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Achieve herd immunity by paying people to get Covid-19 jab, says leading ethicist

Leading ethicist Professor Julian Savulescu has argued that while the Covid-19 vaccination should be mandatory, it is better to get the public to volunteer for the jab. And he has suggested this could be done through providing incentives. 

A leading ethicist has argued that the Government should incentivise the public to get the Covid-19 vaccine, either financially or by ‘payment in kind’.

Anti-vaxxers have been disseminating widespread misinformation online about a potential Covid-19 vaccine, and their ideas have become a symptom of the Covid-sceptic movement – which has been regularly protesting Government guidelines and promoting conspiracy theories. As well as potentially having influenced a significant portion of the public, as one in six UK adults said they were unlikely to accept a Covid-19 vaccine.

Covid-19 vaccination plan B – either pay the public or give vaccinated people social perks

Professor Julian Savulescu, Oxford Uehiro Centre for Practical Ethics University of Oxford, wrote in an opinion piece in the Journal of Medical Ethics that when a vaccine hopefully becomes available, it should be mandatory – if necessitated by a failed voluntary scheme.

He said they while vaccination is generally understood to be voluntary there is a strong case for this vaccine to be mandatory, reliant that four conditions are met: there is a grave threat to public health; the vaccine is safe and effective; the pros outweigh the cons of any suitable alternative; the level of coercion is proportionate.

Prof Savulescu wrote that: ‘To be maximally effective, particularly in protecting the most vulnerable in the population, vaccination would need to achieve herd immunity (the exact percentage of the population that would need to be immune for herd immunity to be reached depends on various factors, but current estimates range up to 82%).’

Although he argued that there are ethical issues if a mandatory approach was adopted, and a judgement would need to be taken on the level of safety of the vaccine: ‘Of course… a 0% risk option is very unlikely.’

‘However, another way of looking at this is that those at low risk are being asked to do a job which entails some risk, albeit a very low one. So, they should be paid for the risk they are taking for the sake of providing a public good.’

He argued that the advantage of payment is that there is a dimension of voluntaryism in getting the jab, rather than the coercion that applies for other state-mandated law or rules – such as wearing a seatbelt or conscription during wartime.

Brushing off the possible criticism that his incentive idea will exploit poorer people as they will be more inclined to take on any potential, although, low-risk paid vaccination, writing that: ‘It is not necessarily exploitation if there are protections in place such as a minimum wage or a fair price is paid to take on risk.’

He pointed out that in many countries people who perform civic duties are paid, for example, blood donation is paid in many countries, although not in the UK typically, but the UK does import blood from countries that do. Incentives he suggested could take the forms of financial payment or a ‘payment in kind’ – such as freedom of travel, not having to wear a mask, and not having to socially distance.

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