MOSCOW (Pakistan Point News / Sputnik - 27th November, 2020) Offering financial incentives will likely be more effective than introducing vaccine mandates, when dealing with people who are hesitant to accept new COVID-19 vaccines over safety and benefit concerns, public health experts told Sputnik.
A number of pharmaceutical companies, including Pfizer, Moderna and AstraZeneca, have released promising results of their COVID-19 vaccine candidates in recent weeks. Once the vaccine candidates receive official approval, which are expected to arrive as soon as December in some countries, the new vaccines could become critical in ending the devastating global pandemic that has infected over 60 million people and killed over 1.4 million worldwide.
However, authorities around the world faced challenges in containing local COVID-19 outbreaks largely because a sizable number of local residents were dismissive of the dangers of the new coronavirus and refused to wear masks or follow social distancing guidelines. The same group of people are also likely to be skeptical of the safety of new COVID-19 vaccines and might raise questions if they are nudged to take a vaccine shot for a disease that they believed presented low health risks.
Many of those who question the seriousness of COVID-19 are young adults who indeed face low health risks personally, as the infection fatality rate among those under the age of 45 stood around 0.068 percent according to a recent study based on data from 34 countries and regions.
In order to convince the young adults who face less personal risks from COVID-19 infection to take a vaccine shot for the sake of protecting those who are more vulnerable, offering them incentives could be much more effective than introducing a mandate to force them to comply, public health experts suggested.
"I have argued one alternative we haven't considered is payment. There are many arguments to favor incentives like payment over mandates. One incentive could be an immunity passport that allows you to travel, socialize, not wear masks, return to workplace, etc.," Professor Julian Savulesu, the lead researcher of the Oxford Martin Program on Collective Responsibility for Infectious Disease, told Sputnik.
The expert explained why payment would be a fair option for young people who face less personal health risks from COVID-19.
"Payment. It changes people's behavior. Young people are doing a job: protecting old people. Pay them and pay them fairly. That means taking into account the time, risks and compensating for any harm," he said.
The expert illustrated how the incentives could work for young people.
"You could pay cash or kind. For example, giving greater freedoms such as movement or association. You could give tax breaks, release from social or military service, etc. It hasn't been used in vaccination, although the Australian 'No Jab, No Pay' [where you only get child benefits if you vaccinate] has been described as an incentive scheme. It is effective," he said.
Other public health experts suggested that authorities could also try to convince young people to take a jab of new COVID-19 vaccines as a way for the society to reopen and return to normal life.
"Ethical arguments really only work on people who are about ethics. If a person really doesn't care about other people, it's not going to work at all. I would go for the economics argument that if you want your life back and you want your economy back, (you need to take a jab). For example in Canada, you can't really go for a lunch or a beer, everything is restricted," Kerry Bowman, a bioethicist at the University of Toronto in Canada, told Sputnik.
According to the most recent survey from Ipsos on people's attitude towards COVID-19 vaccines in 15 countries, the expressed intent to take a vaccine shot when it becomes available has fallen from 77 percent in August to 73 percent in October.
Countries where locals have the lowest intent to get a COVID-19 vaccine were France (54 percent), the United States (64 percent), Spain (64 percent), Italy (65 percent), South Africa (68 percent), Japan (69 percent), and Germany (69 percent).
Professor Savulesu warned that vaccine hesitancy could hinder the goal of reaching herd immunity against COVID-19 through vaccination.
"Estimates put vaccine hesitancy at about 50% in some parts of the world. If that is what happens, we may not achieve herd immunity," he said.
The shortened development time of COVID-19 vaccines could be a main reason why people may have doubts about how safe the new vaccines are, the expert pointed out.
"It may be difficult to convince people to take the vaccine. A decade of work has been compressed into less than a year," he said.
Professor Bowman stressed that transparency of the data related to new COVID-19 vaccines would be the key to gain trust from the public.
"First, I'm a pro-vaccine person. I want to be clear on that. However, we really don't have all the data on many of those new vaccines yet. The data seems to exist, but we're mostly dealing with press releases from pharmaceutical companies. One of the first steps we need to avoid vaccine hesitancy is in fact to have open information. Here is the challenge: when you start to say the risks of the vaccines are minimal or next to nothing, and the benefits are big. Well, we haven't really seen the data yet. It's very hard to reassure the public if the data is not openly available," he said.
The expert believed the pharmaceutical companies would release relevant data in the next few weeks to address public concerns.
Other legal experts pointed out that previous incidents of pharmaceutical companies mishandling clinical trial data on drugs and vaccines could also undermine public trust.
"I think that it is clear that the global future of vaccines is at stake in the next few years. The danger is that drug regulatory authorities will fail to evaluate the vaccine properly and that pharmaceutical companies will not make a full disclosure of clinical trial data," Peter Drahos, professor of law and governance in the Law Department at the European University Institute, told Sputnik.
The expert detailed a recent case where a pharmaceutical company made such a mistake. A report of the Cochrane review that was published in 2014 on oseltamivir found that Roche hid much of the data that showed oseltamivir was not effective, the analyst said.
"Governments around the world spent billions of Dollars stockpiling a drug against avian influenza that was no more effective than aspirin. The Cochrane Review recommended that a panel independent of regulators be set up to evaluate drug treatments in pandemic situations. In short, if governments want to win the trust of public around the world they will have set up a second level of screening that is independent of the drug registration authorities. Trusting in regulators and pharmaceutical companies alone could well be a fatal mistake," he said.
The expert stressed that authorities should focus on winning public trust through procedures of independent evaluation and the public tabling of data.
