"Opt out" option can held reduce vaccine inertia

The Prime Minister has recently laid out some plans for opening New Zealand’s borders. Contrary to what some may think, re-joining the rest of the world is crucial for our future prosperity. The longer we delay the further behind we will fall. 

What is our biggest challenge now? Getting the adult population vaccinated.

Recently, John Key proposed telethon-type messaging on vaccination rates with this information being updated and shown on TV screens.

Here is a better idea.

Despite what the government would have you believe the vast bulk of people are not anti-vaxxers or rabble-rousers. They just want to get on with their lives. What then prevents vaccine uptake? Inertia! 

Currently the government is asking people to log on to websites, find a centre close to where they live, figure out a suitable date and then sign up for a jab. This may be thought of as the “opt-in” option. 

Instead, here is what we should be doing. Send each eligible adult a date, time and place for vaccination. Those above 65 or 70 could be given times during the weekday while those younger would get times during the evening or in the weekend. If needed pay extra to those administering jabs during evenings and weekends.

We do something similar before the elections when we send people information about where to go to vote. This should not be logistically too onerous.

People have the option of changing those dates but offered a date, a vast bulk of people will go ahead and show up at the appointed time.

It would also be useful if people could get this done with their own GPs since when it comes to medical advice these are our most trusted advisors. 

Research suggests that when it comes to retirement savings with employer-matched contributions, firms that use the “opt-in” option, where they ask workers to sign up to a program, often end up with fewer enrolees. On the other hand, firms that use the “opt-out” option do better. In this latter case, workers are automatically enrolled but have the option of opting out. Most workers do not and stay enrolled in the scheme. These people end up with much higher savings.

In one firm that switched from opting in to opting out, participation rate was 35 percentage points higher after three months on the job and remained 25 points higher after two years.

In another firm that offered a default contribution rate of 3 per cent of salary, more than one-quarter of workers contributed exactly that amount, even though the employer matched contributions up to 6 per cent of salary. Once the firm raised the default to 6 per cent, workers started contributing the same proportion.

A 2013 report in the Guardian found that approximately one year after Britain introduced automatic enrolment with an opt-out feature, there were 1.6 million more savers in workplace pensions. Only 9 per cent chose to opt out.

Relying on the “opt-out” option for vaccination will lead to much quicker uptakes. In countries such as Canada or Sweden governments are also trying other innovative approaches such as lotteries and/or financial incentives.

In the meantime, we need to stop talking about vaccine mandates, vaccine passports and ostracizing the unvaccinated etc. None of those things will come to pass or help and such talk only ends up raising people’s hackles. 

To those who are not generally opposed to vaccinations, I suggest the following. Yes, the Covid vaccines are not particularly effective against mutant strains. But nevertheless, the expected value is still positive. If you meet another person, vaccinated or unvaccinated, you are still better off being vaccinated. In the parlance of game theory, this is a dominant strategy; a strategy that does better against all other strategies adopted by others.

Are there side-effects? Maybe. But all vaccines have side-effects and there is little evidence to suggest that the side-effects to the current ones are any more dire than others. These are very low probability events that people often over-estimate. If you are scared or worried, let it be; opt-out. 

But equally the government needs to realize that we will never get as many vaccinated as we ideally want. And it also matters less than is being made out to be. There is little value in holding out for a great outcome when we can get a perfectly good outcome. We need to get going.