I’m Not Eligible for the Vaccine But. Can I Hunt for a Surplus Dose?

I am a college student and I recently learned that my city will open places on the Ministry of Health website to anyone who can be vaccinated if there is an excess of vaccines. We’re still in the first stage of vaccination, but if I check the vaccination website a lot, I could theoretically get an appointment.

Since I am a healthy young person, not an essential worker or at risk, should I wait to be vaccinated in hopes that someone at higher risk or greater risk could take the place? Or should I keep checking this website and taking the dose as soon as it appears? I’m not taking someone else’s place, am I? Ben, Montana

With something perishable – whether it is a lettuce or a thawed carton of Covid-19 vaccines – you can have excess and spoilage with a general deficiency. The minimum order quantity for Pfizer vaccines is one tray of approximately 1,200 doses. Once the vials begin to thaw, they will need to be used in five days. For all approved vaccines, a vial that has been opened once must be used within six hours – Johnson & Johnson uses two hours at room temperature. Each Pfizer vial contains up to six doses. Johnson & Johnson, which has a minimum order of 100 doses, puts five doses in one vial; Moderna will shortly be dispensing 14 doses in each vial.

The point is, vaccines don’t come as “loosies”. Vaccination centers can misjudge the number of registrations, and even when everything is planned correctly, there are sometimes no-shows. Even if a site has a standby list of qualified recipients, there are occasions when a vaccine is wasted unless the eligibility rules are suspended.

Perhaps the question is not whether you would take someone else’s place, but whose place you would take. I think of the verse that we apparently owe to the 19th century English lawyer and joke of Charles Bowen:

The rain, it rains on the righteous
And the unjust guy too.
But mainly to the righteous because
The unrighteous steal the umbrella of the righteous.

In a situation where expired vaccine doses are being offered to all comers – so they don’t just go to waste – you have no reason to believe that the dose you are avoiding will go to someone in greater need. When those concerned with justice demure, the dose can simply go to those who are not so concerned, provided it goes to anyone. There will always be a tradeoff between vaccinating the country quickly and exquisitely fine-tuning the rollout to reflect each person’s risk profile. If a sporadic all-comer approach is the best way to avoid wasted doses, then it’s not unfair and you are not wrong to be part of it.

There will always be a tradeoff between vaccinating the country quickly and exquisitely fine-tuning the rollout to reflect each person’s risk profile.

Updated

March 18, 2021, 12:25 p.m. ET

There is one other thing to note. Although your age is very unlikely to get seriously ill with Covid-19, you can still spread it. In fact, it is not uncommon for people who never show serious symptoms of the disease to transmit the virus. The evidence available suggests that post-vaccination transmission is less likely, perhaps much less likely. Like wearing a mask, your vaccination will help protect you and others. It’s much better for a dose to go in your arm than in the trash.

I live in a state where vaccinations are a priority for people over 65 and people over 16 with chronic illnesses. As elsewhere, the rollout was far from smooth: it was reported that the county received over 30,000 simultaneous phone calls last weekend when it announced that 9,000 appointments were available. No “evidence of chronic condition” is required and our state has made it clear that it relies on the honor system for vaccination seekers.

I am 44 years old and reasonably healthy. I have been overweight since I was a child. At times in my adult life I have been much heavier than I am now, which is exactly the line between “overweight” and “obesity” (classified as a BMI of 30 or higher; I am about 29 years old now). My state regards anyone classified as “obese” as a priority group for vaccination. Is it ethically correct for me to change the definition of the term “chronic condition” and theoretically be one step ahead of someone else who may be in a much higher risk category? Name withheld

You ask if You can lie to get vaccinated faster. My answer is no. But there is an interesting question that you did not ask. Would it be okay to have an eating binge to bring your BMI to 30? In this scenario, you would not be able to assert yourself when requesting an appointment. Surely you would still abuse the system. Any criterion that can be hacked in this way is problematic precisely for this reason. Of course, the BMI thresholds used by states (30 in some cases, 40 in others) are inherently arbitrary: a study in the Proceedings of the National Academy of Sciences last fall found the rate of hospital admissions for Covid-19 increased with our BMI increases linearly, starting with those who are only slightly overweight. This suggests that maintaining yourself at a healthy weight may be a better option than increasing it.

I’ve worked at farmers markets in New York City for many years, but since the pandemic, I’ve moved to full-time communication work at a church (including producing their new livestream) and only invested a day a week in the market. As a market worker, I am now eligible for the Covid vaccine. I want to get vaccinated as soon as possible, for my own safety and for the good of all, but the truth is, my job and lifestyle allow me to stay fairly isolated and protected from infection. Aside from my obvious advantages – or rather the privileges – of being highly computer literate, fluent in English, and having the time to navigate the Byzantine vaccination system, I feel like my exposure is limited than a day-a-week -Worker is essential My entitlement to vaccination is in doubt. I want this vaccine to be introduced ethically, and ideally, privilege doesn’t matter. But is eligibility pure and simple? Damon, New York

What is important is try to remove barriers to vaccination – including those created by lack of access to transport, the internet, or English. Recruiting churches and other community organizations can help reach the city’s underserved and sometimes vaccine reluctant population. Indeed, your work with the Church could enable you to help here. However, once a reasonable system is in place, the authorization is actually the authorization. They don’t suggest using internal connections to skip the line. You will have the advantage of your skills and abilities, but you will likely not qualify for the FEMA zip code restricted vaccination centers, which are specifically targeted at the city’s vulnerable communities. All of this means that your laudable concern for justice does not mean that you should refuse the umbrella that is offered.

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