives alone are unlikely to deliver the population immunity that will end the pandemic.
We need to go further in adopting a combination of behaviourally informed policies that will protect our health and the health of the economy for years to come.