How many people CAN’T get the vaccine but can still go to work in a large company?
A little relevant levity:
Probably quite a few, depending on the vaccine.
People with a certain type of blood clotting issue should definitely avoid J&J and AstraZenica, but that disorder would not interfere with them otherwise leading a normal life. People with an allergy to PEG should not have Pfizer or Moderna because it could potentially kill them, but that allergy does not otherwise interfere with them leading a normal life. Indeed, a PEG allergy interferes with daily life less than my own allergies do.
There are people undergoing treatment for cancer who are still able to work, but such people often can not get any vaccine during cancer treatment.
“Can’t get the vaccine due to known medical problem” is not an indication of visible disability. Most people with an actual, genuine reasons to not get a covid vaccine are probably not distinguishable from other people just by looking or asking what they do for a living.
An explanation offered on behalf of those who express ethical concern over the offer of a substantial incentive. I do not defend it, merely share it.
https://jamanetwork.com/journals/jama/fullarticle/2775005
Broadly the concept is that every medical choice has some individual risk and benefit and some societal benefit. The calculation may be a very solid in favor one but there is still a risk. An incentive like this one is disproportionately more powerful, even coercive, to those who need the money more, pushing the more in need to do something of societal benefit and sparing the wealthier from a similar obligation.
Thank you for that.
Interesting article, and it’s good to see actual arguments presented opposing financial incentives for vaccination.
However, I’m not persuaded.
From the article:
Yet payment-for-vaccination proposals are not only unnecessary. . .
This is simply an assertion, without backup. As of now, it looks like we are not, in fact, able to get to where we need to be without carrots or sticks.
[P]eople have a moral duty to be vaccinated, including a duty to promote their own health, a duty to others to promote the community benefit of vaccination, and a duty to society for individuals to do their fair share in putting a stop to the pandemic.
I could not agree more. Hence my comment above that I’d be happy to see vaccines administered at gunpoint. That was a bit facetious, of course, but my point was that we, collectively, would be justified in requiring vaccination, and not just for COVID (as we do now for, for example, enrolling one’s children in public school).
Being vaccinated in order to receive a $1000 or $1500 incentive robs the act of moral significance.
To which I say, so what? This argument is reminiscent of those religious conservatives who will reluctantly concede that their faith requires them to care for the poor, but who insist that any government programs that are funded by taxation are robbing their (presumed) charity of moral significance, and thus cannot be justified. It’s just a bullshit argument against paying the cost of living in a large and complex society.
It is likely that a majority of the population will be eager to get vaccinated as soon as possible in view of the extremely high and increasing number of SARS-CoV-2 infections and COVID-19–related hospitalizations and deaths.
Two things – first, a “majority” isn’t enough. The authors themselves concede that we need “more than 75% of the US population will need to be vaccinated for the country to obtain herd immunity.” And second, well, obviously, the statement doesn’t seem to be borne out by the facts. Vaccine resistance is frighteningly high. Common sense has been simply rejected (as “fake”) by a significant percentage of the population.
Moreover, some of the documented reluctance may naturally dissipate as individuals observe others—trusted figures such as Anthony Fauci, MD, nationally prominent politicians, and even their own clinicians—being vaccinated without adverse health effects and as reports of vaccine-related adverse effects remain quite rare.
What “trusted figures”? Fauci is not trusted by those who resist vaccination. He’s actually demonized. There are no “trusted figures.” Trust is earned by agreeing with the resisters.
Also, parenthetically and somewhat (unfortunately) amusingly, I can walk around Brooklyn and hear sidewalk preachers of non-mainstream faiths shouting “trust Farrakhan, not Fauci!” I mean, that’s funny, but it’s not funny. And that’s where we’re at. Farrakhan may be replaced by Tucker Carlson or Alex Jones, depending on who the denialist is listing to.
Third, some might feel that a substantial monetary incentive for vaccination is coercive.
I’m not so sure that offering an incentive is “coercive,” but even if it is, I say so what? This is a relatively benign form of coercion. Real coercion would be the denial of any form of public benefit, including SNAP, Social Security, Section 8 benefits, and even public education, to the unvaccinated.
Rather, cash incentives might reasonably be expected to heighten these apprehensions or raise new ones, as offers of payment are often understood to signal that a behavior is undesirable or risky.
This is true. But we’re in a bad situation. We have to do something.
A policy of paying people for COVID-19 vaccination should be adopted only as a last resort if voluntary vaccine uptake proves insufficient to promote herd immunity within a reasonable period of time.
This is also true. But we’re there now. The “reasonable period of time” is running out. It’s time for last resorts.
I think that the thought process that this driving your wife, and barring Pinchesters plausible alternative explanation, those of her colleagues, is that it medical ethics it is generally viewed as a very bad idea to insert financial considerations into personal health decisions.
The key concept in clinical trials is, informed, non-coercive consent. When designing a clinical trial you want to make sure that everyone is informed and the that cost benefit analysis is purely based on their health and their own personal ethical considerations, not on how much they can afford. The only exceptions are purely routine medical procedures with no effect on the health of the patient (such as blood draws). For someone trained in that culture paying people to take a vaccine instantly sets off red flags.
Note this is not necessarily my view in the current situation but just a possible explanation of where the nay side may be coming from.
Um, Liz Cheney voted with the Trumplicans 93% of the time during the last four years. While I applaud her current efforts, I would not put her anywhere close to the level of sanity exhibited by Larry Hogan.
I don’t know if this is actually the case, but another way I can see there being ethical concerns with a cash-for-vaccine program is if it actually causes people to be less likely to get the vaccine (either people who are offered the deal but get more resistant because they perceive it as coercion, or people who aren’t currently eligible for the deal – like, say, employees of another company who have heard about it and decide to hold out until their employer offers a similar program). I don’t know enough about how people react to cash incentives to know if this is a significant concern, but it doesn’t seem like a totally crazy one.
