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Why Paying People To Get The Coronavirus Vaccine Doesn’t Work

The first COVID-19 vaccine to receive emergency approval in the US could hit the market in a matter of days, with the Pfizer and BioNTech candidate being approved by an external advisory board to the Food and Drug Administration on Dec. 10 has been. Two days earlier, an internal FDA had approved the vaccine. These were the final steps required before the FDA approves the vaccine, which will soon be given to health care workers across the country. But while health care workers who are the first to receive the vaccine seem eager, others are not as convinced. In fact, recent studies show that many Americans don’t plan on getting a COVID-19 vaccine even if one is available for free. If vaccination rates are not robust, it will take longer to achieve herd immunity or full protection within a population. In response to these concerns, several people have suggested that the government should provide a financial incentive for COVID-19 vaccination. We are professors of health law, and we believe it is important to understand how these monetary incentives work as COVID-19 vaccines become available, why paying for vaccinations can exacerbate suspicions about vaccines, and how that incentive has entered the broader history of the world monetary incentives for public health fits. The Idea Behind The Cash Prizes For The COVID-19 Vaccination In The Summer And Early Fall Of 2020, multiple polls showed that the number of Americans planning to get vaccinated against COVID-19 was less than desirable. Experts estimate that between 67% and 85% of Americans need to be vaccinated to achieve herd immunity. A recent poll by the Pew Research Center found that only 60% of Americans are considering a COVID-19 vaccine. If vaccination rates are indeed low once vaccines become widely available, it will take the US longer to contain the pandemic. In addition, many Americans who express suspicions about COVID-19 vaccines belong to racial minorities, precisely among the groups hardest hit by the pandemic. The idea of ​​monetary incentives seems straightforward: pay people to get vaccinated. One of its earliest proponents, the economist Robert Litan, called the idea an “adult version of the doctor distributing candy to children.” Litan suggested that the government should pay $ 1,000 to anyone who receives a COVID-19 vaccine. In his proposal, he admitted that he had not relied on studies or data to arrive at this number and stated that the proposed payment amount was an “assumption”. His idea has since been endorsed by prominent commentators. These include economist Gregory Mankiw and politician John Delaney, who proposed increasing the incentive to $ 1,500. If money works and if it doesn’t work, it’s not new to incentivize people who take health risks to help others. The most common example is clinical trials. Participants in these studies often receive fixed payments, typically between $ 25 and $ 1,000, to cover participation costs and possibly to offset participants’ time. The researchers do not intend these payments to induce subjects to take risks they would otherwise refuse. There is concern, however, that if clinical researchers pay prospective subjects to take risks, their clinical trials fall victim to poorer people, for whom the payment would make the most difference. The law refuses to approve clinical trials that have reason to believe that high payments have caused people to take risks against their better judgment. While a number of studies show that nominal payments rarely induce a person to agree to clinical research that the person considers risky, data shows that payments of up to $ 1,000 induce potential participants to consider the proposed research to be very risky . These people look for risk information and examine it more closely than others who have been offered significantly lower payments. In other cases, monetary compensation is also available. For example, the payments for donating plasma are currently between $ 30 and $ 60. Compensation for gamete donation is also possible, with $ 35 to $ 125 for sperm donation and $ 5,000 to $ 10,000 for egg donation. There are also cases where it has been effective in getting people to stop unhealthy behaviors. Studies have shown that paying people to quit smoking can be a powerful incentive. These studies offered rewards to smokers between $ 45 and $ 700. Individuals who received a reward were less likely to smoke even after the financial incentive ended. Conversely, the law on uniform anatomical gifts expressly prohibits the payment of organ donations. The concern here is that allowing payments would undermine the altruism underlying the current system so that no one would make their organs available for free if there was a market for them. And where there is a market, it will exploit the poorest of us, who are the most vulnerable. In countries that do not prohibit payment for human organs, there are scattered references to unscrupulous brokers and healthcare providers profiting from the desperation of wealthy recipients at the expense of impoverished and vulnerable donors. Why Money is Different for COVID-19 Vaccination In the medical context, financial incentives are usually not available when participants are taking a health risk that nonetheless provides them with likely personal benefit. Instead, people who consent to participate in clinical trials that are unlikely to benefit medically from their participation are more likely to be paid. This also applies to payments for plasma and gamete donations, as donors do not benefit medically from their participation.[Get our best science, health and technology stories. Sign up for The Conversation’s science newsletter.]A massive payment plan to promote COVID-19 vaccination would be very different from the current financial incentives. In addition to its novelty, we fear that such a system would have unintended consequences. First, we don’t have actual behavioral studies in this area – as opposed to the case of smoking cessation rewards. Similarly, as vaccination rewards proponents admit, there is no data on how to determine the appropriate reward. Second, the proposal could backfire. Individuals who already do not trust vaccines may consider the mere availability of payments as confirmation that vaccinations are particularly risky or undesirable. And any person or organization interested in promoting vaccine disinformation may use government payments as “evidence” of deep or hidden agendas related to vaccination. If people take advantage of the monetary incentive this way, it could lead to increased vaccine reluctance – just the opposite of what is intended. Third, we are concerned about the socio-economic basis of this proposal. An amount of nearly $ 1,000 is said to induce a person to change their mindset about vaccination. In practice, this means that richer individuals, who may not be moved by $ 1,000, can simply ignore the reward. However, poorer people are expected to change their behavior in exchange for money. This is a paternalistic approach that does nothing to increase the confidence of the poorer communities in the government and health authorities. For these reasons, we advise regulators and legislators to exercise caution in this area. We all want the pandemic to end as soon as possible. But we need to create the right incentives, which means that we are basing ourselves on data, not just unexamined theories. This article was republished by The Conversation, a non-profit news site dedicated to exchanging ideas from academic experts. It is written by: Ana Santos Rutschman, Saint Louis University and Robert Gatter, Saint Louis University. Read More: * Latinos Are Particularly Reluctant to Get the Flu Shots – How a Small Indiana Clinic Found Ways to Overcome It * When Can Children Get These? Covid19 vaccination? 5 Questions Parents Ask The authors do not work for any company or organization that would benefit from this article and do not receive relevant affiliations beyond their academic appointment.

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