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Want people to get the Covid vaccine? Pay them

The vaccines seem to be coming thick and fast.

The task now is to ensure that enough people get them to keep the virus under control.

The first issue is one of logistics. The track record of the UK’s health bureaucracy during the crisis has not been good. But the NHS does have experience of administering millions of flu jabs every year, and the process seems to work well.

The real challenge is how to persuade enough people to come forward and be vaccinated.

There is clearly a section of the population, revealed on social media, which will never agree to it. Some believe that the vaccine is a sinister plot by a tight-knit cabal to control the world.

True believers in such conspiracy theories are probably relatively small in number. The problem will be if they succeed in undermining the science behind the strategy of vaccination and manage to convince others.

Here, members of SAGE getting on TV to urge vaccination are a liability. They are almost doing the anti-vaxxers work for them.

The credibility of these scientists is being shot to pieces. The 1960s avant-garde artist Andy Warhol is currently enjoying a revival. He once memorably pronounced “in the future, everyone will be famous for 15 minutes”.

The huge numbers of hitherto totally obscure academics on SAGE and its various sub-committees are living proof of the accuracy of Warhol’s prediction.  They fall over themselves to appear in the media with ever more gloom-laden predictions, most of which are rapidly exposed as being wrong.

This is a serious problem for the government.

Local GPs do seem to still have a high level of credibility and trust with the public. These doctors should be the ones promoting the message of vaccination. Government scientists and SAGE members, who have become figures of controversy, should simply keep quiet.

Even so, there may be many individuals who carry out a simple cost-benefit analysis for themselves. Virtually no one under 40 in reasonable health, for example, has died of Covid-19.  If the vaccine has unpleasant side effects, they may decide not to have it.

Incentives need to be put in place. There are externalities involved: if I refuse to have a vaccination, I can infect others. That means vaccination cannot simply be left to individual self-interest.

Some negative incentives seem obvious. For example, anyone who refuses the vaccine could be excluded from treatment if he or she caught the disease. Fines or even prison could be applied in vaccine refusers who are shown to have spread Covid.

But such measures would create the wrong sort of climate.

The best incentives in the current circumstances are positive ones. The idea being floated of a “vaccine passport” that would enable immunised people to experience more freedom in their day-to-day lives might work, though it would immediately create a market in forgeries.

But there is a much simpler way: people should be paid when they get vaccinated.

This would not have to be a vast amount from the government’s perspective. Even £25 per jab would amount to a drop in the ocean in the overall context of what has been spent on Covid. A cash incentive would particularly motivate poorer areas where health in general is a real problem.

Thus we solve the vaccine conundrum not with more doom-mongering scientists on TV, but by delegating the task of persuasion to a local level via GPs, and backing it up with real cash incentives. That is how we will beat Covid-19.

As published in City AM Wednesday 25th November 2020
Image: Vaccine by Pixabay
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