Thursday, April 15, 2021

Do you have the COVID-19 vaccine? I want a vaccine

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I’ll admit it: I want vaccines. It’s that feeling of jealousy, disappointment, or resentment you get when someone else gets their COVID-19 vaccine – and you can’t.

I’m not proud of it. We should all celebrate the incredible speed with which several effective and safe COVID-19 vaccines have been developed. Millions of people receive them daily, which brings the increasingly real possibility of collective immunity closer and closer.

So I should just be patient, right? It is not easy.

The craving for vaccines is inevitable

Current evidence suggests that vaccination could save your life and the lives of those around you while helping daily life regain some semblance of normalcy. And while we can reduce the risk of getting infected without the vaccine (for example, by physical distance and face coverings), there are many reports of people “doing everything right” and still being infected. So it is good to know that people are getting vaccinated.

But it can be difficult to see your friends, family, or coworkers beaming at you in emails or social media posts, holding an immunization card, or displaying a bandage on your arm.

Vaccine rollout is testing our patience

It’s hard enough to tolerate the way this pandemic has turned our lives upside down. Every week, thousands of people continue to fall ill and die. But it’s even harder to know that there are highly effective vaccines that only some of us can get. For those who want a vaccine, but aren’t eligible or can’t get a rare appointment, with each passing day another day faces an invisible and uncertain risk. It is therefore understandable that many people lack patience.

Vaccine rollout challenges our sense of fairness

When the first vaccines were approved for emergency use, there were too few doses available for the general American population. Therefore the The CDC has created detailed recommendations prioritize who should get vaccinated first, taking into account groups most at risk for disease and death. Health care workers and residents of long-term facilities are at the top of the list. Essential frontline workers and the elderly followed, followed by those with more severe COVID-19-related illnesses. Further down the list is everyone.

Unfortunately, the subsequent rollout of COVID-19 vaccines was confusing, unpredictable, and in many cases unfair. For example:

  • Eligibility varies considerably from state to state as each state has created its own priority lists. For example, some states have prioritized people who received cancer treatment within 30 days; others have prioritized anyone diagnosed with cancer, even if it was years ago and now in remission. In some states, teachers could receive vaccines in January; in others, they simply became eligible.
  • Certain health problems could increasing the risk of COVID-19, such as certain neurological or autoimmune diseases, does not count as a “co-morbid disease” that advances vaccine eligibility.
  • Planning for immunizations has been difficult in many states. Navigating online dating systems has been impossible for some seniors, those short on time or resources, and others.
  • Vaccine shipments to immunization centers have fluctuated, making it impossible to predict whether there would be enough vaccine to deliver to eligible recipients.
  • Verification of age or health conditions varies widely. Some states rely on the honor system while others require documentation.

So even among similar groups of people, these factors mean that some already have the vaccine and some are still waiting. It just doesn’t seem unfair – it is unfair.

Who collects the remains?

The “remaining” vaccine doses allow some people to get vaccinated before they are eligible. Once an mRNA vaccine thaws at room temperature, it should be administered over a few hours or discarded. Since each vial contains multiple doses, anything left over can be offered to anyone, even those not yet on the priority list, to avoid wasting them. This led to swarms of people – called “vaccine hunters– pouring in wherever there are reports of remaining vaccines.

Social media helped enable this. Connections are also important. Ideally, those responsible for administering vaccines would keep a backup list of eligible beneficiaries who might come on short notice to receive the remaining vaccines. But such systems require maintenance and resources that are not widely available.

The fact that people can jump the line raises questions of fairness.

The deployment of the vaccine tests our ethics

More questionable than accepting remaining doses of vaccine that might otherwise be wasted are efforts to thwart the vaccine eligibility system. For example, there have been reports of

Ethically questionable acts like these can exacerbate existing health disparities suffered by minority groups who are already disproportionately affected by the pandemic. Economically disadvantaged people are less likely to have the time, resources or connections to circumvent eligibility rules, compared to those with more privileges.

The bottom line

The COVID-19 vaccination eligibility rules have put many of us in a tough spot: hoping to get a vaccine as soon as possible, but having to wait for others to get it much sooner while gritting our teeth on people who seem to be in line. But instead of skipping the line too, we should denounce the rules that seem unfair, try to be patient and understanding until our turn comes, and continue to take steps to reduce our risk – including wearing masks (which is no longer required in some states).

In a few months, anyone who wants to get vaccinated may be eligible to get one. In the meantime, if you feel the urge for vaccines, welcome to the club.

Post Scriptum: Shortly after writing this blog post, I became eligible for the COVID-19 vaccine and received my first dose. I hope that widespread vaccination will soon eliminate the craving for vaccine for everyone.

Follow me on twitter @RobShmerling

The post office Do you have the COVID-19 vaccine? I want a vaccine appeared first on Harvard Health Blog.

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