March 4, 2021 – With the proliferation of COVID-19 vaccines and President Joe Biden’s promise that all adults in the United States can be vaccinated by the end of May, many Americans are finally expecting the end of the pandemic.
However, Arthur Caplan, PhD, bioethicist at NYU Langone Medical Center, sees the beginning of a new potential threat: the Peltzman Effect. University of Chicago economist Sam Peltzman first described the phenomenon decades ago when he found that increased safety regulations had no effect on the death toll on highways. It seemed like people adjusted their behavior to take more risks than they realized that a situation or threat was becoming safer.
The Peltzman Effect could spell bad news for the pandemic, suggest Caplan and Brit Trogen, MD, a NYU Langone-based pediatrician, in a recent comment.
“People seem to be settling down [be comfortable] with some risk, “says Caplan.” And different people accept different levels of risk. Often, if you offer them something that seems to reduce that risk, they are increasing the risk in other areas of their life. “
By March 2, more than 26 million U.S. adults, or approximately 10% of the adult population, had received two doses of COVID-19 vaccines, according to the CDC.
Once people are vaccinated, one of their first thoughts might be, “I’m going to have more fun,” says Caplan. So you could go to restaurants or travel, although it is not yet known how variants of the coronavirus could change the course of the pandemic or whether a vaccinated person can still transmit the virus.
Peltzman effect factors
A classic example of the Peltzman Effect in action is when someone drives a car faster after receiving new brakes. When he knows that good brakes reduce the likelihood of an accident. Another example implies the safety of others: one study found that riders came closer to cyclists who wore helmets than to those who did not, although these results have been questioned.
Those who study the Peltzman effect cite four things that influence whether risk behavior increases once a situation appears safer. All four are affected by the pandemic, says Caplan.
- The new measure that makes the situation safer – in this case the vaccine – needs to be visible. It’s hard not to notice a sting in the arm or the long lines for the vaccination.
- People need to be motivated to engage in risky or previously risky behavior. After a year of lockdown, there are many.
- People need to have the control or ability to elevate risky behavior. In some states, this is easier than others as some mask mandates are issued and stores reopen.
- The new security measure must be effective enough that people can do what they previously perceived to be risky. The new vaccines with an effectiveness of up to 95% meet this requirement.
What’s the answer?
Caplan suggests that the new public health message needs to be clearer and more specific than the previous communication so that the likely increase in risk behavior does not lead us back to high COVID rates.
People need to be told what kind of precautions they should still follow, like wearing masks and distancing them until more of the population is vaccinated, he says, and researchers get more answers on whether vaccinated people still get the virus can spread. The CDC may soon issue guidelines for safe activities for those who are fully vaccinated.
People also need details about gatherings, says Caplan, such as, “If you want to have a party, only have it with other vaccinated people.” Grandparents need information on whether it is safe to visit grandchildren and how to deal with these visits – with masks or not?
What is risky in one community may not be as risky in another if the situation changes, says Trogen. “We will increase or decrease our personal prevention behavior based on the perceived risk appetite of the virus,” she says.
As the number of people vaccinated increases, the misguided feeling that there is protective “herd immunity” may increase, says Caplan, “long before widespread immunity is actually in place”.
His conclusion: Reducing the risk, not eliminating it, should be the goal when the security measures are relaxed. But even if risky behaviors increase, as he expects, the change in safety the vaccines provide cannot completely counteract it.
“There will be riskier behaviors like less wearing masks and more of any activity that was scaled back prior to vaccination,” agrees Peltzman, who looked over the paper. But will the cases come back? His prediction: “There will be more cases than if there were no ‘counter-behavior’.”
He, too, says public health messages are important and should focus on vaccination efforts. “The incentives for riskier behavior will not be lost by telling people what is risky,” says Peltzman. “The likelihood of equalization [risky] Behavior makes widespread vaccination even more important. “
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Sam Peltzman, PhD, Ralph and Dorothy Keller, distinguished service professor emeritus of economics, Booth School, University of Chicago.
Arthur Caplan, PhD, bioethicist and Dr. William F. and Virginia Connolly Mitty Professors, NYU Langone Medical Center and School of Medicine, New York City.
Brit Trogen, MD, pediatric resident, NYU Langone Medical Center, New York City.
Journal of Political Economy: “The Effects of Vehicle Safety Regulation.”
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