The long anticipated roll out of the first vaccine to prevent COVID 19 is underway at my hospital. It hasn’t gone without controversy though. Like many institutions, they stated that frontline workers would be among the first to get the vaccine. Of course there are thousands of frontline healthcare workers just at my institution, and only a small fraction of doses available at this time. It begs the question, who should get it first?
I think it was sold that doses would be prioritized to those workers who are at most risk by both most exposed and most vulnerable (age, ethnicity, and chronic health). While this sounds totally reasonable to me, the process of identifying who is in fact the “most exposed” hasn’t been very transparent. The administration announced several “phases” or “waves” with vague titles such as “acute care”, “ICU” or “support staff”. They have not clarified what specific units fit into these broad categories. Our L&D nurses, for example, serve as a triage point for all pregnant women. We see a lot of COVID positive patients, who are allowed to have a COVID positive support person and to remove their masks in active labor. These nurses are at the bedside for their entire shift in very close contact for their entire labor. They support these moms through aerosolizing procedures, active labor and delivery. Their risk is extremely high. Their vaccination opportunity falls in the second “phase/wave”… this was unsettling to learn, but it was much worse when stories of medical students (who don’t have patient contact), residents, and physicians (who spend little time at bedside in contact generally speaking) are receiving vaccines ahead of bedside staff such as our L&D nurses.
As far as who might be at more risk from a demographic/ overall health standpoint, there was no systemwide survey conducted. So there is no transparency around how these decisions are being made.
I know that my risk is lower than many nurses at my hospital, maybe even several physicians and residents, but surely not medical students! I can wait for my turn, I can absolutely appreciate that there people whose age and/or health requires more immediate attention, but it is all an easier pill to swallow when the process of decision making is transparent. I think I have a right to know the process and understand where I reasonably stand, given the sacrifices that I have personally made over the last nine months. Please respect me enough to offer this small curtesy!
And yes, when you are offered a vaccine, you should take it (unless your medical doctor has outlined specific risk factors that are contraindicated)! COVID is a public health issue. It doesn’t know republicans from democrats, race, sex, gender… etc. Healthy people who get vaccinated protect those who can’t, and eliminate horrible deadly diseases from our communities. See Polio, Smallpox, and Measles for more understanding.
Waiting … for my number to protect those I love, and you and those you love!
