Dear Justin Trudeau: Pay people to take the vaccine

OPINION: Vaccinations are finally going strong. But the costs of falling short of “herd immunity” are huge, and there’s a simple way to help boost our numbers — cash
By John Michael McGrath - Published on May 05, 2021
Prime Minister Justin Trudeau receiving his COVID-19 AstraZeneca vaccination in Ottawa on April 23, 2021. (Adrian Wyld/CP)

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Vaccinations for COVID-19 are finally, truly, lifting off as massive volumes of Pfizer and Moderna vaccines are starting to arrive. By the end of the month, Ontario now projects it will have vaccinated nearly two-thirds of people 18 and over, and the good news on Wednesday that Health Canada has approved the use of the Pfizer vaccine for people 12 and over is an additional reason for hope.

But vaccinating two-thirds of eligible people is unlikely to be enough to do what we all want: end every last public-health measure, let people resume their normal lives (for better and for worse), and get to a time when we can gather with friends in a tightly packed bar and say, “Hey, remember the pandemic? What a weird year THAT was.”

The math is daunting and straightforward. So-called herd immunity is reached after a certain proportion of the population has been immunized such that an infection won’t turn into an outbreak. Whatever we thought the threshold was for Covid Classic (a WHO estimate from last year was between 60 and 70 per cent) has been driven up by the increased transmissibility of variants of concern, which now account for nearly all of Ontario’s new cases, and it could now be above 80 or even 90 per cent. And if our population-wide level of vaccination plateaus before we hit herd immunity, some of our public-health measures might have to be retained for years into the future.

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“We're going to have to live with potentially fewer people in stores and retail spaces," McGill University professor Erin Strumpf told the CBC this week. "We're going to keep wearing masks. We're going to still continue to work from home and maybe some in the office. So it'll be more of a gradual adjustment."

I’ve never hated wearing a mask, and I suspect I’ll wear one again during the next flu season now that I’ve gotten used to it, but we shouldn’t understate what this means: the public-health measures we’ve adopted have brought enormous, world-changing economic costs. The ramifications of keeping even much smaller versions of them in place could be huge.

The costs will get even worse if we end up facing a fourth wave in the fall, as a projection from the Scarsin Corporation suggests is possible. Another wave, and another even partial lockdown, would be only slightly less disruptive than the first three and still massively costly.

So it’s in the interest of everybody — individuals, businesses, and governments — to make sure we do everything we can to ensure that as close to 100 per cent of the population as possible gets a shot and to regard anything less than 100 per cent as a failure.

Most of this will be up to the provinces, either directly or indirectly: they administer vaccine programs, for example, and decide how much leeway to give employers and business operators to inconvenience the unvaccinated. (People who are still angry about the indoor-smoking ban are going to love it when bouncers stop the unvaccinated at the entrance to a club.) Ontario is still debating whether and how to give citizens a vaccination certificate, but officials confirmed this week that the IT capacity is there if government decides to do it.

But there’s a federal role here that goes beyond simply procuring the vaccines. We need both carrots and sticks, and Ottawa has one of the best carrots around: cold, hard cash. It’s a grubby but real fact of the universe that people respond to incentives, and money is a heck of an incentive. A recent article published with the National Bureau of Economic Research in the United States indicates that incentives don’t need to be very large, if they’re working in conjunction with other policies, such as digital outreach and the hiring of local “ambassadors.” New research from UCLA suggests that $100 is enough of a treat to move a large number of people from the vaccine-hesitant camp to the vaccine-gimme one.

To be clear, money on its own isn’t a replacement for other good vaccine policies; it’s just another weapon in our arsenal. But some back-of-the-napkin math suggests the costs would be entirely manageable and the benefits huge. If we paid every single living Canadian $100, that’d add up to roughly $3.8 billion. (That’s assuming that, for fairness’ sake, people who had already been immunized would get the cash and that we’d pay parents to get their kids jabbed.)

It’s unlikely we’d need to pay out the maximal amount, but even that large number is dwarfed by the economic costs of lockdowns: last year, the Financial Accountability Officer estimated that a new lockdown would cost Ontario $11.5 billion, and that’s just one province. We could pay Canadians $100 per dose — $200 for the lucky few who get the single-dose Johnson & Johnson vaccine — and still easily come out ahead if it meant getting the country to herd immunity and ending the threat of new lockdowns for good.

Getting people vaccinated is good policy. Giving people money is popular. Ending this pandemic by getting as many people vaccinated as quickly as possible is the single most important public-policy goal in the country right now. And Ottawa can help press the gas pedal a little bit harder, if Justin Trudeau is willing to get his cheque-writing pen out of the drawer one more time.

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