Thread by @ErikAngner

Quick English summary: There is no doubt that mandates and monetary rewards can motivate people to get vaccinated. Money in particular is an excellent incentive. But! /1

https://twitter.com/ErikAngner/status/1461610137198768129

The benefits risk being temporary. Suppose you offer your teenage kid a tenner to take out the trash. It's pretty likely they will, in fact, take out the trash. That's not the problem. /2

The problem concerns what will happen the next time you ask them to do their chores. There is some danger that they will never again agree to take out the trash unless they're paid to do so. /3

Parents and psychologists alike are well aware of this phenomenon. They know not to offer extrinsic rewards (such as money) when they risk displacing intrinsic motivation (such as the desire to do the right thing). /4
en.wikipedia.org/wiki/Motivatio…

The benefits risk not only being limited in time, but also in scope. >85% of eligible Swedes have already received ≥1 shot. We'll never hit 100%, since some people are exempt and some will resist no matter. We're talking about a few percentage points. /5 folkhalsomyndigheten.se/smittskydd-ber…

In all, the benefits look limited. Meanwhile, there's a real downside. Another parenting metaphor might help. Many parents are tempted to say things such as "If you don't eat your vegetables, you can't have dessert." /6

The line sometimes works, in the short term. But it also sends a clear, unintended message: "Dessert is good; vegetables are so bad you have to be forced to eat them." That message is not what you want your kids to hear – but they will. /7

It's worth noting that the vast majority of Swedes have an intrinsic motivation to get themselves and their kids vaccinated. Vaccination rates are 90–95% for established vaccines, without any mandates or financial rewards. /8
folkhalsomyndigheten.se/folkhalsorappo…

Loads of research suggests that the most important driver of vaccine uptake is *trust*. Here's @goldenbergmaya1, who wrote a whole book about this. /9
uoguelph.ca/research/artic…

If we want people to get vaccinated, the #1 priority has to be to build trust – in the health-care system, scientists, and public-health officials – and to refrain from taking action that risks undercutting it. /10

Mandates and financial incentives risk hurting trust. They may be experienced as targeted punishment, and they risk sending the (false) signal that vaccines are so bad for you that you have to be forced to take them. /11

I share the frustration with my fellow citizen who can get vaccinated but wont. I appreciate that many vaccinated people feel an urge to just *do something* about vaccine hesitancy. /12

But taking everything into account, the cost–benefit analysis suggests we should eschew the quick and misguided fixes of mandates, bans, and financial rewards. /13

Without trivializing the tragedies of covid-19, the problems of vaccine hesitancy are even bigger. Globally, vaccines and clean water are the two most important tools in the public-health toolbox. We *must not* lose track of the bigger picture. /fin
folkhalsomyndigheten.se/smittskydd-ber…

PS: If anyone reading this is not yet vaccinated – it's not too late! Kind and competent health-care providers are on standby right now, just waiting for you to show up. They've got you covered 🙏

For a different view, esp. if you found my argument compelling, read this thoughtful response by @strijkers:

https://twitter.com/strijkers/status/1462019089162031104