Tuesday, July 20, 2021

Are incentives for vaccination coercive, exploitative, or otherwise unethical? Persad and Emanuel think not, in JAMA

 Many jurisdictions and venues are now offering incentives for people to be vaccinated against Covid-19.  It will not surprise the readers of this blog to learn that some people have found incentives for vaccination to be repugnant, and perhaps to be immoral and unethical coercion or exploitation.  Here's an article rebutting those concerns, in JAMA

Ethical Considerations of Offering Benefits to COVID-19 Vaccine Recipients  by Govind Persad, JD, PhD1; Ezekiel J. Emanuel, MD, PhD, JAMA. Published online July 1, 2021. doi:10.1001/jama.2021.11045

"Entry into a million-dollar lottery for getting vaccinated against COVID-19 is Ohio’s offer to adults. Teens who get vaccinated receive a lottery ticket for state college tuition, room, board, and more. Other states are offering gift cards. Now many employers are offering rewards for COVID-19 vaccination. Businesses ranging from Krispy Kreme and Sam Adams beer to the Cincinnati Reds have announced discounts or prizes for vaccinated individuals. Are these benefit programs ethical? Are they useful? Are they better than mandates?


"The ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals.1 If benefit programs increase vaccine uptake, they directly protect recipients. By reducing transmission, increased uptake also protects the population, including ineligible children and adults, unvaccinated adults, and individuals with conditions reducing vaccine efficacy (Table). Because transmission has been higher and outcomes worse in less-advantaged communities, stemming transmission especially protects those in disadvantaged communities. In addition, costs, such as time off work for getting a vaccine or dealing with vaccine-related adverse effects, finding daycare for children, and transportation to a vaccine site, hamper access for poorer and marginalized people. Benefit programs, especially in the form of guaranteed cash payments, could improve access and increase uptake by offsetting these costs."

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