Positive reinforcement – and not operative conditioning – for the unvaxxed

By Atty. Anfred P. Panes

We are not a First World state; a Big Brother State no less. Anything novel in the field of epidemiology is a long process to be campaigned for before it can be universally accepted. Vaccine hesitancy of the populace has become a focal public policy consideration nowadays. Vaccination for a novel disease is expected to be met with cynicism especially when people tend to rely more on the facts brewed by the relatable social and socio-digital spheres rather than on the language of medical science which some might find obscure, unfortunately.

On a positive note, it appears that government institutions are eventually getting the knack of dealing with this pandemic. The objective has shifted, though not necessarily diluted, from centralized response to COVID-19 on community quarantine to a national framework vis-à-vis local autonomy in addressing the reluctance of people to get vaccinated, be it positive or negative.

The Department of Health of the Philippines reported that more than 53.3 million Filipinos have already been fully vaccinated as of this writing.  Currently, there are at least 111 million Filipinos. The position of the World Health Organization on herd immunity suggests that at least 70% of the population should have been vaccinated.  Are we there yet? No, but at the very least, we are getting there. In order to do this, we need to take a closer look at our domestic situation to lay the groundwork for our goal of achieving herd immunity.  We live in a condition where we animate our contemporary survival instincts to make ends meet and where a bulk of the population can barely provide the most basic necessities in our hierarchy of needs.  For a working Filipino who would rather skip his vaccination schedule than lose a fair day’s wage or two – this speaks volumes on the plight of the ordinary Filipino.

Vaccine availability should not be the sole basis in sanctioning a citizen who is not yet vaccinated. The national health crisis indeed regulated our right and privilege to travel and to access public and private establishments.  However, it is a rather reasonable step to encourage the people to get vaccinated, albeit through a mechanism that employs the use of operative conditioning, of reward and punishment. The last thing we can do is to employ a defeatist response to achieve herd immunity at the very moment when the people’s trust on vaccines is not yet of absolute resolve. We cannot just deprive the people’s access to basic services on ground of lack of positive evidence of vaccination cards or certifications.  The policy needs to be tempered with humanitarian and equitable considerations, taking into account an individual’s access and eligibility, or lack thereof, to vaccination programs.

People are naturally cynical, yet empirical.  They may doubt everything that is novel to them yet they eventually submit to the truth of a fact when they see reliable and relatable proof. In this context, what we can import from this behavior is to establish a social pattern to model an effective vaccination drive, incentivizing its availment, and maintaining an aggressive campaign on the effectiveness of vaccines.  It is vital that the people trust the vaccines, and this effort must be clearly communicated by the government. People should want to get vaccinated, not because they fear the punishment that comes with not getting inoculated, but because they believe in its effects. The effectiveness of vaccines and the equitable distribution of the same are just some of the empirical facts to be clearly conveyed to at least dispel the doubts of the populace.

Positive reinforcement by incentivizing vaccinated individuals is a better approach than a punitive one. Exacerbated by this pandemic, the general hesitancy of those wanting of proper information and risking a lost meal on the table for the family is already a befogging situation to be compounded with the imposition of negative reinforcement for those who were not yet vaccinated, at least for now.

Placing the unvaccinated individuals as the major variable, herd immunity is still highly attainable. Although it entails time and motion process, it is better enforced with a positive and incentivizing mechanism in mind, not a punitive one. Opting for a carrot in a carrot-and-stick situation is never a sign of weakness. It breeds trust rather than distrust; encourages cooperation rather than reluctance.