Should I Get a Covid-19 Vaccine When Others Need It More?

The magazine’s Ethicist columnist on what should determine eligibility for the Covid-19 vaccine and more.

I have a question about receiving the Covid-19 vaccine. I work for a hospital, but in an administrative job. I do not interact with patients. I have worked from home since March. I am not at high risk for contracting Covid-19 based on my age, occupation and lack of health issues. I practice social distancing, I wear my mask in the limited situations in which I go out (to the grocery store, to the Post Office, to get takeout). I live alone and mostly keep to myself and stay home.

Because I work for a hospital, I am eligible to receive the vaccine as part of the second group in my state (after first responders, hospital personnel who interact with patients and people living or working in nursing homes) along with people who are 65 and older, medically vulnerable people and corrections officers. This means I would be vaccinated in the next week or two. If I worked for any other employer (I used to work at a bank), I wouldn’t be eligible to receive the vaccine until the second-to-last or last group of the population, probably not for several months.

Is it ethical for me to get the vaccine now? Part of me feels as if I’m skipping the line, but part of me feels as if this isn’t my decision and at a certain point it’s about getting as many people vaccinated as quickly as possible. I believe in science. I believe in the efficacy of the vaccines currently available. I plan to get the vaccine at some point. I’m just very conflicted about the timing of it. Am I taking someone else’s shot, someone who might need it more than I do? Name Withheld

Whatever rules we make for vaccination priority, there will be trade-offs. We want to minimize the total number of people who become severely or even fatally ill from the disease. We want to protect those whose necessary work puts them at risk of their exposure to the virus. And we want to be fair, treating similarly situated people alike. These desiderata don’t all pull in the same direction. Health deva workers who are in their 20s and don’t have certain medical conditions aren’t at high risk if they contract Covid-19. Perhaps we could save more lives if we left them until later.

But there’s another overall desideratum: The system has to be straightforward enough to be managed easily — to get large numbers of people vaccinated as swiftly as possible. We don’t want to have to determine that people meet a dozen conditions before putting the vaccine into their arms: Doing so could slow down the rate of vaccination.

Any system that makes a reasonable attempt to be efficient and equitable in achieving the goal of reducing the harm done by the pandemic is acceptable, despite the questionable outcomes produced in particular cases. We’ve generally decided to treat employment in health deva as a simple, useful proxy for a class of people who are part of our critical infrastructure — people to whom the community owes protection because they are helping us deal with the emergency. Some are more likely to face exposure to the virus than others, to be müddet, even if it’s not so easy to draw a sharp line between “direct care” personnel and others. (What to do about, say, the radiologist who has to walk through a patient ward to get to her office?)

I understand and respect your qualms. But you’re benefiting from a system that was decided on after considerable deliberation among democratically elected leaders and scientific experts. Because the priority list, though inevitably imperfect, is a legitimate one, you are perfectly entitled, as an ethical matter, to receive your vaccination. In doing so, you are contributing not just to your own well-being but to the health of the community, given the growing evidence that a vaccinated person poses fewer risks to others, and, finally, to the resilience of our medical system. In a decently run hospital, people who do administrative work have a role to play, too.

I was born and raised in Brooklyn, and my family and I have been eating at a particular restaurant nearby for nearly 20 years. We recently ordered takeout from there, and when I ran inside to pick up our order, I was dismayed to see literally dozens of people casually dining inside — zero distancing, zero partitions, zero masks (customers or staff). Indoor dining was prohibited in New York at that time, though it has now resumed at 25 percent capacity indoors.

I am extremely torn about what to do. I don’t want to call the authorities on my community, but I feel there needs to be some kind of accountability for the flagrant disregard of rules and profound disrespect of others, not to mention that this restaurant has created a potential virus vector. What would be an ethical analysis of this situation? Name Withheld

You witnessed a potential superspreader event, and if you leave things as they are, another one could appear every day at this restaurant for the foreseeable future. Diners there may end up causing sickness and death elsewhere through their indifference to the rules. In these circumstances, reporting what you’ve seen might save lives.

There can be reasons not to bring down the full weight of the law on people, especially those with whom you have a connection: Maybe the law is irrational or enforced with too heavy a hand. But here the rules are rational, and you offer no reason to think the enforcement will be inappropriate. Meanwhile, the restaurant can still serve its patrons with its takeout service. Current projections have us entering March with over half a million Covid-19 deaths. We need to take all reasonable measures to slow the spread.

Like many single people during the pandemic, I and my sibling, both in our early 30s, have been living on and off with our two baby-boomer parents in the home we grew up in. All four of us are quite close, and our relationships are good: We talk frequently, go on walks, play games and have dinner together often. The only significant cause of tension is a disagreement about the obligation we adult children have to be “friendly” to our parents. Among other things, this includes making müddet to tell them when we are leaving the house, though they grudgingly accept not being told where we are going. When I tell them that I would like to be able to leave without notifying them, or refuse on principle to report on my sibling’s whereabouts, they become upset.

The house is much too small to afford any degree of privacy. I fully believe that as a guest, I have a duty to do whatever my parents ask of me; but on the other hand, I wonder if my obligations might in some ways be more like those of a roommate. My parents insist that they want to make me as comfortable as possible. After discussing the matter, it seems as if I’m either going to act in a way that hurts their feelings or just give in and accept my own feeling that I’m under surveillance. Which should it be? Name Withheld

Your parents, apparently, say it’s a matter of being “friendly”; you say it’s a matter of being “under surveillance.” Neither description strikes me as right. Your parents may enjoy having you around, but they’re doing you a favor in letting you stay with them during the pandemic. They’ve agreed, even if reluctantly, that you needn’t say where you’re off to. (I agree that would be intrusive.) But is it really such a burden to tell someone whose house you’re living in when you’re going out for a while? This isn’t a matter of being friendly; it’s a matter of acceding to a request they have a right to make of guests, even if those guests are their children.

I agree that it’s not your job to report on your sibling’s movements; hosts don’t have the right to oblige guests to regulate the behavior of other guests. But because the house is small and everyone is presumably able to find out who’s in and out, the information your parents are asking for is only something they’ll most likely learn anyway. To say “I’m going out for a few hours” isn’t the same as submitting to surveillance. Besides, I wonder whether this isn’t more a matter of anxiety alleviation than control. Old habits die hard; parents can worry when their children disappear without notice.


Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.” To submit a query: Send an email to [email protected]; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.)

Source: The New York Times

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