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Officials: Ethical Pitfalls Abound With COVID-19 Vaccine Incentives

File Photo by Scott McCloskey Wheeling-Ohio County Health Administrator Howard Gamble works at a COVID-19 vaccination clinic at The Highlands.

WHEELING — What would it take to coax a person to get off the couch and get the vaccine? A six pack? A gift card? A $100 savings bond?

Weighing options to make COVID-19 vaccine incentives enticing, without compromising ethical integrity by making them into bribes, is a challenge officials across the state have grappled with openly in past weeks. Gov. Jim Justice wants to offer $100 incentives for residents aged 16-35 to get vaccinated, hoping to bring young adult vaccination rates up to par with those of older age groups.

Yet such incentives must not put pressure on a person who would otherwise be reluctant to get the shot, says Wheeling-Ohio County Health Administrator Howard Gamble.

Gamble said the vaccination is a medical procedure, and it’s very possible to be unethical in coercing someone into accepting a medical procedure under duress.

“This is a procedure. It’s an invasive procedure, you’re injecting someone with a biological product,” Gamble said. “When you say ‘Let’s do all sorts of incentives,’ realize, this vaccine is purely voluntary, versus vaccines to go to school in West Virginia and a few other states — those are required by law, and you can get an exemption. So you’ll see higher rates of hepatitis and (measles, mumps and rubella vaccines), because it’s required.”

Workplaces and schools requiring vaccines as a condition of employment or enrollment, Gamble said, are not comparable or particularly useful when considering what incentives could be offered, as those are mandatory, with exemptions, rather than opt-in.

“This is solely voluntary, and when we put in an incentive for it, we have to think of incentives for our other vaccines, and we don’t really have that,” Gamble continued. “… You’re trying to coax someone into doing something that we should all be doing purely because we need to get back to a level of normal. To do that, we have to step up as citizens.”

Gamble said the incentives should be simple and tangible, like those a person might get for attending a ball game on a certain day or filling out a survey.

“It may be as simple as, ‘Here’s some cash, here’s a gift card, here’s a T-shirt,'” Gamble said, “and it’s very simple, it’s tangible, I walk away with it. You can make the decision based on ‘Yes, it’s nice to do this, and I’d like to do it.’ It has to be something that’s nice, but you made the decision to (get the vaccine) and get a little something, so there is some personal responsibility.

“A lot of times, we think, ‘I’m not going to do this unless it’s required.’ We’re not there yet,” he added. “Some businesses are doing that, because they know it benefits the entire world.”

Gamble had spoken to the Wheeling City Council last week, saying that reluctance to get the vaccine would likely see the health department having more on hand than they could use, and eventually discard. Gamble said that needing to discard surplus doses would not negatively impact the county’s ability to get doses in the future.

Each week, Gamble said, the health department orders extra doses of vaccine on top of how many appointments are scheduled to account for walk-ins.

“Each week, we’ve pulled the exact number (of appointments) that we have, and a little extra, and keep in mind we have three types of vaccines,” he said. “A walk-in may ask for a specific kind. … You’ll have more used, or not used, depending on what the person asks for.

“But it does not affect our orders going forward,” Gamble continued. “Right now, with the partnerships we have with the hospital and clinics, we’re able to pull cold-storage vaccine — Pfizer, in particular — and can store those for next week, so we don’t have to order more Pfizer.”

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