Recently, President Joe Biden of the United States called on state and local government officials to offer residents up to one hundred dollars in cash payments as an incentive to receive a COVID-19 vaccine. This latest vaccine push has arisen as numbers of infected coronavirus cases in the U.S. begin to spike once again due to the highly contagious delta variant. In fact, New York City announced payments of $100 to anyone who goes to a government-administered vaccination sites to receive their first dose of the vaccine.
While these cash incentives which began in Serbia may seem like an attractive solution to address vaccine hesitancy especially in population groups that have recorded very low levels of vaccine uptake, this strategy could ultimately reinforce the narratives and conspiracy theories perpetuated by vaccine hesitant ‘anti-vaxxers’.
Fears about the consequences of unbridled spread of the delta variant with similar impact on health systems as experienced during the early phases of the pandemic have spurred desperate attempts to increase the numbers of vaccinated. However, top behavioural scientists are concerned that paying people to vaccinate could increase scepticism about the vaccines. In addition, there are ethical concerns about the morality, fairness, and equity of such incentives.
At the heart of vaccine hesitancy is a distrust of government and constituted authority. Therefore, resorting to paying people to receive vaccines as contentious as those for COVID-19 could feed the narrative that there are ulterior motives behind the vaccination campaign. After all, it is known that “There is no such thing as a free lunch”. These cash payments may end up being the “gift horse that is looked in the mouth”.
No matter how desirable the short-term effects of this strategy may seem, breaking down the barriers of vaccine hesitancy and distrust cannot be dissociated from community-led advocacy and health education.