The Economist - USA (2022-01-22)

A shot in the arm

O

neinfiveAmericanadultshavenot
yet got a covid­19 vaccine. This recalci­
trant  fifth  remains  despite  behavioural
nudges, vaccine lotteries and schemes that
pay  people  to  get  jabbed.  On  January  13th
the Supreme Court blocked a harder­nosed
approach—a  vaccine­or­test  mandate  on
over 80m workers—from going into effect.
How  much  might  it  have  helped?  The  re­
cent,  successful  experience  of  America’s
northern neighbour sheds some light.
On August 5th 2021, Quebec became the
first Canadian province to announce a vac­
cine  requirement  to  enter  bars,  gyms  and
restaurants. In the following months other
Canadian provinces followed suit. That va­
riation created a natural experiment: com­
paring provinces with these requirements
to  those  without  provided  a  way  to  esti­
mate how effective they actually are.
Four  economists—Alexander  Karaiva­
nov, Dongwoo Kim, Shih En Lu and Hitoshi
Shigeoka, all of Simon Fraser University in
British Columbia—ran the calculations. In
the week after the announcement of pass-
sanitairerequirements, first­dose vaccina­
tions  increased  by  42%  over  the  previous
week; and by 71% over two weeks. They es­
timated  that  287,000  more  people  were
vaccinated within six weeks as a result.
In the summer of 2021 France, Germany
and  Italy  all  introduced  similar,  nation­
wide  vaccine  mandates  for  non­essential
activities.  The  authors  calculated  that
these were effective, too. By the end of Oc­
tober 2021, more than 85% of Italy’s eligible
population had been jabbed, an estimated
12 percentage points more than if the rule
had not gone into effect. In France the poli­
cy  was  credited  with  an  eight  percentage­
point increase; in Germany with five.
Another working paper, by Miquel Oliu­
Barton  and  his  colleagues,  corroborates
these  findings.  They  found  that  requiring
evidence of vaccination in France, Germa­
ny and Italy not only increased jab uptake
but also prevented 46,000 hospital admis­
sions, €9.5bn ($11.2bn) in economic losses
and 6,400 deaths.
Rich countries are now diverging on re­
strictions.  Some  are  doubling  down  and
proposing  more  punitive  mandates  (see
Europe section). Quebec now has plans to
introduce  a  “health  contribution  fee”.  In
America,  left  without  a  federal  mandate,
the  vaccine­refusal  problem  may grow
more entrenched. The converse ofstriking
success is squandered opportunity.n

Vaccine requirements in Canada and

Europe boosted uptake significantly

Daysbefore/aftervaccine-restrictionannouncement

Alberta Ontario Quebec BritishColumbia

Jul Aug Sep Oct Jul Aug Sep Oct Jul Aug Sep Oct Jul Aug Sep Oct

65

70

75

80

0

100

200

300

-30 -20 -10 0 2010 30 40 50 60 70 80

Unwilling Uncertain Willing

0 5 10 15 20 25

Britain

Sweden

Italy

Germany

Canada

France

Spain

UnitedStates

→ Restricting amenities for the unvaccinated boosted vaccination rates

Change in first doses of covid-19 vaccine administered, 221

Seven-day moving average, date of vaccine-restriction announcement=100

→ New rules pushed Canadian vaccination rates measurably upwards

Share of population with first dose, most populous Canadian provinces, 221, %

France

Canada

Actual Estimated with no imposed restrictions

Restrictions

announced

Italy

Germany

Sources:“Covid-19vaccinationmandatesandvaccineuptake”,byAlexanderKaraivanov, Dongwoo Kim, Shih En Lu and

HitoshiShigeoka,01,workingpaper;CDC;ECDC;GovernmentofCanada;OurWorld in Data; Statistics Canada; UK HSE

→ Across the rich world, vaccine hesitancy remains stubborn

Share of adults not vaccinated, January 222 or latest, %

The Economist January 22nd 2022

Graphic detail Vaccine requirements

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