The race for a safe and effective coronavirus vaccine appears to be bearing fruit nine months into a pandemic that has killed over 257,000 Americans, wrecked the US economy, and dealt a ferocious blow to Hispanic and Black communities suffering higher death rates and job losses.
The nation, though, may be nearing an important juncture in the pandemic as new virus cases rise unchecked. Two vaccines could get emergency OKs from regulators in December, paving the way for them to be injected into upper arms next month. Top US health officials have said about 20 million people in the US could get coronavirus vaccines if both are authorized.
Yet another roadblock is appearing on the horizon: a substantial share of the public is reluctant to get a COVID-19 vaccine, the fastest ever developed.
A recent poll from Gallup showed that around 42% of Americans say they wouldn’t get a shot right away, only a small drop from October. Other polls in the last few months suggested distrust of a vaccine regardless of political ideology. That skepticism tends to run deeper among Black and Hispanic Americans, surveys show.
Robert Litan, a non-resident senior fellow at the Brookings Institution who served in the Bill Clinton administration, designed a plan to encourage more people to take it: A $1,000 payment. It’s an amount comparable to the millions of stimulus checks sent to Americans earlier this year under a federal rescue package.
Support from unlikely figures
The novel proposal comes as the US confronts a daunting set of challenges in the coming months. Public health officials are scrambling to set up the infrastructure to deliver a vaccine to essential workers and other vulnerable populations — and experts are weighing ways to boost uptake in a polarizing political environment.
The payments are drawing support from an unlikely arrangement of figures. N. Gregory Mankiw, a former top economic advisor to President George W. Bush, backs it. Then John Delaney, a former 2020 Democratic presidential candidate, said he favored it as well. He pitched paying people a larger sum of $1,500.
“Money would go into Americans’ pockets just when the US economy can begin fully reopening with a vaccinated population that can go about their daily lives without fear of catching the disease or infecting others,” Delaney wrote in a Washington Post op-ed on Monday.
Litan argues that a financial incentive to encourage shots would help the US reach herd immunity faster, saving lives. He said it could also serve as a critical boost for many households strapped for cash because Congress has not passed another coronavirus relief package since the spring.
“Unlike previous payments, this is stimulus tied to socially responsible behavior. So society is getting a benefit from handing out the money,” he told Business Insider.
Litan’s plan includes a $200 upfront payment for individuals, with the last $800 distributed when a 70% vaccination rate threshold is crossed at the state level. Such a program would cost $265 billion, per his estimate.
He said it was a small price to pay compared to the ruinous cost of the pandemic on lives and businesses, which one recent economic study in the Journal of the American Medical Association estimated at $16 trillion.
“If we somehow don’t get to true immunity, our economy will be operating with a huge weight on its chest,” Litan said. “We won’t get back to normal.”
‘Some serious challenges’
The US doesn’t pay people to get vaccinated. Instead, states generally enforce vaccination requirements for children in K-12 schools, though some allow exceptions on religious grounds. For adults, federal standards state that employers can mandate workers to get the flu shot, but employees have the right to seek a religious or medical exemption.
Business Insider recently surveyed six economists spanning the political spectrum to collect their thoughts on the vaccine payment proposal. The group was evenly divided between both conservative and liberal experts that served past presidents and lawmakers in Congress. They included:
- Jason Furman, former top economist to President Barack Obama and now a Harvard professor.
- Sherry Glied, healthcare economist and dean of New York University’s Robert F. Wagner Graduate School of Public Service.
- Gbenga Ajilore, senior economist at the liberal-leaning Center for American Progress.
- Scott Winship, director of poverty studies at the conservative American Enterprise Institute.
- Brian Riedl, senior fellow at the right-leaning Manhattan Institute.
- Stephen Moore, an outside economic advisor to President Donald Trump.
The plan drew support from only one economist in the survey. Ajilore said he backed it but preferred to pay only up to $500 and encourage skeptical people to get a vaccine.
Others said there were hurdles to implement it. “I think the plan has some serious challenges,” Glied told Business Insider in an interview.
While Glied said the payments were worth considering, she argued other longstanding public health measures could be better at increasing takeup of the vaccine. Glied said schools and universities have long mandated students be vaccinated for diseases like measles and polio — and suggested private businesses like bars and restaurants could do the same with a coronavirus vaccine.
She also raised possible ethical concerns which were echoed by others in the survey. “I would be really worried that if you’re paying people for this thing, you’re saying it’s risky and it doesn’t work very well,” Glied said.
“There’s an issue of whether it sets a dangerous precedent for government to take advantage of low-income families by paying them to do things with their bodies,” Riedl said.
Litan pushed back against the criticism: “I think now there’s enough trust in the process that the FDA is going to do the right thing and that risk is diminished.”
“It’s not as if we’re paying people to jump off a bridge,” he said. “We’re asking people to do something that will almost certainly get government approval and is going to be endorsed by Dr. Fauci.”
Others like Winship argued a federal payment program could undercut the effectiveness of future public health campaigns and cause their price tags to swell.
“Once you commit publicly to paying people $1,000 to get vaccinated, it becomes something everyone’s gonna want,” Winship told Business Insider. “There’s no reason to get vaccinated without getting $1,000. I think it ends up being really expensive.
A cash incentive could motivate a portion of the public to get the shot. A Harris poll conducted this month found 39% would want a vaccine even if the government did not offer any money, Bloomberg reported. But 23% said they would not want a shot even if they were paid for it.
It’s unclear whether a vaccination payment plan will gain more traction among lawmakers debating another federal rescue package. But it represents a potential opportunity to kickstart efforts at shaping what a nationwide vaccination campaign should resemble — and whether federal cash to individuals should play any part.
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