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Problems With Paying People to Be Vaccinated Against COVID-19

JAMA. 2021;325(6):534-535. doi:10.1001/jama.2020.27121

The US Food and Drug Administration has issued Emergency Use Authorization for 2 vaccines for the prevention of coronavirus disease 2019 (COVID-19). This impressive scientific achievement paves the way to ending the pandemic, provided that vaccine uptake is sufficient. While the exact proportion is uncertain, it is likely that more than 75% of the US population will need to be vaccinated for the country to obtain herd immunity.1 Yet surveys have repeatedly shown that many members of the US public are reluctant to be vaccinated, although this may change in the coming months.2 As a result, vaccine uptake may fall short of necessary levels.

Numerous proposals to improve voluntary uptake of COVID-19 vaccines have been advanced. These proposals are often focused on fostering public trust in the vaccine approval process, removing practical barriers to vaccination, and promoting vaccine acceptance through community engagement, identification of trusted leaders, and public health messaging.3 Recently, however, several individuals from across the political spectrum have proposed paying cash incentives for COVID-19 vaccination.

In this Viewpoint, we describe features of 2 payment-for-vaccination proposals that have garnered attention from academics and politicians, outline several important objections, and maintain that payment for vaccination is morally suspect, likely unnecessary, and may be counterproductive.

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