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The morals of jumping the line for a COVID vaccine
I've started seeing lots of stories or posts elsewhere on the internet about people managing to schedule appointments for their COVID vaccinations even if they're not in the current phase and I'm curious what people's thoughts are about it.
To be clear, I am specifically not asking about people who are able to snag leftover or "thawed" doses that would otherwise have to be tossed at the end of the day.
Broadly speaking, I think it's an immoral thing to do. Kant's categorical imperative is useful here - if one person is asking themselves "should I cheat and skip the line?", they should also ask "what would happen if everyone with an opportunity to cheat made the same decision I make?" One person cheating and skipping the line doesn't seem like a huge deal, but if everyone did it it would add significant chaos to the system.
But, in the realm of things about the pandemic that piss me off, it's very low on the list. Government action (or lack thereof), especially here in the US, has caused much more unnecessary suffering than people getting vaccinated before their "turn" and thus delaying someone else from receiving their dose.
I think skipping your phase should generally be discouraged because there is a lot of thought going into deciding who should get it and who should not. You are deciding you are more important than someone else when you decide to skip, which is ethically dubious.
That said... sometimes the guidelines have things that fall through the cracks. Maybe you've got some rare disease that is somehow left off the phase list. There's some wiggle room there.
I suspect the majority of people skipping phases, though, are not in that category. They are skipping because they have privilege and can do so. That's abhorrent.
I guess I'm of two minds when it comes to this. One the one hand, my personality morality tells me that I should wait my turn, because they are far more deserving folks in line before me. On the other, every jab in the arm helps us collectively, regardless of who received it.
My wife just got her first dose last night, thanks to her job teaching at a university. But no one verified or even asked about her eligibility, which leads me to believe that anyone could have made an appointment. I'm surely at the bottom of the list, since in a healthy adult that is not in any kind of enhanced exposure risk. But I'd be lying if I said the thought hasn't crossed my mind of making an appointment.
As with most things it seems, I'm conflicted.
Is it a net negative? Or, is it less of a positive than the hypotheticals you provided? In my view, every jab gets us closer to herd immunity.
Mind you, I'm not disagreeing with the spirit of your argument. My moral side is well aware of how my selfish side is trying to rationalize things.
I would highly suggest speaking with a healthcare delivery network that you plan on getting vaccinated with - I think they will be able to allay some of your concerns if you're a relatively young individual who doesn't want to 'take the place' of someone more at risk. In many cases the elderly and those who may want a vaccine but have more difficulty scheduling or are at a higher priority and just have not had the chance to get vaccinated yet will still be given priority of some sort, but in an 'off-the-books' kind of way. The person scheduling will likely be looking for ways to get them in when they are available by taking up dedicated priority slots, reserve slots, extra slots, or moving around the schedules of other people as necessary. In some cases they may even have separate vaccination locations which get priority. Obviously I can't speak for each vaccination location and every scheduler, but I think calling with your concerns is a good way to get more information.
While this is true, I think the problem is not a lack of demand at the moment.
In Germany the current problem is the bureaucracy. I'd rather have a few people be vaccinated out of order, rather than vaccines lying around, because "you're in group 3 and not 2, so you should wait 2 more weeks"
I wonder about that.
I looked at my local pharmacies this morning and they had a bunch of available appointments (I want to say 60+ over the next day or two.) Even looking again now several hours later I can see there are still some available.
I know Biden/Fauci/CDC/etc did say that they think at some point in the near future we are going to switch from a supply issue to a demand issue. I don't think we're there yet, but I am curious if we're starting to get close.
That's sort of where I'm at too.
My fiancée would technically qualify right now because she works 2 jobs and one of them is at a restaurant. She stopped picking up shifts there though when the pandemic started and so she doesn't really feel right about taking one now. She qualifies in the next phase though due to "underlying health problems" and is probably going to get it then.
Personally I'm not sure if I feel safe with her going back to the restaurant even when she's vaccinated until I am as well, which of course brings up another dilemma about denying her/our household income that we generally have.
I’m generally a rule follower, but I will admit that I very strongly thought about skipping the line myself. I had some difficulty reconciling that and whether it would be “right” should I choose to do so. Here are some of the places I ended up in my thinking:
The rules for vaccine distribution draw clear lines out of necessity. They have to prioritize some populations and deprioritize others, and they have to be clear for ease of distribution and messaging. That clarity, I believe, can yield a false sense of corresponding morality, where any action that counteracts or goes against it having the taint of being unethical/immoral by nature.
I get where that is coming from, but I also think the spirit of the guidelines is at play here as well. The idea of the vaccine rollout is that high risk populations should be prioritized, and the current phase system is a clear but ultimately imprecise way of delineating that, as @eladnarra covered in their comment. I think a valuable question to consider is that, should the rules fail to identify someone who is at high risk, is it immoral for that person to seek a vaccine for themselves anyway?
