Employees at JBS Meat Processors receive a $100 bonus to get vaccinated against COVID-19. The Lidl grocery chain offer $200 to employees who are vaccinated. Trader Joe’s offers employees two hours pay per dose of vaccine. In the town of Acworth, Georgia, $200 gift cards waiting for city workers who can prove they have received the vaccination.
Offering financial incentives to unvaccinated people provides a visibly dramatic demonstration of the importance of moving to that 90% vaccination rate where herd immunity stops the spread of the COVID virus.
But as Arthur Caplan, a prominent American bioethicist said in an interview with the Today Show“If you’re paying people to get vaccinated, the strong implication is that it’s not safe, there’s something wrong, you have to use money to persuade them.”
Resorting to paying people for free, scientifically proven vaccinations to protect against serious illness, hospitalization and death, is curious, even staggering, given that vaccination is in the vital interests of those who receive it – so than of all those who meet the vaccinated. And Caplan is right: Paying people to get vaccinated is a bad idea if it sends a misleading and false message about safety.
But a bigger problem is that money for vaccine participation obscures a moral obligation. In times of pandemic, vaccination imposes the duty to take care of oneself and not to burden others with preventable illness and death. When vaccination is presented as a way to promote the good of others, we are in golden rule territory – ethics 101.
Our moral obligation to get vaccinated involves civic duties. Getting vaccinated is how, in the midst of a dangerous pandemic, citizens act for the good of their neighbors, society at large, and even the global community. Unvaccinated people expose themselves and others to the spread of disease, hospitalizations and even death, defying the obligation to protect life and advance the common good.
This is where the idea of “paying people to get vaccinated” kicks in. It is the choice not to be vaccinated that should have a cost. Rather than paying people to get vaccinated, those who refuse vaccination should be seen as indebted to society. What needs to be thought about are the means by which the unvaccinated can fulfill this obligation.
Putting aside the political motivations to consider more noble logics, the refusals of vaccination invoke as a general justification the individual conscience. The US legal system provides such exemptions. The model that should be used to think about this relates to other citizenship obligations.
For example, when America still had conscription for military service, thousands of young men resisted conscription for reasons of conscience, and many of them took up alternative service, working as doctors or in rehabilitation centers rather than carrying a gun in the Vietnamese jungles. These conscientious objectors have not been exempted from their citizenship obligation, and the citizenship obligation has not disappeared. Rather, the obligation has changed to reflect conscience.
In the current COVID crisis, conscientious anti-vaxxers have not been asked to undertake an equivalent route of “alternative service” to meet citizenship obligations. The question that needs to be asked is therefore: how can those who refuse vaccination fulfill the obligation of citizenship that is incumbent on all citizens because of the pandemic? It is not fair that non-vaxxers enjoy the potential benefits of herd immunity by refusing their obligation while others have satisfied it through vaccination. Without the possibility of fulfilling their obligation with an alternative to vaccination, they fall into the category of “free riders”, unfairly taking advantage of an advantage they have not earned. What is needed is an acceptable alternative to vaccination that would satisfy the citizenship requirement.
A monetary penalty is perhaps the easiest option to consider. Rather than paying people to get vaccinated, unvaccinated people should pay to meet the citizenship obligation they continue to have. The unvaccinated should, in the interests of fairness, bear a financial burden as the moral equivalent of vaccination; an “alternative service” option much like those in our country’s history who have sought exemptions from military service through conscientious objection.
More difficult options could include hospital triage policies that would allow a vaccinated person to take the bed of an unvaccinated person if there were no more beds available. It might pass a fairness test, but it would be excruciating for healthcare workers to adopt such a triage policy. Such options should be discussed, however, and the discussions themselves could inspire increases in vaccination as they dramatically highlight the severity of the pandemic.
Whatever options are considered, emphasis must be placed on the fact that vaccination is a civic obligation, which people must accept not only for their own well-being but also for that of others. The plea for exemption from vaccination should be met by a compulsory option for “alternative service”, a burden comparable to that accepted by conscientious objectors who have refused military service.
Imposing such a mandate will weed out potential free riders and fulfill an obligation that in times of pandemic all people owe to each other in the interest of justice.
Lloyd Steffen is a professor of religious studies and university chaplain at Lehigh University. His most recent book is “Violence and Christianity” (Cambridge 2021).