The Canadian province of Quebec is introducing a tax on the unvaccinated, making it the first jurisdiction in North America to do so. As pandemic-related hospitalisations continue to climb, Quebec Premier Francois Legault says the 10 percent of the population who are unvaccinated make up 50 percent of patients in intensive care beds.
“A health contribution will be charged to all adults that don’t want to get vaccinated,” he said on Tuesday. “All Quebec adults who refuse in the coming weeks to at least get a first dose, will be getting a bill.”
But for Palladium Partner Ruth Berg, the decision to impose financial penalties needs to follow an understanding of the reasons people choose not to vaccinate in the first place, from misinformation on social media to political ties to lived experience.
“A tax may make sense in response to some types of resistance, but some communities are rightfully motivated by distrust based on historical experience with the medical field,” she explains. “In the U.S., this has been the case for some African American and American Indian persons. Taxing these individuals could drive the wedge deeper, creating further distrust and exacerbating health inequities.”
In Berg’s experience, the answer for these communities is to see and hear from those they already trust.
“For example, what began as a wide gap in vaccine uptake between Black and white Americans is now narrowing thanks largely to work done by Black leaders and Black-led coalitions,” she says. In April 2021, 38 percent of white Americans versus 24 percent of Black Americans had their first dose of vaccine. That spread now sits at 54 percent and 46 percent, respectively, narrowing from 14 percent to 8 percent.
Reed Tuckson, a community leader with the Black Coalition Against COVID-19, attributes this trajectory to an “aggressive outreach campaign to the Black community from our medics, our health leaders, our church and faith organisations, and our own community-based organisations.” The coalition has seen up to 750,000 people attending a single live streamed community meeting.
Yolo County in California took a similarly community-based approach to addressing the concerns of migrant farmers, resulting in vaccination rates that exceeded state and national averages in the earliest days of the vaccine roll out.
“The root causes of vaccine resistance can be multi-faceted; they’re complex because people are complex,” says Dr. Shanthy Edward, Palladium Vice President of U.S. Health. “When considering historical, political, and personal reasons, a tax may address some. But we always need to dig deeper and thoughtfully develop complementary solutions that get at each of those root causes to really overcome the problem.”
In Quebec, some are calling the new tax discriminatory, with a legal challenge expected in the coming weeks. Meanwhile, countries such as Austria, Greece, and Singapore have introduced similar measures of their own, from a flat rate fine to bills for otherwise universal medical care. The outcomes of these measures remain to be seen.
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