There was a news article from a while back, when schools were reopening, about a school that moved its students every 15 minutes in order to circumvent "close contact" designations and corresponding quarantines. I think this is a good example of the absurdity that can come from abiding by the letter of the law and not the spirit, and I see the vaccination rollout as something more guided by spirit than letter. Our goal is to vaccinate the highest risk people, so a high risk person pursuing that spirit, even if it goes against the letter, doesn't really bother me.
I don't think this is what most people picture when they think of someone "hopping the line", but I encourage you to consider that people like this are probably more numerous than the outright selfish and "undeserving" people whose stories tend to pull focus. Rather than focusing on the millions of people who waited their turn or those who chose to get vaccinated as an informed decision regarding their own health and situation, our sense of justice tends to zoom in on and heavily weight the handful of entitled jerks brazenly cutting in front of others and think that they represent more than they actually do.
The piece that I think is most vital here, however, is that I don't think we can consider vaccine acquisition in a vacuum. This is an issue where it's very easy to play up the "individual failing" angle as a way of pulling focus from broader systemic issues.
For example: how many people who want a vaccine but aren't eligible only want it because their employer is flouting health guidelines? I've seen this first-hand as a teacher. I am not in a high risk demographic, but I am in a high risk profession made worse by leadership that is failing to do its part. When the very leadership that is failing to protect me is also telling me to wait for a vaccine, I encourage you to consider: why should I buy in to that?
I think one of the more damaging things we're seeing society-wide is a loss of trust and faith in each other and particularly in leadership (which, given the actions of many leaders, is unfortunately well deserved). With the COVID crisis in particular, we have seen leadership at many levels and in many areas take a "we don't owe you anything" approach. Doing this erodes faith in collectivist beliefs and structures and incentivizes individualist behavior. The message many people have gotten throughout COVID is that they have to look out for themselves at all costs because their leadership certainly isn't going to.
So, when the leadership that has failed to adequately lead throughout the COVID crisis also gives guidelines regarding COVID vaccine distribution, why should people take that guidance seriously? What authority do those guidelines stand on? Why wouldn't people go with what leadership has been implicitly and sometimes even explicitly telling them all along: "you're on your own"? In this way, I can understand even how someone flagrantly and selfishly taking a vaccine out of turn makes sense and isn't worth too much ire in the current climate.
I think tales of "bad behavior" are often ways of getting people to focus on issues at an individual level rather than a systemic one. If we turn our focus to those entitled selfish assholes taking vaccines from vulnerable populations, then we don't have to consider any of the bigger issues surrounding that -- like how our need for vaccines is so great in part because so many institutions failed to take adequate action on COVID in the first place, or how the rules for vaccine distribution have failed to consider certain high-risk populations, or how even the vaccine distribution itself is mishandled (the US's national rollout should not involve millions of people refreshing websites hundreds of times a day to try to get an appointment, for example).
Ultimately, if we're looking at ethical fish to fry, I think there are far larger ones we could cook up than people cutting in the vaccine line. If anything, I think most of the cutting is symptomatic of other larger issues elsewhere, rather than being particularly noteworthy on its own.
Agreed - I answered the question with an assumption of a healthy person with no other risk factors (like grad students who have no contact with patients getting one). But even in that scenario, which I've seen happen, it's the fault of the system (either the college or the health department) that didn't allocate those doses properly and let unqualified people sign up.
I hate how this whole process turns groups against one another. I'm trying to get my first shot, and in FL I can only get appointments at pharmacies or walk-ins at Federal sites. (State sites are off limits to high risk people.) But now pharmacies like Publix are giving teachers priority for appointments. And I find myself resentful of a system that values teachers more than sick people (who have only been able to get vaccinated outside hospitals for about a week), even though I do believe teachers deserve to be getting vaccines right now.
As amazing as the vaccine rollout is at scale, when zooming in it has unfortunately very much failed (and continues to fail) people like you, and I’m so sorry. I hope you are able to get yours soon, and without too much trouble. You deserve better.
I feel this so much, from a place very deep inside. I’m honestly disturbed and even hurt by our modern societal trend of making seemingly everything a divisive fount of friction and fireworks. I think we’re addicted to conflict and we’re pushed to find it at every turn, no matter the subject or issue. It’s unnecessary, exhausting, and it takes the shine out of even unequivocally good things — like mass vaccination finally curbing a hellish year-long pandemic.
It seems like this is a real conflict though? There aren’t enough doses to go around yet. Somehow, this conflict needs to be resolved by deciding who gets a shot. I do wish we weren’t giving some people two doses when others haven’t gotten any, though. Also, a lottery would be a fairer way to do it for people in a similar situation.
