4 questions to help resolve the ethics of getting a COVID vaccine before you are eligible

So far, many people have received one: A tip about a nearby pharmacy that doesn’t seem to be checking people’s eligibility for their COVID-19 vaccination line. A text with a link to a clinic that does not ask questions about underlying health problems.

Or maybe you’ve heard rumors that friends or family are applying for a chance, even though they don’t meet state and federal eligibility requirements.

Should you sign up too?

It is an ethical dilemma that many people are facing as Minnesota expands access – and eligibility for – the COVID-19 vaccine.

In just a few months, the number of doses of the three available COVID-19 vaccines has grown dramatically in Minnesota. The variety of places where people can be vaccinated as well. Pharmacies, health care providers, county public health departments and even churches are setting up vaccine clinics across the state.

But the eligibility parameters at each location – the age matrix, health conditions, location and occupation that make people eligible for the vaccine – can vary, sometimes outside the limits of state requirements. This is usually due to a number of factors, including the organization or entity that distributes the vaccine, to whom a clinic or location is intended to serve, and whether the particular vaccine stock came from the state or federal government.

To complicate matters, it is a state rule that requires doses to be used quickly. This time constraint, set to speed up vaccination, has led some places to offer more flexibility in vaccine eligibility to keep pace.

So: Out of a call from your doctor or an alert from the state vaccine connector, when is it possible to apply for a vaccine – especially if you do not meet the eligibility rules set by the state?

‘Participation in the common good’

In general, University of Minnesota bioethicist Joel Wu says the answer is straightforward: if you are not entitled to a vaccine according to state rules, you must wait your turn.

This is especially true because the demand for vaccines continues to exceed supply. The state’s phased eligibility approach was designed to prioritize vaccination for people most at risk of serious cases of COVID-19.

Because of this, Wu said, a person’s decision to skip the line to get a vaccine for which they are not yet eligible comes down to opposing individual desires to our obligations to society at large.

“There really needs to be a reawakening of the idea of ​​participation in the common good, where each of us has to do our part to be together in health and safety,” he said.

Wu compares this to driving at random.

“You can’t drive the way you want to, because even if a fraction of a percent of people don’t respect the red light, the whole traffic venture collapses,” he said.

But sometimes – because of the circumstances, the moment or chance – people are faced with the question of skipping the line and trying to get vaccinated before their turn.

If you find yourself in one of these cases, here are four questions to ask:

1) Do you have access to this scene because of the privilege – or your position in society?

The state has a long and detailed plan to vaccinate as many Minnesota residents as possible, but it is happening in phases, putting people at greater risk of contracting, spreading and dying from COVID-19 on the front lines.

This includes older people; people with underlying health conditions that put them at greater risk for a serious case of COVID-19; people whose work puts them at greater risk of contracting the virus while at work; and people living in congregational care.

Young, healthy people are being asked to wait a little longer for their injections.

But Wu said that things get dangerous when not everyone agrees to adhere to that plan – because then the plan is no longer useful and it is no longer fair.

“People who don’t need [the vaccine] and are less likely to be injured they can receive more doses, and less privileged people with less access will bear the greatest burden, ”said Wu.

In the real world, Wu said, it may seem that someone has the means and the time – because they work from home, for example, or have easy access to a computer or the internet – to search for and apply for a vaccine for which they are not. eligible.

Or it may look like someone with easy access to transportation, who can reach the vaccine site in a short time.

It can also manifest itself in social connections – if you have a friend or family member in a position to prepare you for a vaccination appointment later in the day.

If these factors contribute to a scenario where you can get a vaccine, the ethical thing to do is to wait, said Wu.

2) Would your life change significantly if you waited until you were officially eligible?

If you have the opportunity to get a vaccine, said Wu, consider whether waiting a few more weeks to get the vaccine will make a big difference in your life. And consider whether getting an injection today aimed at someone who is most at risk could put you in danger.

Ask: “Am I using a specific type of access or privilege that I have and that benefits me only marginally, but can harm many more people?” he said.

“If that isn’t going to help me a lot and, in the long run, it’s going to make circumstances less fair and people at high risk remain at greater risk for longer, I think it’s ethically problematic.”

And remember: younger, healthier people will not have to wait much longer for a vaccine.

Vaccine allocations are likely to increase dramatically in just a few weeks. State health officials said Minnesota is likely to receive 100,000 doses of the Johnson & Johnson vaccine soon.

And eligibility groups will continue to expand. State officials said that every adult who wants a vaccine is likely to be eligible in April.

3) Do you need to lie or be vague about your situation to receive the vaccine?

The state has clear guidance on who is eligible to be vaccinated now, and providers across the state are generally following this.

There are exceptions, in which some providers – including some pharmacies and clinics, federally qualified health centers, Veterans Affairs clinics, Indigenous Health Service facilities and sovereign indigenous nations – operate under different sets of rules, established, for example, by federal government, programs administered by the state or by tribal governments.

But in practice, some providers that are subject to state rules are not monitoring the eligibility of each person who signs up. For example, you are unlikely to have to prove your employment in an eligible work sector or your underlying health condition if you make an appointment at a pharmacy.

Some are taking advantage of these loopholes, saying, for example, that they work “in the courts” as a way to qualify for a chance when, in fact, they work from home to a private law firm – or a parent saying that they do. for a photo as a “child care provider”.

“This is ethically problematic, even if you are not arrested for it,” said Wu.

It’s a complicated balance, said Wu. The state does not want to put up too many barriers because vaccination slows down.

But it also makes the system mature for people to take advantage of it.

4) Will this dose be thrown away if you don’t take it?

Wu said that this is a situation where the rules change.

Vaccines are scarce and no one wants to miss a dose. So if you have the option of taking a dose that would otherwise be dropped, Wu said, you should take it, even if you are not eligible under state guidance. (State health officials said this is also OK.)

“This is ethically appropriate,” said Wu. “If it is otherwise wasted, the benefit is not for anyone in the community.”

The benefit of none a person receiving the vaccine benefits the community as a whole, he said, because it is an additional small step towards collective immunity.

“The more people we vaccinate, the more likely we are to stop transmitting the virus in the community,” said Wu.

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The data in these charts are based on the Minnesota Department of Health cumulative totals released daily at 11 am You can find more detailed statistics on COVID-19 at Department of Health website.

Coronavirus is transmitted by respiratory droplets, coughs and sneezes, similar to the spread of flu.