Should Oregon seniors get a Covid vaccine before teachers?

There's little debate about who should get the first doses of Covid vaccines allocated to Oregon: health care workers and long-term-care residents/staff.

These groups are at high risk of being infected by the virus. Plus, the older someone is, the more likely they will die after falling ill with COVID-19. Those 65 and older account for the vast majority of Covid deaths, with people 85+ accounting for about a third.

So it makes sense that both the CDC's Advisory Committee on Immunization Practices (ACIP) and Oregon health officials agree on who should be immunized initially with the Pfizer and Moderna vaccines.

After that, though, who should be next in line?

Oregon Governor Kate Brown has said that she wants teachers and school staff to be a priority. Reportedly ACIP has a somewhat different idea.

Regarding who will be next in line for the subsequent rollout phases, the ACIP has named as priority groups “workers in essential and critical industries, people at high risk for severe COVID-19 illness due to underlying medical conditions, [and] people 65 years and older.”

Those ACIP priorities obviously need to be refined, as the way they're stated above is much too general to be useful. So who exactly should come next? Essential workers such as teachers, people with underlying conditions, or seniors 65 and older?

Here's my thoughts, which I readily admit are biased by the fact that I'm 72 and my wife also is over 65 with an underlying condition, asthma. I'm well aware how anxious our friends are about getting COVID-19, most of whom are about our age or older. 

Our chances of having a severe case of Covid are high, much greater than, say, a 35 year old teacher. 

But it's reasonable to take other factors into consideration, such as the desirability of reopening schools to in-person learning as soon as possible. Governor Brown now is allowing local school districts to decide when to reopen -- a controversial move that is making many parents happy, but disturbing many teachers.

Especially if a school district reopens before teachers and staff have gotten vaccinated. 

Again, I'm biased because of my age. Even so, it's a plain fact that dying from Covid is something that can't be reversed, while falling behind in school because of distance learning likely is temporary. And you're still alive, regardless.

To me that argues for prioritizing those 65+ over teachers and other essential workers, most of whom are younger. This happens to be in line with an August Harris poll of Americans cited in a CDC presentation. (The poll defined seniors as 55+.)

Those with preexisting conditions apparently are "immunocompromised people." They deserve to be a vaccination priority, though here's a good reason to have seniors be an even higher priority.

Age is clear-cut. It is on Oregon drivers licenses.

Since pharmacies like Walgreens and Rite-Aid are going to play a large role in getting people immunized, it would be easy for health officials to announce that currently those 80 and older can go there and get the vaccine. Then lower the age to 70 and older. And so on.

This eliminates the complexity and confusion of people having to prove that they have an underlying condition. Perhaps those people are best served by getting vaccinated at their doctor's office, since the doctor knows what health problems they have. 

A key thing is to make the priorities for vaccination simple and fair. Oregonians shouldn't have to worry about people cutting ahead of the line, so to speak. A vaccine free-for-all has to be avoided at all costs. 

I'm reminded of the Vietnam draft lottery that took place on December 1, 1969, when I was a senior in college.

The lottery was intended to reduce the inequities of who got sent off to possibly die in the Vietnam War. I remember sitting around with friends in front of a TV, watching birth dates drawn one by one from a glass jar. My birthday was the 234th chosen. The first 195 were later drafted, so I escaped by virtue of chance.

This was a fair, though nerve-racking, way of choosing who was put at risk of dying in an unpopular war. I'm not suggesting that Covid vaccines be prioritized this way, but some form of a lottery could make sense in determining, say, when those aged 65 get to head off to a pharmacy to get their shot 

Rather than having everybody that age compete for vaccinations at the same time, birth dates could be chosen randomly and publicized by the media. Maybe this wouldn't be necessary, but it would help promote a sense of fairness among the public.

Comments

[Jim Scheppke]

Good reasoning Brian. I agree. Another argument that can be made for seniors over school personnel is the fact that it may be a couple months before the two doses of the vaccine are effective. That puts us into March or April. The school year will be coming to an end soon after that anyway. Given all the difficulties involved with restarting live instruction, to do that just a month or two before the end of the school year doesn't make sense.

[Rain Trueax]

I say school teachers over elderly and it's because those who can isolate should do it and teachers can't if schools are to reopen.