The more usual way to resolve it in a capitalist society is to charge more, and that has a lot of problems too.
Ah, thanks for saying this. I actually had a LOT more written out before I posted but edited nearly all of it out in the interest of not soapboxing once again. Unfortunately that made my post a lot less precise and clear than I was intending.
The conflict I'm referring to here isn't the innate conflict triggered by a limited resource but how people are leveraging that into a larger culture war (as we seemingly do with everything now). I can't tell you how many disparaging takes I've seen using vaccine distribution as, well, just another way of shitting on people. Stories of people cutting the line activate our sense of injustice, making us angry and outraged, giving us people who are easily hateable. Judgments about eligibility, meanwhile, allow us to shit on entire demographics. I've read innumerable takes using vaccine distribution as a proxy for casting teachers as being selfish, entitled, and inconsiderate, for example.
Outside of Tildes and other teachers who I also know got vaccinated, I'm not mentioning my vaccination to anyone because it's unfortunately part of an unnecessary cultural flashpoint and a way of imparting negative moral judgment on me. Despite the fact that I waited my turn and have been working up close and personal with the virus for months, my vaccination doesn't have a popular public face. I should be delighted that I got my shot, but the inane culture war surrounding it dampens that joy and makes it private and unshareable. Before I got mine I should have been happy for other people getting theirs, but the only way I could see them was through a lens of selfishness -- of wanting what I didn't have and begrudging those that did. I dampened their joy. I made it private and unshareable for them too.
Vaccination as it's happening now is a wonderful thing. It's an amazing feat of science and logistics. It is our path out of the darkness, and it is here and it is happening, right now. Unfortunately, I feel like the internet’s and society's optimization for conflict hides all of that good behind activating people's frustrations and a malignant self-interest. Instead of people looking at those getting vaccinated and seeing the beauty of that moment being the initiation of a personal peace, safety, and relief for that person, we're instead encouraged to look at them and find ways to see them as unworthy all while inflating our own sense of worthiness in comparison. The dominant discussions about vaccines aren't celebrations but condemnations, and it doesn't have to be that way.
There are situations where the guidelines are not good enough. For example, my dad teaches fifth grade. Despite him and his students doing very well this semester, his school is trying to get back to in person as fast as possible. They have said that the teachers will get a jab before they come back, but they didn’t say anything about the people who have to interact with the teachers on a daily basis.
In this scenario, my dad would have to go elementary school, which has always been a perfect breeding ground for diseases of all types, and come home to my mother and siblings who are unvaccinated. Therefore, I would not feel that it would be ethically wrong for someone in my mom’s position to seek a vaccine.
My mom, instead, is going to wait and my dad is going to ask (and possibly demand) to stay remote.
As another example of how the system fails, my dad is a high risk teacher, so should be pretty high on the list. My sister is low risk, so should be dead last. She works for a wine producer on the bottling line. Her job somehow got her a vaccine. She had completed both doses before my dad even had the option of getting the first dose.
I know many teachers who have jumped the line, and they have my full support. The same goes for anyone whose work situation is putting them at risk. The guidelines for phases assume that all workplaces are following adequate safety protocols, but we know that’s definitely not the case. I don’t think doing what you need to do to protect yourself or your loved ones is unethical in that situation, as “unethically” obtaining vaccination is a way of counterbalancing the unethical behavior of employers.
A high risk teacher I work with got vaccinated over a month ago on the advice of his doctor, who told him flat out “do or say whatever you need to do to get one”.
I hope your dad gets his vaccine soon, or has his remote request accepted.
That’s a really good point that I didn’t think about.
It’s sad that teachers, who should be very valued members of our society, have to go through this shit. If anyone thinks that school districts exist to help kids, COVID should be an eye opener. Schools exist only to help themselves (yes, I’m talking about public schools). I helped my dad out at his school yesterday. They have his room setup as a “model” room. The student desks are about 3 feet apart. They might just be 6 feet apart from the center of the desk, but that isn’t how social distancing works. There is no way to move throughout the room or teach and maintain social distancing. Their current plan is to split the students into two groups and have them each do a half day with an hour in between to sanitize the rooms. Each school has one fogger, and it takes an hour to fog each room nobody knows how the district plans to fog 20 or so rooms in one hour with 1 machine. The school cannot offer bussing for either group, but they won’t even tell that to the parents yet.
Sorry, that got a little rambly. It has been pretty frustrating watching the ineptitude of the school systems throughout this pandemic.