The argument emphasizes the class inequality of the coercion. This kind of incentive is not coercive to someone of upper SES but is potentially very coercive to someone who needs it to make rent or get the food on the table. This is a bigger deal the more the need for the coercion is societal greater good and the lower risk for disease complications the individual coerced is.
To me the argument fails most the less significant the incentive is. The bigger it is relative to the needs of the individual the dicier the ethics potentially get.
I think it’s a great idea to pay folks to get vaccinated, and I’d further suggest cutting the $300 award by $25 each week until it’s claimed (after 1-month scheduling period).
You get the full amount for getting vaccinated NOW, not whenever you get around to it. The scheduling website is acting wonky? Re-check it twice a day and get tech support on the horn. Time’s a wasting, best be compliant and proactive.
Two firms with an average annual salary of $30,000.
Firm A gives each immunized employee $300.
B, concerned with coercion equality, gives each immunized employee 1 percent of salary.
I prefer A, but, then, I’m a bit old fashioned.
(Actually, I prefer C, which is that they open a short midterm negotiation with the unions on how to distribute, but that may be impossibly old fashioned.)
I would say that they misunderstood the ethical concern argument.
Put it this way - one person A who hasn’t eaten in days versus one B who has just had a large good meal. Offering A a cheap cheeseburger to do something might be considered coercive but offering B 100 cheeseburgers, or even a steak cooked in rare expensive truffles with a glass of expensive wine would not.
Again I do not think the argument applies at all to a $300 incentive assuming the company otherwise minimally pays living wage.
Of course there’s class inequality in offering a financial incentive to get vaccinated. It’s undeniable. There are a huge number of people to whom a few hundred bucks, or a thousand bucks, means nothing. And a significantly larger number of people who whom it will mean a lot. That is true, although I’m still not convinced that offering a financial incentive to those people is “coercion.” I mean, when my firm offers to give me a Fitbit if I participate in the company’s wellness program, am I being coerced? Is the person who works in the mailroom, who probably makes maybe a bit more than half what I make, being coerced into joining the program?
It is also true that we, all of us, desperately need to get vaccination levels up over a certain point to put this pandemic behind us. And we’re not getting there. And it looks like we might never get there, if we just keep doing what we’re doing now.
So I’m unwilling to put some abstract idea of treating all classes equally ahead of getting everyone vaccinated.
There’s so much coercion of lower-income people going on, every minute of every day, that does not benefit society in any way, that this truly mild form of coercion, if it’s even coercion, doesn’t bother me in the least.
I’m reminded of a very minor little controversy that arose decades ago, when New York City was moving away from using tokens to ride on the subway or buses, to the current, vastly better, MetroCard system.
The proposal was that MetroCards could be purchased for single rides, or a certain number of rides, or for a period of time, meaning one could buy a MetroCard good for an unlimited number of rides for a month. The cost of an unlimited monthly card was significantly less than the cost of paying for each ride individually (assuming one commuted to work every day, and maybe took a few rides on weekends).
Some critics said that this was unfair to poorer New Yorkers, since it would be harder for them to come up with the cost of a monthly card every month.
This criticism was rejected, of course. For one thing, poor people benefit more from a discounted subway fair than those with higher incomes, who (a) don’t need the break, and (b) are more likely to take cabs or cars than lower-income people. Yes, it’s harder to come up with $127.00 (the current cost of a monthly MetroCard) than $3.00 (the cost of a single ride ticket). But the benefits of the monthly card are obvious.
The point being that in that case, exactly as in the case of incentivizing vaccines, the benefits outweigh the downsides of the disparate treatment of socioeconomic classes.
Afterthought:
The alternative to incentivization is real coercion.
We could require vaccination. We could require it, as I said above, at gunpoint. I wasn’t entirely serious, but we could do that.
That would be real coercion. And it would affect all classes, at all income levels, equally. The rich denialist would be coerced just as much as the poor denialist.
Is that preferable to an incentive?
That brings up the related real world ethical issue of ends justifying the means, most good for most people. And that is a very real discussion and real world that abstract ideals sometimes are a luxury. Many are very committed to things like equality … in theory.
While at gunpoint is a bit absurdist, the basic premise is IMHO ethically preferable. A requirement to work for this company is proof of immunization or documentation of medical exemption. It applies to the minimal wage workers and to the C suite and all other levels equally.
I personally don’t see a thing wrong with “bribing” people to get the vaccine. Not sure what the smoking question is though, smokers have paid higher life insurance rates for years so I don’t see how that’s any kind of controversy.
A friend visited Spain in the 70s, and there’s was an outbreak of, iirc, cholera. The army literally lined up everyone at gunpoint and vaccinated them. My friend and his family included.
Well, maybe they didn’t need to actually point the guns, because everyone knew what would happen if they refused to be vaccinated. Still, it’s not absurd, it’s something that has been done, and may be done in some places in this pandemic, should governments get hold of enough vaccine to do so.
I said this above, but didn’t get any response. Maybe i didn’t make the argument clearly enough: given that healthy young people often are sick enough to lose a day’s wages from the vaccine, and are at relatively low risk from covid, it seems to me that is not coercive, but “making them whole” to offer cash payments to young people eligible for the vaccine who earn little enough that $300 is a big deal.
Sure but in this case we’re talking about employees. If they are struggling to put food on the table such that their hand is forced on the vaccine, then that is the thing to get outraged about here. Why should society pay the food stamps of your employees just so you can cut costs?