Vaccine policies that are ineffective and unethical

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You report that several governments have been offering cash incentives, lotteries or gifts to citizens who opt to get vaccinated (Savings bonds, lotteries and cheap food: do vaccine incentives work?, 3 August). However, there is evidence that offering incentives may discourage vaccination – particularly among those most concerned about adverse effects.

Behavioural research confirms that paying people to perform altruistic actions often backfires. For example, because paying blood donors breaks social norms about voluntary contribution, it can substantially reduce the numbers willing to donate. People collecting charitable donations invest more effort and raise more money when not paid than when paid a small commission.

Vaccination payments rob the act of its moral significance: offering incentives undermines intrinsic motivation and messaging emphasising the selfless goal of helping others – and may be too little to motivate selfishly. Behavioural research also shows that payments can signal that an action is undesirable, unpleasant or risky, and not worth taking based purely on personal benefit.

A number of studies have shown no positive effects of incentives on Covid-19 vaccination, yet the risk of incentives strengthening opposition to the vaccine is real. Policies to promote vaccination should be justified by behavioural evidence of their efficacy and any unintended consequences.
Prof Peter Ayton
Director, Centre for Decision Research, Leeds University Business School

It feels deeply wrong to pay people to be vaccinated (Johnson’s scapegoating of young people over Covid jabs is not a wise tactic, 1 August). Vaccination is the litmus test of social responsibility. To commodify social relations by offering payments to fulfil them would be another triumph for the rabid variant of capitalism that Larry Elliott wrote about previously (During the pandemic, a new variant of capitalism has emerged, 30 July).

These payments would reward bad behaviour and make those young people who have done the right thing look like mugs. The prospect of payments will probably stall those who might have come forward but will now await the possibility of a financial reward. Payments for vaccination might seem pragmatic, but the longer-term consequences will be dire. Ask people who contracted HIV from contaminated blood about the unforeseen consequences of the commodification of health – in that case, blood products sold by US prisoners rather than gifted by UK citizens.
Prof Mark Doel

I am shocked that we are choosing to vaccinate 16- and 17-year-olds while elderly populations worldwide are at risk (UK faces difficult choices on future Covid vaccination strategy, 5 August). I am 16 years old, so I am part of the affected age group.

I am not anti-vaccination. We do not yet have herd immunity; 70% of people have had at least one jab in the UK. Only 30% have had at least one jab worldwide. In some countries, such as Afghanistan, only 2% have received at least one jab.

We are vaccinating low-risk populations in the UK while people in their 70s and 80s are at risk worldwide. Why not stop vaccinating healthy kids and, instead, help those who need it most? Many countries lack infrastructure and require help. These places cannot buy enough vaccines and need help with administration. Let’s help the vulnerable in other countries to keep Covid deaths to a minimum.

If we fully vaccinate the UK, we might create a Covid-free bubble. This could lead to complacency; if we get a vaccine-resistant strain from a country such as South Sudan where almost no one is vaccinated, our complacent fairytale bubble could burst and cause devastation. This happened in Taiwan and Australia when they became complacent.

If we have a decent vaccination rate worldwide instead of an extremely high rate in a few countries, there will be fewer infections and deaths. This will reduce the risk of mutations that could undo all our work.

Let’s put Covid-19 in the same history book as smallpox. This can only happen if we think of others, not just our kids.
Isaac Ohringer

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