I admit it: I have vaccine envy. It’s that feeling of jealousy, disappointment, or resentment you feel when someone else gets the vaccine for COVID-19 — and you can’t.

I’m not proud of it. We should all be celebrating the astounding speed with which multiple effective and safe COVID-19 vaccines were developed. Millions of people are receiving them daily, bringing the increasingly real possibility of herd immunity closer day by day.

So, I should just be patient, right? It’s not easy.

Vaccine envy is inevitable

Current evidence suggests vaccination could save your life and those around you while helping daily life achieve a semblance of normalcy. And while we can reduce the risk of becoming infected without the vaccine (for example, through physical distancing and face coverings), there are plenty of reports of people “doing everything right” and still getting infected. So, it’s good to know people are getting vaccinated.

But it can be tough to see your friends, family, or coworkers beaming up at you in emails or social media posts, holding a vaccination card or flaunting a band-aid on their upper arm.

The vaccine rollout is testing our patience

It’s hard enough to tolerate the way this pandemic has upended our lives. Every week, thousands of people continue to become sick and die. But it’s harder still to know there are highly effective vaccines that only some of us can get. For those who want a vaccine, yet aren’t eligible or cannot get a rare appointment, each passing day is another day facing unseen and uncertain risk. So it’s understandable that many people are running out of patience.

The vaccine rollout is testing our sense of fairness

When the first vaccines were approved for emergency use, there were too few doses available for the entire US population. So, the CDC created detailed recommendations to set priorities for who should get the vaccinations first, by considering groups most at risk for illness and death. Healthcare workers and residents of long-term facilities topped the list. Frontline essential workers and the elderly were next, followed by those with conditions linked to more severe COVID-19. Farther down the list is everyone else.

Unfortunately, the subsequent rollout of the COVID-19 vaccines was confusing, unpredictable, and in many cases unfair. For example:

  • Eligibility varies widely from state to state because each state created its own priority lists. For example, some states prioritized people who received cancer treatment within 30 days; others prioritized anyone with a cancer diagnosis, even if it was years ago and now in remission. In some states, teachers could receive vaccines in January; in others, they’ve just become eligible.
  • Some health issues that could increase COVID-19-related risk, such as certain neurologic or autoimmune diseases, do not count as a “comorbid condition” that moves up vaccine eligibility.
  • Scheduling vaccinations has been difficult in many states. Navigating online appointment systems has been impossible for some older adults, people lacking time or resources, and others.
  • Vaccine shipments reaching vaccination centers have fluctuated, making it impossible to predict whether there would be enough to provide to eligible recipients.
  • Verification of age or health conditions varies widely. Some states rely on the honor system while others require documentation.

So, even within similar groups of people, these factors mean that some already have the vaccine and some are still waiting. That doesn’t just seem unfair — it is unfair.

Who gets the leftovers?

“Leftover” doses of vaccine allow some people to get vaccinated before they are eligible. Once an mRNA vaccine thaws to room temperature, it must be administered within a few hours or thrown out. Because each vial holds multiple doses, any left over may be offered to anyone, even those not yet on the priority list, to avoid wasting them. This has led to swarms of people — called “vaccine chasers” — flocking to wherever there are reports of leftover vaccines.

Social media has helped enable this. Connections matter, too. Ideally, those in charge of vaccine administration would keep a backup list of eligible recipients who could come on short notice to receive leftover vaccines. But such systems require upkeep and resources that aren’t widely available.

The fact that people can jump the line raises questions of fairness.

The vaccine rollout is testing our ethics

More questionable than accepting leftover vaccine doses that might otherwise be wasted are efforts to game the vaccine eligibility system. For example, there have been reports of

Ethically questionable acts like these may worsen existing health disparities suffered by minority groups who are already disproportionately affected by the pandemic. The economically disadvantaged are less likely to have the time, resources, or connections to get around the eligibility rules, compared with those with more privilege.

The bottom line

The COVID-19 vaccination eligibility rules have put many of us in a difficult spot: hoping to get a vaccine as soon as possible, but having to wait as others get it much sooner while grinding our teeth over people who seem to be cutting in line. But instead of jumping the line as well, we should speak out against rules that seem unfair, try hard to be patient and understanding until our turn comes, and continue to take measure to reduce our risk — including wearing masks (which is no longer required in some states).

Within a few months, everyone who wants a vaccination may be eligible to get one. Meanwhile, if you’re experiencing vaccine envy, welcome to the club.

Postscript: Soon after writing this blog post, I became eligible for the COVID-19 vaccine and have received my first dose. I hope widespread vaccination soon eliminates vaccine envy for everyone.

Follow me on Twitter @RobShmerling



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