Vaccine incentives must maintain balance between encouragement and ethics: professor

Whether it’s free coffee, free fries, or even a chance to win free tuition, more and more businesses and organizations are coming up with creative ways to encourage Manitobans to get vaccinated.

The province is set to unveil its own vaccine incentive program sometime this week, according to Manitoba Premier Brian Pallister.

“The best way to get Manitoba through this pandemic, to shorten this third wave, is to get needles in arms as fast as we can,” the premier said during a press conference Thursday.

Read more: Can incentives help vaccine hesitancy? Experts say it’s a short-term solution

Michelle Drieger, a professor in the department of community health sciences at the University of Manitoba, says vaccine incentives can be beneficial, but can also pose some ethical challenges.

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“I think it’s really important to kind of take a step back, in a sense that those who have already either received their first dose of their vaccine or they’ve been able to complete their two doses, for them the incentive of having access to vaccine was sufficient,” Driedger said.

“So now we’re talking about what are the different kind of incentives that might be used to convince those who maybe still have the intention of getting the vaccine but maybe won’t make the specific time to do it, and an incentive might be enough of a reason for them to prioritize it right now.”

Driedger says vaccine incentives work well, depending on the scenario, adding that they have worked well in some of the province’s Indigenous communities. But she says the same can’t be said of some vaccine incentives in some of Manitoba’s correctional facilities.

Read more: Manitobans come up with creative ways to incentivize vaccination — but is it necessary?

“With incarceration centres earlier on, there were some that were using ‘if we had 75 per cent acceptance within a particular group, then they would receive incentives,’” Driedger explained. “And that of course created a problem of coercion of some inmates who were maybe not wanting to have a vaccine but then we’re being coerced into doing so by their fellow block mates.”

She says vaccine incentives need to maintain a balance between encouraging people to be vaccinated and staying ethical.

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“Incentives, if they’re going to be used, need to be something that is freely offered based on the action of an individual, not the inaction (of another) or kind of forcing everybody, you know, before they get the incentives, a certain number have to reach that decision.”

She says vaccine incentives also pose other ethical implications.

“If you offer incentives now, what does that mean to all of those people who followed the recommended behaviour of making an appointment and getting a vaccine already,” she said.

“So you now start raising issues of kind of fairness and equity, for people who are now saying ‘maybe I should have waited since incentives are now being introduced. maybe I should have waited.’”

Read more: Majority of Canadians support COVID-19 vaccine passports for concerts, travel: Ipsos

Vaccine passports

Some jurisdictions are considering using vaccine passports to allow people to travel or attend large events, which is another idea that could encourage people to get inoculated. A recent Ipsos poll shows the majority of Canadians are in favour of the idea.

Driedger says that was reflected in some focus groups she has hosted with her students.

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“There was some sense of if [they] need to have a vaccine in order to travel, then any kind of hesitation they had about whether or not to get the vaccine was kind of overwritten by their desire to be able to travel to particular countries,” Driedger said.

“So the incentive of being able to have access to those countries because they were vaccinated was something that was really important to them.”

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When it comes to using vaccine passports to go to concerts or large sporting events, she says there could be challenges with that as well.

“That starts to raise a number of challenges and what kinds of implications it opens up for those individuals [who] have medical reasons for why they can’t be vaccinated,” she said.

“So now they almost have to self-disclose their personal health information because they can’t be vaccinated. So some care and consideration needs to be provided for people who have a legitimate medical exemption, much like we would for any other kind of immunization.”

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