Clamoring to be ‘most eligible’ for the vaccine

The pandemic is a triage situation that makes it important to prioritize the ability to help all groups by helping one.

What does it mean to be eligible?

It is the right to do something, the right to get something. If you are looking to fix your daughter up with the perfect guy, you are looking for the most eligible bachelor — the guy who will check all the boxes. To be eligible generally means something good. You are eligible for contests or honors or opportunities.

And right now, the word “eligibility” is partnered with the coronavirus vaccine.

The list of people eligible to get the COVID-19 shot was short when the Pfizer approval was given in December. It began in the hospitals where the battle against the disease was being fought. It made sense, especially because those people had a high instance of contracting covid because of their exposure.

Since then, the eligibility has expanded.

It went to nursing homes. The staff and the patients — people whose age and pre-existing conditions put them most at risk — needed to be protected.

Then there were more additions. All of them were important, and all of them were needed. The state is in Phase 1A of vaccinations, and health care workers of all kinds, from pharmacists to dentists to prison clinicians are included. So is anyone older than 65. So is anyone with a list of high-risk conditions like cancer or heart disease, regardless of age.

It’s an expansion that might mean next to nothing given providers are reporting there isn’t enough vaccine to go around.

So how do we know who is getting the shot? How do we know eligibility means what we think it means?

“People are asked at the time of requesting a COVID-19 vaccine, and again when they arrive for vaccination, to answer ‘yes or no’ when asked if they have any of the underlying medical conditions that the CDC lists as placing them at higher risk for severe covid-19 illness,” UPMC spokeswoman Taylor Andres said.

But no one has to prove they have a sickle-cell disease or a kidney condition to sign up for the shot. There is no requirement that you present documentation the same way you would to qualify for a driver’s license or a passport or food stamps. It’s all about the honor system.

The problem is that expanding who is in 1A is frustrating for people in 1B who are every bit as deserving.

Let’s take smokers, for example. There is logic to moving smokers up. Cigarettes put them at risk for a number of respiratory diseases such as emphysema and cancer, both of which are on the list of pre-existing conditions.

But for corrections officers, whose job requires them to be in close quarters with a contained population where disease is spread easily, that can feel like a slap in the face.

“Our members are overworked, exhausted and are working massive amounts of overtime due to COVID-19 illnesses within their ranks. The mental anguish of passing the virus to their loved ones also takes a tremendous toll,” said Pennsylvania State Corrections Officers Association Vice President John Eckenrode. “It’s time for this administration to use common sense in its vaccination plan.”

The state has yet again tripped over its own good intentions, as it has repeatedly since March. The pandemic is a triage situation that makes it important to prioritize not just need but the ability to help all groups by helping one. It’s like when the oxygen masks drop on an airplane, and adult passengers are told to put on theirs before helping children.

Expanding eligibility for 1A would have been a morale issue if there was plenty of vaccine to go around for that first phase. Expanding eligibility when there wasn’t enough just invited more problems.

The pandemic is a triage situation that makes it important to prioritize not just need but the ability to help all groups by helping one. It’s like when the oxygen masks drop on an airplane, and adult passengers are told to put on theirs before helping children.