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Should people be paid to get the COVID-19 vaccine?

The financial incentive would help get the country to herd immunity faster, supporters say. But critics worry a payment would send the wrong message.
A volunteer receives a COVID-19 vaccination at the Research Centers of America in Hollywood, Florida.Chandan Khanna / AFP - Getty Images
/ Source: TODAY

The reluctance of many Americans to get the COVID-19 vaccine when it’s ready has some wondering: Should people get paid to get the shot to ensure herd immunity?

The latest Gallup poll — conducted before Pfizer and Moderna announced encouraging clinical trial results of their candidates — found 58% of Americans would get a free U.S. government-approved COVID-19 vaccine if it were ready today.

That’s up from half in September, but Dr. Anthony Fauci, the government's leading infectious disease expert, has said it would take “an overwhelming majority of the people” to get the shot in order to reach herd immunity reasonably quickly. It’s estimated 60-70% of the population must be immune for that to happen.

That’s led to some high-profile voices suggesting people get paid as an incentive to get the vaccine.

Former U.S. representative and presidential candidate John Delaney is suggesting $1,500 per person — calling it “a stimulus check & big vaccine incentive rolled into one” in a tweet this month.

“Result: more people get (the) vaccine, it saves lives, helps people financially,” Delaney wrote, arguing the $400 billion price tag for the effort would pay for itself by ending the pandemic and leading to an economic boost.

Robert Litan, a senior fellow at the Brookings Institution, a nonprofit public policy organization in Washington, D.C., suggested paying at least $1,000 per person.

“If the nation doesn’t get to herd immunity once the vaccine becomes widely available and has been independently validated, we’re all out of luck,” Litan wrote earlier this year. “The economy will continue to struggle with a weight on its chest, and American society won’t get back to normal.”

Paying for vaccination may be “an ethically superior option” over making the shot mandatory, and could be “very cheap” when compared with the alternatives, according to a paper recently published in the Journal of Medical Ethics.

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There have been other examples of people getting compensated in a health setting such as being paid for donating plasma or taking part in medical studies. Many companies also offer financial incentives for employees who take part in wellness programs, including reducing health insurance premiums or funding a worker’s health care account.

Paying people to get a shot that’s likely to improve their health doesn’t necessarily raise ethical concerns, said Seema Shah, a bioethicist at Lurie Children's Hospital of Chicago.

“Paying people to take vaccines is worth considering in order to end the pandemic more quickly by protecting the population from COVID-19,” Shah told TODAY.

“When we worry about payment, it’s because the lure of money might entice people to make bad decisions. In this case, people would be paid to take vaccines that would benefit them and others, which has the potential to be a win-win.”

But other experts were opposed to offering money as an incentive to get immunized.

“People should understand that they are part of society. It's like paying people to stop at stop signs,” said Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia.

Arthur Caplan, founder of the division of medical ethics at NYU School of Medicine, called it “a very bad idea.” He explained that "anti-vaxxers" — people who are part of the anti-vaccination movement — would use any payment efforts to build more distrust.

“If you pay people to get vaccinated, the strong implication is it's not safe, there's something wrong, you have to use money to persuade them,” Caplan said.

“Historically, we've never paid anybody to vaccinate with routine vaccinations — we've always said they’re safe and they work, and that's why you should use them. You start rewarding them financially, I think many people may get nervous that they can't be safe, they can't work, there must be some reason you have to pay me to get it.”

In studies, participants who are paid spend more time examining the risks, suggesting that paying people to do something signals that something is risky or might not be good for them, Shah noted.

People who are paid to donate plasma or take part in studies are compensated because they don’t directly benefit, but people who get a highly-effective COVID-19 vaccine will benefit by becoming protected from the disease, Caplan said.

He also believed much of the reluctance to get the shot will change quickly when the first vaccines are given to health care workers and other high-risk groups, and people see the shot is safe and effective.

“In the past, people haven't wanted to take vaccines because they haven't really seen cases of measles in their kids,” Caplan noted.

“With COVID, everybody knows somebody who got sick or died — it’s a huge number. People know their job is in jeopardy. They're locked up in their homes, they can't travel, they can't go to sports and recreation. They see the cost of the virus being out of control, so I think they'll start to change their minds.”

There are other ways to build trust in the COVID-19 vaccine, including seeing celebrities and other high-profile people get the shot, the experts said. It would mean a lot to see President-elect Joe Biden, Dr. Anthony Fauci, singer Dolly Parton or basketball star LeBron James get publicly vaccinated, Caplan noted.

The government could also vow to keep tracking any side-effects, and promise compensation and free health care to anyone who experiences any serious issues from the shots, he added.

"If they're safe and they seem to provide protection, people will want to do it," Caplan said.