Should people pay for Covid19 vaccines?

Three Covid-19 vaccines are approved by regulatory authorities in many countries including US, UK and EU and vaccination programmes are being speedily implemented. Other countries including China and Russia have also authorised and started vaccination by their local companies’ vaccines.

Developing countries are supposed to wait for doses allocated by Covax to gradually vaccinate at risk groups defined by the WHO as health and care workers, older people and those who have chronic conditions. As rich countries have been hoarding millions of doses to vaccinate their populations, some developing countries went ahead entering contracts with pharmaceutical companies to secure some doses for their own people.

Covax has been raising funds to pay for the vaccines and decided that low and lower middle income countries contribute a co-payment of up to $1.6-2 /dose. In addition, countries have to buy millions of doses and pay the cost of logistics and delivery of the vaccines. Therefore, there is a question on whether people should pay “low price” to acquire the vaccine.

However, I can see 7 reasons for why people all over the world should have covid19 vaccines free.

1. Vaccines have externality benefit. Basically, vaccination does not only protect the vaccinated person but contribute to creating what is called “herd immunity” which protects the whole society.

2. It is difficult to decide the level of “low price” given that we do not know the real “cost” of R&D and manufacturing because cost is considered a trade secret.

3. Paying even “low price“ excludes poor people who cannot afford such price. By the way- who decides how low is low? Paying will mean that only those who can afford it get vaccinated irrespective to their vulnerability to the infection while priority people may not get it because of payment. We already see this in countries that allow paying for tests.

4. Paying could lead people to only have one dose instead of the two doses regime of most vaccines in order to save money thinking that “one dose is better than nothing”.

5. Paying could lead families to prioritise who gets the vaccine. For example, families may prioritise a male income earner at the expense of women or disabled people.

6. The cost of R&D and sometimes production are already paid by public financing especially in the north. People in the south participated in the “cost” of making vaccines through offering themselves to clinical trials.

7. People in the north are getting the vaccines free paid by public revenue. It is immoral to make people from poorer nations to pay for the vaccines.

World leaders keep saying “nobody is safe until everybody is safe”. Safety is only secured if people all over the world can access a vaccine free at the point of use.