Four questions that can help you sort out the ethics of getting a COVID vaccine before you are eligible

Currently, many people have gotten one: A tip about a pharmacy in the area that apparently does not investigate the fitness of the people in its COVID-19 vaccination line. A text with a link to a clinic that does not ask questions about underlying health conditions.

Or maybe you heard through the vine that friends or family members are signing up for a shot even though they do not meet the requirements of the state and the federal requirements.

Do you also have to log in?

This is an ethical issue that many people face as Minnesota increases access to and eligibility for the COVID-19 vaccine.

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

But the parameters for each site – the matrix of age, health conditions, place and occupation that people are eligible for the vaccine – can vary, sometimes beyond the limits of state requirements. This is often due to a number of factors, including the organization or entity distributing the vaccine, who a clinic or site is intended to serve, and whether the specific vaccine supply comes from the state or federal governments.

The complicated matter is a rule that requires doses to be used quickly. That time constraint, set to accelerate vaccination, has led some sites to offer wider flexibility to be able to keep vaccine.

So: when is it okay to sign up to get a vaccine – especially if you are not within the fitness rules set by the state, should you sign up outside of a call from your doctor or a warning from the state vaccine?

‘Participation in the common good’

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

This is especially true because the demand for vaccine still exceeds the supply. The state’s phased approach is designed to prioritize vaccination for people at greatest risk of developing severe cases of COVID-19.

That is why Wu says that a person’s decision to get a vaccine for which he is not yet eligible amounts to individual desires against our obligations to the wider society.

“The idea of ​​participating in community welfare really needs to be revived, where each of us needs to play a role in being healthy and safe together,” he said.

Wu compares it to random driving.

“You may not drive as you please, because even if a fraction of a percent of the people do not respect red lights, the whole business falls apart,” he said.

But sometimes – due to circumstances, timing or serendipity – people are confronted with the question of whether to skip the line and try to be vaccinated before their turn.

If you are in one of these cases, there are four questions to ask:

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

The state has an extensive, detailed plan to vaccinate as many Minnesotans as possible, but it happens in phases, putting people at greatest risk of getting COVID-19 at the front of the line, spreading and dying.

This includes older people; people with underlying health conditions who are at higher risk for a severe case of COVID-19; people whose work they run the risk of getting the virus to work; and people living in congregational care.

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

But Wu said things get dangerous when people do not all agree to abide by the plan, because then the plan ceases to be useful, and it ceases to be fair.

‘The people who do not need [the vaccine] and it is less likely to be harmed, can get more doses, and the people who are least privileged and have the least access will bear the greatest burden, ”Wu said.

In the real world, Wu said, it might seem like someone who has the means and the time – because they work from home, for example, or have easy access to a computer or the Internet – to switch to a vaccine for which they do not are not eligible.

Or it may look like someone who has easy access to transportation, who can arrive at a vaccination site at short notice.

It can also manifest itself in social commitments – if you are a friend or family member able to fit in for a vaccination appointment at the end of the day.

If these factors play into a scenario in which you can get vaccinated, the ethical thing to do is wait, Wu said.

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

If given the opportunity to get a vaccine, Wu said: consider whether it will take a few more weeks to get a chance to get a chance. And consider giving today a chance intended for someone at higher risk, then it could do harm.

Ask, ‘Do I use a certain kind of access or privilege that benefits me only slightly, but which can hurt many other people more?’ he said.

“If it’s not going to help me that much and in the long run make the circumstances less equitable, and people at high risk take a higher risk for longer, I think it’s ethically problematic.

And keep in mind: younger, healthier people do not have to wait much longer for a vaccine.

According to all accounts, the allocation of vaccines is likely to increase dramatically within a few weeks. State health officials said it is likely that Minnesota will soon receive 100,000 doses of Johnson & Johnson vaccine.

And the fitness groups will continue to expand. Government officials said every adult who wants a vaccine is likely to be eligible by April.

3) Do you have to lie or be otherwise vague about your status to get the vaccine?

The state has clear guidelines on who is currently eligible to be vaccinated, and providers across the state usually follow this.

There are exceptions in which some providers – including pharmacies and clinics, federally qualified health centers, veterans’ clinics, Indian health care facilities and sovereign indigenous countries – operate under different rules, set out by, for example, the federal government, state-run programs or by tribal governments.

But in practice, some providers bound by state rules do not stop the suitability of every person who enrolls. For example, if you make an appointment for a pharmacy admission, it is unlikely that you will have to prove your work in a suitable work sector or your underlying health condition.

Some use these loopholes and say, for example, that they work “in the courts” as a way to qualify for a shot when working from home for a private law firm – or if a parent says they qualify . for a shot as a “babysitter.”

“It’s ethically problematic, even though you may not master it,” Wu said.

It’s a tricky balance, Wu said. The state does not want to set up too many barriers, because then the vaccination will go slower.

But it also makes the system ripe for people to utilize.

4) Will this dose be discarded if you do not take it?

Wu said this is a situation in which the rules are changing.

Vaccinations are rare, and no one wants to waste a dose. So if you have the option of taking a dose that would otherwise be thrown in the trash, Wu said you should take it, even if you are not eligible under state guidance. (State health officials said it’s OK, too.)

“It’s ethically appropriate,” Wu said. “If it’s going to be wasted otherwise, the benefit is to no one in the community.”

The advantage of any one person getting a vaccine benefits the community as a whole, he said, because it’s one small, extra step toward herd immunity.

“The more people we are vaccinated with, the greater the chance that we will interrupt the transmission of the virus in the community,” Wu said.

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The data in these graphs are based on the cumulative totals of Minnesota’s Department of Health released daily at 11 p.m. You can find more information about COVID-19 at Website of the Department of Health.

The coronavirus is transmitted by respiratory drops, coughing and sneezing, similar to the way flu can spread.