Vaccinations are accessible, affordable, and highly effective, but vaccination coverage is lower than it should be, and hundreds of thousands of adults, who constitute the majority of the insured population, are still dying annually of vaccine-preventable diseases. In addition to the human toll, there are huge financial costs associated with treating affected patients.
This paper explores the ethical and practical considerations of using vaccination history as a rating factor for life insurance products. Insurers have an interest not only in accurate pricing and assumption of risk, but also in minimising the significant mortality and morbidity implications of these diseases.
While it is not expected that vaccination history as a rating factor will take on the statistical significance of age, sex or smoking in premium discrimination, the financial and social benefits of encouraging better vaccination behaviour may very well outweigh the costs. And, if so, do the insurance industry and actuarial profession not have an ethical duty to play their part in the prevention of unnecessary disease and the improvement of quality of life?
It is hoped that the ideas introduced and conclusions drawn will spark discussion on this topic. The paper is not intended as a technical work but rather as a thought experiment, combining ethics, healthcare, politics, culture, actuarial science and medical science.
Recent events have shone a spotlight on the issue of vaccination, which makes now an opportune time start the conversation. On the one hand, the world desperately awaits a Covid-19 vaccine. On the other, there is a vocal and growing anti-vax movement based largely on “fake news”, which has led to the resurgence of diseases once assumed to be virtually eradicated. These two opposing forces raise many interesting points to be discussed, including the ethics of mandatory vaccination, the financial burden of infectious diseases, and the role the insurance industry has to play in their containment.
The topics in this paper have been examined in a South African context where possible. While incidence of disease, attitudes towards vaccination and resources available may differ between countries, the insurance and ethical concepts considered are universal.