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While the COVID-19 vaccine distribution appears disorganized and messy on its face, eligibility standards were meticulously designed by the CDC’s Advisory Committee on Immunization Practices. Those standards, plus varying availability across cities and states, mean that elderly folks in some places are now watching young, seemingly healthy folks in others get vaccinated well before they do. Which feels wrong—given everything we know about who is most severely affected by this virus—and has led to a certain amount of vigilante vaccine policing and concern that younger or relatively "healthier" people are “stealing” vaccine doses from more eligible folks.
VICE asked some epidemiologists about these moral conundrums, but the epidemiologists were unambiguously clear: From a public health perspective, all the concern trolling is unnecessary. If you can get the vaccine, you should absolutely get the vaccine. As Shira Shafir, an associate professor of epidemiology at the UCLA Fielding School of Public Health, told VICE, “We want everybody to wait until it’s their turn to get the vaccine, and not a minute longer.” For some, that could mean watching young folks in the next county over get the jab well before their grandparents or parents are able to. Shafir gave the example of the Los Angeles area, where she lives. “We have Orange County, Long Beach, Pasadena, and Riverside County all within a one-and-a-half hour drive,” she said. “There could be very different eligibility criteria an hour away from your house, and that’s very hard for people.” Shafir added that in some counties, the priority is now on vaccinating essential workers (regardless of age or comorbidity), while others are still focused on the elderly population. There’s no justification for the argument that one person getting a vaccine when they’re able is stealing a vaccine from another, perhaps-more-eligible person. As Joshua Salomon, a public health expert at Stanford Medicine, told VICE, the CDC knew there would be visible tradeoffs in any distribution plan. “They spent so much time really weighing tradeoffs,” he said. “I think they’ve done that so that each individual doesn’t need to try and second guess anything.”
Even in the few, outlying instances in which people who don’t meet local eligibility criteria are able to get an end-of-day, imminently expiring dose, Shafir argued that “from a public health perspective, it is better for that dose to go in an arm than for that dose to go down the drain, even if it means it’s going to someone who otherwise would not be eligible.” Where this perhaps becomes an issue, Shafir added, is when only the extraordinarily privileged are able to get expiring doses before they’re eligible. “We’re starting to see very significant equity issues around those end-of-day doses,” Shafir said. “If the end-of-day doses are going to people who have eight hours to sit outside of a vaccination site, and they're having food delivered while they're in line and they’re able to watch movies on their device, there is an enormous amount of privilege in being able to do that. If what we're seeing is the privileged coming in and swooping up the end-of-day doses, that's where I would be concerned. But not with them just going to people.”Even in the cases of ineligible folks getting the vaccine, preliminary research suggests that there’s some degree of community impact in being vaccinated. Early studies suggest that a vaccinated person is less likely to transmit COVID-19. Or, as Salomon put it, “there are benefits to others when you get vaccinated.”The public health argument is clear: The approved COVID-19 vaccines have been proven to be safe and effective, and when you can get it, get it. While it may feel wrong to get the jab before your grandparents who live elsewhere; or your friend’s mom; or your uncle’s wife, from an epidemiological perspective, everyone should get vaccinated as soon as they have the chance to. “At the end of the day, if you’re eligible under the rules in the area in which you live, you should make an appointment and get vaccinated,” Salomon said. “The goal as a society is to get as many people vaccinated as possible.” Follow Hannah Smothers on Twitter.