Thursday, September 09, 2021

Opinion: Nobody wins when Alberta plays games with COVID vaccines

Author of the article: Amy Kaler
Publishing date: Sep 08, 2021 •
Premier Jason Kenney announces the province's new COVID restrictions at McDougall Centre in Calgary on Friday, Sept. 3, 2021.
 PHOTO BY AZIN GHAFFARI /Postmedia

Last Friday, Jason Kenney announced that his government will pay people who haven’t been vaccinated yet a hundred dollars to get their shot. No one thinks this is a good idea, except presumably a few UCP caucus members. Most of the negative reaction comes from the vaccinated majority in Alberta, who resent what they see, correctly, as a reward for procrastinating and heel-dragging on vaccination, while the fourth wave of COVID gathers steam and threatens to swamp our hospitals.

I’m a sociologist who studies infectious diseases. There are even bigger problems with the COVID-cash scheme than ticking off everyone who already got vaccinated.

Putting a cash bounty on shots is what economists and sociologists call gamification. Gamification means taking any process or activity and making it similar to playing a game, in order to motivate people to engage in it. The appeal of gamified activities is that they offer individual players a chance to get the highest score or win big through strategizing and outsmarting other players or through betting against the house.

Gamification has its place — in casinos and video games. It does not have a place in public health. Gamifying COVID vaccines, by awarding money to people who delay getting their shots, sets Albertans up to see themselves as games players rather than citizens or people who have responsibilities to look out for each other. If delaying your shots for six months gets you $100, why not hold out a while longer and see if the province will up the payout to $200 per shot? Why settle for $100 now?

Sure, you’re a lot more likely to get COVID if you aren’t vaccinated yet, or to spread COVID to vulnerable people. But by Thanksgiving, if you bet strategically, you might be getting $500 for a shot!

In the gamified world, people who got vaccinated on time and followed the rules are bad players. Sure, they did their part to protect the vulnerable and so forth, but they lost out on the money. Next time around — and there will be a next time; COVID-19 is not the last pandemic virus we’re going to see — how much can I get for a shot in my arm? What will the payout be? Getting vaccinated without getting paid for it will appeal to some people, but for an unknown part of the population, the expectation has now been set that public health emergencies are games, and holding out for money is a winning gamble.

In addition to setting a terrible precedent, paying people per shot just doesn’t work. A study by the University of Pennsylvania, released last Friday, comparing 24 states with different incentives for vaccination, found that paying people per shot does not increase vaccine uptake at all.


What does increase vaccine uptake is mandates — requiring proof of vaccination to take part in activities ranging from attending sports events to air travel. We’re seeing this right now in Ontario, where Premier Doug Ford announced on Wednesday the creation of a provincial vaccine certificate which could be used to access restaurants, bars and indoor entertainment, and within 24 hours, the number of vaccination bookings through the provincial health system doubled.

Vaccine certification is fair — everyone who gets vaccinated can benefit from it. It is easy to implement, through provincial health registries. It’s voluntary — no one is vaccinated against their will. And it works. And most importantly, it doesn’t turn COVID into a game, in which winning means not getting vaccinated until the province shows you the money.

Alberta has had a terrible year and half with COVID. Let’s hope the provincial government stops making it worse by ill-advised and ineffective COVID cash giveaways.

Amy Kaler is a professor in the department of sociology at the University of Alberta.

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