Pay for vaccination? Vaccinated? There is such an idea

If we want to reach the level of vaccination on Covid-19 needed to achieve adequate herd immunity, we should pay for undergoing vaccination – argues in the journal “Journal of Medical Ethics” prof. Julian Savulescu, an ethicist at the University of Oxford. In his opinion, the required vaccination of about 80 percent. of the population can be difficult without appropriate additional incentives, not necessarily financial in nature. Perhaps it is enough to release the vaccinated from wearing the mask.

The Covid-19 vaccination case is very emotional. Most experts believe that only its appearance will allow us to control the epidemic and return to at least partially normal. There are also opponents of vaccinationswho just in the case of the coronavirus seem more numerous than usual. This has led to voices in some countries, including the UK, that vaccination against Covid-19 should be mandatory.

Prof. Savulescu argues that vaccination should generally be voluntary, but practice shows that under special conditions it can be mandatory. This is the case for diseases that pose a serious threat to public health, when there is an effective and safe vaccine, when the benefits of its use outweigh the arguments for any other solution. In the case of Covid-19, additional arguments may have to be used if the voluntary vaccination system does not work.

“For vaccination to be as effective as possible, especially to protect the weakest and most at risk, the procedure should help achieve so-called herd immunity,” writes Savulescu. The key problem is, of course, to create an appropriate, effective and safe vaccine, to produce it in the right amount and deliver it wherever it is needed. However, the problem does not end there. “Vaccinations are one of the safest and most effective methods used in medicine, they brought many successes to mankind, prevented us from suffering from diseases that decimated our ancestors“- emphasizes the author.” Unfortunately, the need for even well-known vaccines with documented effectiveness is being questioned more and more often “- he adds.

With a new vaccine, the problem is likely to be bigger. While ideally we expect a 100% safe preparation. this time, due to the rush accompanying its production, we have to take into account a greater risk. “Each compulsory vaccination program requires a precise risk-benefit assessment, the safety level should be as high as possible, but here it is difficult to expect that the uncertainty will drop to zero. We cannot judge whether the introduction of compulsory vaccination for Covid-19 is fully ethically justified until we can learn the nature of the vaccine, the seriousness of the problem and the probable profit and loss account in relation to other methods of operation “- emphasizes prof. Savulescu.

“However, you can look at this issue differently and say that each of us deserves extra reward for taking this slight extra risk for the common good“He adds.” Antivaccines may never be persuaded, but additional motivation may persuade others to get vaccinated. Ultimately, being rewarded for the added risk means that people can choose to do so voluntarily rather than under duress. They will judge for themselves whether the profit and loss account is beneficial for them “- he emphasizes.

According to Savulescu, the offer does not encourage taking unreasonable risks, because work on the vaccine, including clinical trials, is to ensure that the likelihood of an adverse reaction will be very low. In short, if the vaccine is offered to volunteers without any remuneration, the additional motivation will not violate the rules of ethics and may significantly increase the percentage of vaccinated persons. If this helps to lift economic constraints faster, it will also pay off for the state. Savulesku does not rule out that the incentives may also be of a non-financial nature. These can be facilitations in traveling, permission to participate in events where social distancing is not kept, or finally the right not to wear a mask.

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