Is a shot at prize a shot in the arm for vaccine?

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This article was published 25/04/2021 (1243 days ago), so information in it may no longer be current.

In the scramble to reach herd immunity and return to normal life, some communities and organizations have offered incentives in an effort to persuade some people to roll up their sleeves for a COVID-19 vaccine.

Personal-care homes in Winnipeg have held prize draws. Cross Lake and Peguis First Nations have done the same.

Peguis Chief Glenn Hudson doesn’t know whether to credit the incentive or overall enthusiasm for the vaccine effort, but he said Friday that 55 per cent of the reserve’s population has had a shot and the community has used all of its available supply.

“Now that the upside of Wave 3 is here, I think they’re taking it a lot more seriously,” said Hudson.

Door prizes aren’t uncommon at special events in First Nations communities, said Denise Bear, who works at the Peguis Health Centre.

“That’s nothing new,” she said.

Recently, provincial jails offered a bag of chips, a bottle of pop, a chocolate bar, a 15-minute phone call to family and a meat and cheese tray to share among any unit reaching 90 per cent of inmates vaccinated. The results were disastrous. Anger toward hesitant inmates at Headingley Correction Centre ended in at least one beating and the suspected intimidation of three others.

Regardless of the apparent success or failure of vaccination incentives, they raise many questions.

“First of all, you need to know what the problem is,” said Arthur Schafer, a bioethicist and founding director of the University of Manitoba’s Centre for Professional and Applied Ethics.

The goal of a vaccination program is to immunize enough people in any given community to reach herd immunity. Before considering incentives for getting a shot, Schafer said, you need to know if vaccine hesitancy — or vaccine hostility, which he considers a separate issue — threatens a population’s ability to reach that critical point.

It’s unknown what percentage of people must be vaccinated to reach herd immunity for COVID-19, according to the World Health Organization. Estimates range anywhere from 60 to 90 per cent.

For context, it takes about 80 per cent of the population to be vaccinated against polio. The threshold is near 95 per cent for measles.

If the results of a recent Doctors Manitoba survey are accurate, reaching COVID-19 herd immunity is going to be a challenge. It found 26 per cent of adults are hesitant about the vaccine. The 74 per cent remainder becomes all the more ominous, because adults comprise just 57 per cent of the province’s population; Manitobans under the age of 18 aren’t yet eligible for the vaccine.

Incentive programs may not strike the core of hesitancy, said Schafer. After all, a number of “intrinsic incentives” already exist: it protects you from a harmful and potentially fatal virus, it protects your family and friends and if herd immunity is achieved, it allows public-health officials to lift restrictions.

“The two main problems are access and trust,” he said.

Obstacles to vaccination will likely cause fewer people to get vaccinated, he said.

Three Winnipeg neighbourhoods — Downtown East, Inkster East and Point Douglas South — had barriers to vaccination removed Friday. The province announced residents and some workers in these areas are now eligible.

“We’re all really excited about it,” said Greg MacPherson, executive director at West Broadway Community Organization, which is in the Downtown East neighbourhood.

“This is a great chance to get a lot of people who have other barriers in their life a chance to get vaccinated,” he said.

The organization has been working with other community groups to figure out how to get services to the people they serve, most of whom are without private vehicles, he said, so accessibility is crucial. He said he’d like to see local vaccination sites.

In Vancouver’s Downtown Eastside, the nucleus of Canada’s struggles with the brutal P.1 COVID-19 variant, Guy Felicella, peer adviser at Vancouver Coastal Health, has been working to make vaccinations more accessible to his area’s population.

“What we’ve found early on was a lot of people have major challenges with poverty and substance-use disorders and homelessness,” he said. “So asking them to come to our clinic would be rather challenging.”

Instead, his organization set up clinics at a high-traffic intersection and offered on-the-spot vaccinations. Felicella said the increased accessibility has proved an “extremely successful” tactic.

People who roll up their sleeves are offered $5 to get an injection, but he doesn’t believe it played a major part in the overall success rate.

“There were some people that didn’t even take the five bucks,” he said. “They didn’t want it.”

Vancouver’s Downtown Eastside and Winnipeg’s West Broadway area have a similar demographic of low-income workers.

When they have to book time off and face the prospect of lost wages, there’s a disincentive to get a shot, Schafer said. That’s a big concern, because low-income workers may be more likely to be exposed to the virus at their jobs.

That’s why the provincial or federal government should require employers to offer paid time off to get the vaccine, similar to how employers must provide time off to vote in elections.

The other big issue is trust, said Schafer. The long and dubious histories of many “Big Pharma” companies may have eroded trust in the drugs they produce, he said. A national production site for vaccines, which Canada lacks, he said, could help people get beyond their hesitancy by eliminating companies they feel they can’t trust.

fpcity@freepress.mb.ca