Anti-Vaxxers: Make ’em Pay

8/3/21

I’ve been trying to understand the rationale underlying people’s decision not to take a Covid-19 vaccination; and I can’t — except possibly for a tiny portion of the population of those eligible. I had been under the impression that anyone with a compromised immune system might legitimately be wary of the vaccine and elect to pass on it; but that caution may be overstated if I am to believe the CDC’s website.

Although I’m quite sure that some readers will dismiss the CDC guidance out of hand, I’m ready to ignore those partisans’ inclinations. Admittedly, the CDC’s messaging had been tainted during the last administration, but I believe those days are over (thankfully) and that science is again driving the agency’s pronouncements.

The CDC admits to a lack of data and hence some degree of uncertainty in connection with the vaccines’ effects in these four circumstances:

· Those with weakened immune systems

· People who have had autoimmune conditions

· People who have had Guillain-Barre syndrome

· People who have had Bell’s palsy

But even in these instances, the CDC guidance never advises against getting the vaccine. It’s not that the vaccines necessarily pose a danger, but rather, the effects or effectiveness of the vaccines haven’t been reliably assessed. We just don’t know how well they would perform, or more to the point, whether the vaccines would be more dangerous than would be the danger of actually contracting the virus. The CDC is agnostic about this critical question and defers to the authority of individuals’ trusted healthcare providers.

I don’t mean to be cavalier about the decision that anyone in the above categories would be facing, but the conclusion that not taking the vaccine is necessarily the rational choice is questionable. Given the scale of deaths and discomfort that have been brought on by this virus, and the fact that such outcomes are overwhelmingly occurring in the non-vaccinated population, hesitancy to line up for the vaccine seems to me to be more prevalent than I would expect.

My real gripe (no surprise) is with the political partisans who see it as their right to remain unvaccinated irrespective of the consequences for the rest of us. Appreciating that kids under 12, among others, are ineligible for vaccination and as a result are vulnerable to infection, I find the indifference to the public health concerns exhibited by the anti-vaxxers to be indefensible — and despicable. These actors of “principle” should bear consequences for their decisions.

I believe the appropriate policy action to take is to mandate vaccination for all but those who fall in the categories of uncertainty listed above. The “out” for truly committed non-vaxxer should be requiring testing as frequently as once or twice a week. Moreover, those who elect to be tested instead of vaccinated should pay the out-of-pocket cost of testing — every time. Beyond that, I’d like to require those who opt out of the vaccine to bear at least some of the cost of covid-related health care expenses they end up requiring.

This second category of cost sharing could take the form of some means-tested obligatory deductible feature on their health insurance — whether private or public — that would apply only to the non-vaccinated. It shouldn’t be so much as to wipe them out, financially, but it should be enough to serve as a genuine incentive to get on the vaccination bandwagon.

If people want to exercise their “freedom to choose,” at a minimum they should be prepared to cover some portion of the direct costs of their decision. Expecting the public at large or the US taxpayer to bear costs that derive in large measure from people who willfully disregard the public health hazards of this virus is asking too much. Let them pay for their convictions that put the rest of us at risk.

The Biden administration has recently suggested the carrot of a $100 inducement to get the unvaccinated to roll up their sleeves. It’s time now to complement that policy by introducing the stick. Make the anti-vaxxers put their money where their mouths are. Let’s not kid ourselves: Lives depend on it.

Kawaller holds a Ph.D. in economics from Purdue University.