No need to apologize! As a teacher, I’ve done more than my fair share of school-related ranting on this site, so it’s nice to see it from someone else as well. Your words are falling on sympathetic and understanding ears. I wish the best for your dad and his difficult and frightening work situation, and I hope he is able to get vaccinated soon (even if that means taking one out of turn).
He currently has two appointments for a vaccine, one of which is through the local education office. Hopefully at least one doesn't get cancelled. He already had a previous appointment that got cancelled. You would think that the hospitals would know how many appointments they can make based on their number of vaccines, but I guess not.
I can't speak for every healthcare delivery network, but many will schedule based on a combination of history (how many vaccinations they've received), how many confirmed orders they currently have, and a projected receive date of said orders.
At our own system we have seen fairly regular delivery date changes and have had both mRNA manufacturers push dates for some shipments out by more than a week.
We are trying to ensure we can get out as much as possible as fast as possible, and unfortunately for us that means at times we are basing our appointments around what data we know. When a manufacturer waits until a week or two before the shipment is supposed to arrive to tell us it will be another week, we need to reschedule as appropriate.
It’s nice to hear from someone who is helping with the deployment. Thanks.
Do you know if the slow communication on the part of the vaccine producers is actually slow? As in, do they communicate with you as soon as they know there is going to be a delay? Or are they waiting for whatever reason to communicate?
It just seems that, as an outsider to this process, communication should be the most vital piece of the puzzle now that vaccines exist.
Also, thanks for what you do regarding this vaccine rollout.
I really can't comment on the internal politics. I suspect there's some slowing for political reasons at times just as there are a plethora of other issues such as shipping problems, operational problems, production issues, overseas issues, communication errors and any other possible breakdown along the complicated chain from production to injection.
There's always trade-offs to be made when it comes to this kind of stuff. We could wait until we have received the vaccine to schedule anyone and then we'd never have to reschedule, but that also means longer delays to people receiving the vaccination. I'd rather play slightly faster and nimbly even if it means we need to reschedule patients when there's a bigger problem than usual.
This question goes back to one's view of ethics. If one holds the belief that the ends justify the means then they'll respond this way to this question. If one ascribes to the deontological view of ethics then they'll answer no to the question.
I agree with your scenario and feel like it's justifiably reasonable; however, I don't ascribe to the view that the ends justify the means so it would still remain unethical as there are standards and procedures clearly defined around who can and cannot request a vaccination - regardless of whether or not the administer is checking that the patient is qualified.
I'm not really familiar with deontology so I'm genuinely curious: what would it say about someone whose desire to break the rules is directly related to someone else's rule breaking? Not in a "they're doing wrong so I can too" sense, but in a "someone else's rule-breaking materially impacts my decision to follow them". In the context of this discussion: many people wanting to break the rules for vaccine distribution are doing so only because their employers are breaking health and safety rules and putting them at risk, thus creating the desire to break vaccine distribution rules in the first place. Does a deontological perspective weigh those equally?
No, to my understanding of it. The action is good or bad by definition, and is its ethics isn't swayed by context or situation. A common scenario is stealing. We'd nearly all agree that stealing is not ethical and that it is most definitely not a victimless crime; however, some people change their answers when considering the context of stealing. If you're starving, does stealing some food to survive remain unethical? To the deontological group, yes. The consequence or situation surrounding the action is not taken into account, only the action itself.
It feels kind of shitty, tbh. There are so many people who are higher risk that still haven't managed to make an appointment, or don't even qualify yet because their state doesn't include "immunocompromised due to medication" or whatever.
I'm currently waiting for a form that my doctor is mailing so I can qualify for vaccination as a vulnerable person. I feel a little weird about it ethically, since I don't have any studies I can point at to say that I'm at a higher risk of dying. But my doctor and I think the long term consequences could be bad for me, so... I'm going to do it now, assuming I can find an appointment, rather than waiting. I can't really afford to be more disabled than I already am, and I'm already putting off medical care to avoid exposure.*
It still feels bad to know that people who are sicker than me can't get vaccinated in other states.
*I see some folks saying that if you take an appointment from someone who is higher risk, at least you're helping with herd immunity, so it's not that bad. But you're helping society devalue the lives of disabled people, and delaying their access to important healthcare.
Follow up question: What about someone paying to skip the line, with their money going towards funding covid relief?
I haven’t actually heard of this being an option. I’m sure extremely wealthy people can do this, though. If I had the opportunity to pay my way ahead and the money was deemed enough to be a collective benefit, I’d do it.
This is an option indirectly by volunteering. Many places will give you a vaccine after a certain number of hours volunteered. I have tried to get a spot volunteering, but my area is full completely.
I think it's wrong if you're jumping in line prevents somebody from getting one. That doesn't seem to be happening, but I'd only be willing to give it a pass if I could know for sure that it doesn't short somebody at the end of the day.