People should be paid to get a Covid vaccine to ensure that millions get protected against the disease, a leading expert has said.
Oxford University ethicist Professor Julian Savulescu said people could either get money or an exemption from face mask and social distancing rules if they got the jab.
He said that simply asking people to volunteer for the jab might fail because many people don’t trust vaccines.
Or some – particularly younger people – might decide not to get the vaccine if they don’t see any benefit in it for them because they’re not at high risk from Covid-19.
But enforcing vaccines by law would be fiercely opposed by many as a breach of personal freedom, even if it could help spell an end to the pandemic.
Therefore, Professor Savulescu argued a plan B based on encouraging people undecided about getting vaccinated might be useful in ensuring the widespread coverage needed to achieve herd immunity.
Herd immunity is a state in which so many people are resistant to catching the virus, either because they’ve already had it or because they’ve been vaccinated, that it can’t spread any more.
It is not yet clear whether either of those options will produce total immunity to Covid-19, so even people who have had the illness will likely be encouraged to get the jab.
Exactly how many people will have to have it to stop the virus spreading is unknown, with estimates ranging from fewer than half to more than 80 per cent. The more people get vaccinated, the better herd immunity works.
Major research has found only half of British people say they are ‘very likely’ to get a Covid-19 vaccine if one becomes available.
Bogus conspiracy theories claiming that the vaccines are dangerous or will be used to implant tracking chips into people’s bodies have spread online, denting public trust. Officials will not approve a jab until rigorous trials prove it is safe and effective.
A voluntary vaccination scheme could fail due to hesitancy about safety of a Covid-19 jab, even if it has been through rigorous trials and approved by regulators, Professor Savulescu warned. Pictured: A volunteer receiving the experimental Pfizer jab, tipped to be one of the first to finish trials
When a coronavirus jab is first proven to work, only the most vulnerable will receive it, experts have confirmed, because there will be short supply.
And health bosses have warned the first wave of vaccines won’t be good enough to allow society to immediately return to normal.
Professor Savulescu, director of the Oxford Uehiro Centre for Practical Ethics, argued his case in an opinion piece in the Journal of Medical Ethics today.
Given the rising global death toll – more than 1.22million have died worldwide – and the devastating impact of lockdowns, there have been calls to make a Covid-19 jab mandatory.
But many people will strongly object to state-enforced vaccination as an infringement on personal freedom and human rights.
Professor Savulescu said: ‘Vaccines are some of the safest and most effective interventions we have, and have achieved incredible successes. We no longer face diseases that killed our ancestors.
Professor Julian Savulescu says people should be paid to get the Covid-19 jab to ensure widespread uptake
‘But vaccine hesitancy is on the rise even for well-established vaccinations. The problem is likely to be bigger for a new vaccine.
‘In an ideal world, the vaccine would be proven to be 100 per cent safe. But there will likely be some risk remaining, and there are risks that have not yet been identified.’
Before a Covid-19 vaccine is rolled out across the population, the developers need to take their final trial data to regulators who will decide whether to approve it for mass use.
But in any case, the first Covid-19 jab is not expected to be 100 per cent effective, and may even fail to prevent serious disease.
The UK’s vaccine tsar Kate Bingham said last week that ‘we should be prepared’ that jabs might not prevent infection but rather reduce symptoms and, even then, ‘might not work for everyone or for long’, adding that the first jab will be ‘imperfect’.
Professor Savulescu said a ‘zero per cent risk option’ for a Covid-19 vaccine is very unlikely and therefore one can’t be made compulsory.
‘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,’ he said.
‘So they should be paid for the risk they are taking for the sake of providing a public good.’
Therefore, governments should consider offering people an incentive to get the jab, he suggested.
The incentive could be either financial or ‘payment in kind’, such as being allowed to forego the need to wear a face mask in public, he said.
‘Anti-vaxxers’ may never be convinced to change their stance but people sitting on the fence might be persuaded by a cash grant.
‘As long as we are accurate in conveying the limitations in our confidence about the risks and benefits of a vaccine, then it is up to individuals to judge whether they are worth payment,’ Professor Savulescu said.
He insisted payment isn’t about coercion or encouraging people to take unreasonable risks.
Vaccine development and trials are in place to ensure confidence that there is very low risk, he emphasises.
And he said it is not necessarily exploitation of poorer people if ‘there are protections in place such as a minimum wage or a fair price is paid to take on risk’.
‘A payment model could also be very cheap, compared to the alternatives,’ he argues.
‘The cost of the UK’s furlough scheme is estimated to reach £60billion by its [original] planned end in October, and the economic shut down is likely to cost many billions more, as well as the estimated 200,000 lives expected to be lost as a result.
‘It would make economic sense to pay people quite a lot to incentivize them to vaccinate sooner rather than later—which, for example, would speed up their full return to work.’
But a number of scientists were not in favour of a paid approach.
Helen Bedford, professor of Child Public Health at UCL, and Dr David Elliman, consultant in community child Health, said in a joint statement that offering money, especially when many people are struggling financially during the pandemic, was ‘dangerous’.
They said: ‘It is highly unlikely that we will know exactly how effective a vaccine is in preventing spread of the disease in the early stages, and until we do know, it would be dangerous to offer these incentives.’
Keith Neal, emeritus professor of the epidemiology of infectious diseases, University of Nottingham, agreed ‘paying people to get vaccinated would set a very dangerous precedent’.
He added: ‘If we did this, people will expect it for other vaccines and also social media falsehoods would have a field day suggesting it can’t be safe if that’s what you need to be paid to have it.’
Experts said the money would be better used to provide vaccines to other countries, to avoid re-introduction of the coronavirus into the UK, to bolster public health campaigns and ensure easy access to vaccination services.
A major study warned in September that a fifth of people in the UK may refuse to be vaccinated against coronavirus when a jab is available.
In the largest survey of its kind, 22 per cent of people said they were unlikely to be vaccinated with 10 per cent strongly opposed to it.
Just half (49 per cent) of the 17,500 people asked by University College London researchers said they ‘very likely’ to be immunised, while three-quarters (78 per cent) said they considered it ‘likely’.
Concerns over vaccine safety, mistrust of pharmaceutical companies and a preference for natural immunity were some of the factors behind the low uptake, which authors stressed ‘lack any basis in fact.’
Almost one in three (30 per cent) had substantial beliefs that vaccines can cause unknown future problems, while one in seven (15 per cent) said they believed to varying degrees that vaccines do not work.
Researchers found a ‘concerning level of misinformation around vaccines’ which could significantly affect uptake once a Covid-19 vaccine is approved.