Medical bioethics is treacherous territory. At the extreme, it involves a person deciding who should live and who should die. Simply engaging in this calculus is morally damaging, and so, when presented with tough choices, we are better served by simple, maybe even arbitrary, rules rather than complex calculations.
Accordingly, our coronavirus vaccine distribution plan should be as simple as possible. We’ve decided that doctors and nurses, particularly those most likely to treat COVID patients, ought to go first. That makes enough sense. But after that, things get grayer, and the calculations that go into making a nuanced, multi-layered priority last become dicey.
In general, all the plans prioritize those most at risk. But often, this gets complicated with questions of “who is an essential worker?” or “what about racial equity?” Tied up with these is the question of “preservation of societal functioning.” That is: Who do we need on the playing field first? Soon, things get complicated.
Do we really want state or federal health authorities or politicians deciding whose work is most important and how to weigh that against who is more at risk?
That’s a very perilous moral game to play.
Instead, we should have a simple rule: You get vaccinated in age order.
Outside of the front-line healthcare workers, we should just start with the oldest people. About 6.6 million Americans are 85 and older. Hit them first.
Another 6.3 million Americans are 80 to 85. They should go next.
After we’ve gotten everyone born in 1940, the next day, let’s hit everyone born in 1941, with 1942 on deck. Keep this up and go until you’ve hit everyone.
Sure, there’s a good case for creating a fast lane for the immunocompromised who are younger. In general, doing it in age order is a pretty good proxy for protecting the most at-risk first.
It’s possible some people don’t know this because so much of the media has been dedicated to convincing you that everyone is equally likely to die or get hospitalized from the virus. They love telling the “perfectly healthy 25-year-old died story” without providing the context that this is extremely atypical.
Almost every young person who gets the coronavirus is fine, and the majority of COVID deaths are people over age 75. There are about 22 million Americans over age 75. Get them vaccinated first, and you can prevent the overwhelming majority of COVID deaths in the next year.
Keep it simple. Save as many lives as possible.
