It was a long hard battle in California to reduce nicotine dependency. That’s what it is. I don’t know the extent to which NJ has gone after big tobacco. But there should be a program along with the vaccine to get this risk group into addiction counseling and other services. And Big Tobacco should pay for that. Smoking increases risk for a massive number of health threats so this kind of precedent could bump the “users” up the ladder for every epidemic to come.
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My wife (a physician who’s been vaccinated because she treats patients with covid) were discussing vaccine prioritization. Because the science on whether the vaccine impacts transmission is still out healthcare providers still need to quarantine after an exposure. Just like two months ago. As such if the desire is to remove burden on the healthcare system then it may make more sense to vaccine first those most likely to clog up the ERs, hospital wards, ICUs, and morgues. This could have a significant impact on available beds and covid deaths thus reducing the burdens (including emotional and psychological) on the medical practitioners.
So while I find it personally repugnant that those who have chosen to compromise their own health should get preferential treatment it does seem to be for the greater good. The same thing applies to all the covidiots out there.
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MA too.
I agree with that. There are a host of “lifestyle” choices that put health at risk. Processed foods, lousy diet, too much sitting… I don’t think it makes sense to cast opprobrium on smoking, particularly, just because it’s a very visible sin. Also, I don’t want to be in the business of counting sins.
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Are you saying that you believe a significant number of people will start smoking over the next decade because they might get an earlier vaccine during the next pandemic?
Giving a benefit to people who acted badly in the past is not the same thing as an incentive.
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I’m saying that at the very least this incentivizes people to lie in order to get earlier access to the vaccine, and creates an ethical conundrum for doctors who genuinely want to do what is best for their patients. A person who smokes rarely, or quit smoking long ago, or never smoked at all might claim to be a smoker to jump in line, and their doctor would probably sign off on it because their duty is to keep patients healthy rather than keep them honest.
Also as stated above, trying to sort out every possible risk factor for Covid-19 will slow down overall distribution. If implementing a system to assess who is “high risk” delays the vaccination effort by even a single day then that could mean another 4,000 American lives lost.
Yeah, I definitely agree with that. Weirdly, it seems that we don’t have a shortage of vaccine right now, but rather a shortage of ready arms. In my state, it seems nobody is in charge. 
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- Smokers are more likely to get complications.
- Complications are more likely to need a hospital bed.
- That means the hospital bed isn’t available.
- Vaccinating smokers increases hospital capacity (for COVID and non-COVID patients).
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Exactly. Treating this as “incentivizing” bad behavior misses the point. An airborne viral pandemic is a collective health risk and decisions should be based on minimizing that collective risk. That’s why I’m happy to receive the vaccine when trained medical authorities say I should and not before. It’s the same reason I’m not happy when even the most vile covid deniers on the planet contract the disease. An airborne virus doesn’t care about character; each host is just a vector to infect more hosts.
The way much of the public and pundits have treated this whole pandemic reminds me a lot of certain religious sects tendency to think that illness is a sign of immorality, thereby fueling the infection rate in prisons, pretrial and otherwise, which spreads to guards, police, officers of the court and then all the rest of us.
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Yeah, I’d say put out the criteria and let people self-select. I would say don’t even verify age - you say you are 70, fine, jab, next. Sure, assholes will cut in line, but most people will go when they should, and we want to get everyone anyway.
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It already is a great Babylon 5 episode, Confessions and Lamentations [S2, ep18].
From Synopsis: "Confessions and Lamentations"
Dr. Franklin injects himself with stims in order to keep himself awake. Lazarenn, still inside the isolation area, tries to convince Dr. Franklin to sleep, but Franklin says that, if the plague has spread, that won’t matter much. They haven’t found out anymore about the Pak’ma’ra, but more and more Markab continue to die, though the violence has been brought under control. Franklin explains that he doesn’t understand why humans never learn from all the diseases they face, such as the Black Death, AIDS, and Chalmer’s Syndrome. Lazarenn asks about the Black Death, and Dr. Franklin explains how it hit Europe in the 14th century, and that it too was considered an immoral disease, possibly sent by the devil. Cats, the familiars of the devils, were killed by the millions, but since they were the only way to control the rat population, the true way the disease was spread, the plague spread even faster. Lazarenn finds the situation humorous, since often the strategy that makes the least sense is the one that’s done the most. He then collapses against the window of the isolation booth, and explains that his suspicions are confirmed: he has contracted the plague. He tells Franklin to run tests as quickly as possible, now that he has someone in the earliest stages of infection.
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Personally, I’m much more concerned about anti-vaxxers than line-jumpers.
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The actuaries have calculated a lot of risks out to the third decimal place.
And if we make getting the vaccine as complicated as getting life insurance then thousands more will die from the delay.
I’m not saying it should be a first come, first served free-for-all but there’s a point at which trying to assess individual risk for all vaccine recipients becomes counterproductive.
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A combination of “most likely to end up in the hospital if they get sick”, “most likely to get sick”, and “most likely to cause people to die by leaving holes in professions that we need to keep people from dying”. Policy is messy, but all of these have to be balanced.
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The problem with that approach, as satisfying as it might feel, is that it leads to more filled hospital beds. An infected young teacher, with no underlying commodities is more likely to spend their illness at home. Someone with smoking related lung damage is more likely to land in an ICU bed. Given the duration of a lot of those ICU stays it is likely that system wide you’ll have better resource utilization protecting the smokes. An overcapacity ICU risks every group, whether they fit our moral concerns or not.
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If I were coordinating vaccine distribution, I would first vaccinate those who make the most physical contact with others. Wouldn’t that spread protection more efficiently and get the most impact out of each shot? This would slow the spread quickly and perhaps could be determined by profession? Of course, this approach requires a big picture, collectivist, systems thinking mindset that helps the most people the most quickly so it would never happen in the US.
Yeah, this. Especially since we don’t yet know how effective the vaccines will be at preventing transmission, the goal is to get it into people with the highest risk, rather that “the most important” people. This also includes prisoners, the homeless, and people with other health issues that are either caused by or exacerbated by personal “choices”. 95% of people would be in better health if they ate healthier and exercised more. But while medical professionals can recommend healthier practices, their job ultimately is to treat patients how we are, not how we wish we were.
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just vaccinate people JFC it doesn’t matter who goes first
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So some vaccinations are effective at completely stopping transmission of disease while others let you catch the virus and become infected but have no or mild symptoms. One of the things that was delayed in favor of fast vaccine development and testing was finding this out. All of the trials were heavily focused on whether the vaccine was safe and whether it prevented disease and serious disease. Most people in the field seem to suspect that it will also reduce transmission and maybe eliminate it entirely at least for a period of time, but that is just a (well) educated guess.
But that is at least one reason that public health experts are recommending prioritizing people with the highest personal risk – rather than the people with the highest likelihood of transmission. The latter could even potentially be harmful: for instance if you vaccinate people who work in nursing homes but not the people who live there you might actually increase the chance that people go to work unknowingly spreading virus.
Of course risk of exposure is one component of risk of illness, so that is why essential workers and medical workers are still prioritized above the general population.
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