The unvaccinated owe a figurative debt to society that should be literal

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Employees at JBS Meat Processors receive a $100 bonus for getting a COVID-19 vaccination. The Lidl grocery chain offers $200 to employees who get vaccinated. Trader Joe’s offers employees two hours of pay per dose of vaccine. In the city of Acworth, Ga., $200 gift cards await city workers who can show that they have received the vaccination.

Providing financial incentives to the unvaccinated does provide a visibly dramatic demonstration of the importance of moving to that 90 percent vaccination rate where herd immunity stops the further spread of the COVID virus.  

But as Arthur Caplan, a preeminent American bioethicist said in a Today Show interview:  “If you pay people to get vaccinated, the strong implication is it’s not safe, there’s something wrong, you have to use money to persuade them.”

Resorting to paying people for vaccinations that are free and scientifically proven to protect against serious illness, hospitalization and death, is curious, if not stupefying, given that vaccination is in the vital interests of those who receive it — as well as everyone who encounters 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 more important issue is that money for vaccine participation obscures a moral obligation. In a time of pandemic, vaccination imposes a duty to take care of ourselves and not burden others with preventable sickness and death. When vaccination is framed as a way to promote the good of others, we are in Golden Rule territory — ethics 101.

Our moral obligation to get vaccinated involves citizenship duties. Getting vaccinated is how, in the midst of a dangerous pandemic, citizens act for the good of neighbors, wider society and even the global community. Unvaccinated people put themselves and others at risk of disease spread, hospitalizations and even death, defying an obligation to protect life and advance the common good.  

This is where the idea of “paying people to get vaccinated“ has things backward. It is the choice not to be vaccinated that should come at a cost. Rather than paying people to get vaccinated, those who refuse vaccination should be viewed as owing a debt of obligation to society. What needs to be thought through are the ways the unvaccinated can meet this obligation.

Bracketing political motivations in order to consider more high-minded rationales, those refusing vaccination claim as their general justification individual conscience. The American legal system makes allowances for such exemptions. The model that should be used to think this through concerns other citizenship obligations. 

For instance, when America still had a draft for military service thousands of young men resisted conscription for reasons of conscience, and many of them undertook alternative service, working as medics or in rehab centers rather than carrying a rifle in the Vietnamese jungles. These conscientious objectors were not exempted from their citizenship obligation, and the obligation of citizenship did not disappear. The obligation changed, rather, to accommodate conscience.

In the current COVID crisis, anti-vaxxers appealing to conscience have not been asked to undertake an equivalent “alternative service” route to meet the obligations of citizenship. So the question worth pondering is this: How can those who refuse vaccination meet the citizenship obligation that has fallen on all citizens because of the pandemic? It is not fair that non-vaxxers receive the potential benefits of herd immunity by refusing their obligation while others have met it through vaccination. Without the opportunity to meet their obligation through an alternative to vaccination, they fall into the category of  “free-riders,” unjustly taking a benefit they did not earn. What is needed is some acceptable alternative to vaccination that would meet the citizenship obligation.

A financial penalty is perhaps the easiest option to contemplate. Rather than paying persons to get vaccinated, unvaccinated persons should pay to meet the citizenship obligation they continue to bear. The unvaccinated should, in the interests of fairness, take on a financial burden as a moral equivalent to vaccination; an “alternative service” option much like those who have in our nation’s history sought exemptions to military service through conscientious objection.

More difficult options might include hospital triage policies that would allow a vaccinated individual to take the bed of a nonvaccinated individual if there were no more beds available. This might meet a test of fairness, but it would be excruciating for health care workers to enact such a triage policy. Such options should be discussed, however, and the discussions themselves might inspire vaccination increases since they dramatically highlight the seriousness of the pandemic.

Whatever options might be considered, the focus should be on the fact that vaccination is a citizenship obligation, which persons should accept not only for their own wellbeing but for that of others. The plea for vaccination exemption should be met with a mandatory option for “alternative service,” some burden comparable to that accepted by conscientious objectors who refused military service.  

Imposing such a mandate will eliminate possible free-riders and meet an obligation that in a time of pandemic all people owe each other in the interests of justice. 

Lloyd Steffen is a professor of Religion Studies and University chaplain at Lehigh University.  His most recent book is “Violence and Christianity” (Cambridge 2021).

Tags anti vaccination misinformation Conscientious objector Vaccination Vaccination policy Vaccine hesitancy

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