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Yeah, but what about me? When can I get vaccinated?
It’s the question on the lips — and in the rising anxieties — of millions of impatient New Yorkers who aren’t eligible yet or can’t book an appointment or otherwise find themselves ready and willing but still unable to get the undersupplied COVID-19 vaccine.
It’s nice that all those otherpeople are being vaccinated. But what about me?
“I hear that question all day long,” Dr. Arthur Caplan said.
Of course, he does. That’s what happens when you are the founding head of the Division of Medical Ethics at New York University School of Medicine and the in-house bioethics guru for the NYU Langone Health system. People ask. A lot of people.
According to the New York City Health Department’s COVID-19 Vaccine Tracker — yes, there is such a thing — 1.677 million Pfizer PFE, -0.98% or Moderna MRNA, +4.33% doses were administered as of Friday morning. But in a city of 8.3 million, where the current inoculation regime calls for two shots, that still leaves a huge number of unpoked arms. And no one thinks the rolling eligibility system, as it’s unfolded, has been rational or fair.
“The vaccine rollout has been a god-awful mess, and that’s undermining people’s trust,” Caplan said. “When we started, we had national agreement that we were going to try and prevent deaths because we knew that’s what the vaccine did. We didn’t have data on preventing spread.”
So, many of the first doses went to patients in nursing homes and then to healthcare workers. “You can’t tip over the healthcare system because that would only cause more deaths,” Caplan said. But the good intentions quickly collide with an out-on-control process.
“Some hospitals began to vaccinate every person who had any kind of relationship to the healthcare institution, meaning you could get a vaccine even if you were doing psychotherapy from Montauk and saw no one in person,” he said. Soon, donors, board members and other connected people stepped forward. “Hey, I’m kind of a healthcare worker,” they said. Then, the politicians started including their friends. Before you knew it, professional wrestlers and ski-slope attendants were rolling up their sleeves.
At the same time, there was the sudden appearance of surplus vaccines. “A lot of those places began to vaccinate their buddies or people they’d dragged off the street. I’m not saying that was wrong. They had no guidance, but it wasn’t fair, Caplan said. “And in a few instances, people threw the vaccines away, which was even worse.”
Who could feel loyal to a system like that?
“When people saw this mess, they started to wonder, ‘How ’bout me? I’d like to get some surplus vaccine. Can I go stand in line at Yankee Stadium? Can I get in line in Florida, even if I’m a snowbird? People just started breaking the rules. And that’s where we are now.”
Dr. Arthur Caplan
Courtesy Dr. Arthur Caplan
Add in a couple of other big wrinkles — the way the internet skews access to the well-off and techie, the easier time people with money have finding their way to remote test sites — and the recipe is ripe for resentment, jealousy and a dash of class warfare. Said Caplan: “You really think a poor mom with three kids in a tiny apartment with crappy internet is going to beat me to the front of the line? Probably not.”
And good luck getting the state and local governments to come up with subtle plans that rank the relative needs of school teachers, UPS UPS, +0.20% drivers, baristas and supermarket clerks.
The good news, according to the medical ethicist, is that more vaccines are coming soon, including the one-shot Johnson & Johnson JNJ, -2.64% version getting emergency approval now. “Stay isolated, quarantine, distance and mask for two more months, that’s all I ask,” Caplan said. “Give me two more months, and we’ll get you vaccinated. There will be vaccines for anyone who wants one. That’s not the bigger issue.”
The bigger issue?
“The bigger issue is how are we going to respond to all the people who say, ‘I don’t trust it. I don’t want it. I don’t know.’ We’ve never addressed the resistance and the hesitancy and the doubt.”
Also see: As New York City COVID-19 variant spreads, mayor promises Johnson & Johnson vaccines by March
And there’s a lot of it out there. In some of those first-round nursing homes, the no-thank-you rate approached 50%.
“If the healthcare people are saying ‘no’ half the time,” Caplan said, “we need answers for the people who are asking, ‘Is it gonna make me infertile? Are they experimenting on me? Do you think they went too fast?’ No! But you have to address all that. You can’t just hang out a shingle and expect everyone to come running. They won’t.”
Ellis Henican is an author based in New York City and a former newspaper columnist.
