Julia Marcus: Vaccinated people are going to hug each other
It’s nearing the end of the month, and I still haven’t followed through to get my shot. I posed my dilemma to many colleagues—am I queue-jumping if I take the chance to get vaccinated now, when people at far greater risk of acquiring SARS-CoV-2 and getting seriously ill potentially haven’t been vaccinated yet? I also took the question to Twitter, where physicians and other health-care workers, ethicists, and members of the lay public urged me to take the opportunity to get vaccinated now. The reasons were compelling. In the chaos of the moment, with supplies low, just getting jabs into people’s arms is what is important. Vaccines shouldn’t go to waste. I would be contributing to herd immunity. My HIV status still presents some risk beyond that of others in my age cohort. Most of this, particularly the need to get as many people vaccinated as quickly as possible, is true.
But I still don’t feel like the advantage given to me is fair. In the United States, we have far too much practice in ignoring the ethical dilemmas staring us in the face, and the coronavirus vaccine rollout continues deadly old patterns. In 16 states that release data on the demographics of vaccination, Black Americans are falling behind, while their white counterparts are being vaccinated at rates two and three times higher. Deaths from COVID-19 have and continue to hit communities of color hard, so even if people callously dismiss calls for racial equity, the epidemiological case stands on its own: Those at greater risk of getting COVID-19 and getting seriously ill are not being vaccinated first.
Zoom out further and the global scenario is catastrophic. Oxfam predicts that nine out of 10 people in poor countries will not get vaccinated this year. Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said on January 18 that more than 39 million vaccine doses had been given in 49 rich countries, but one poor nation—Guinea—had just 25 doses. Imagine if President Joe Biden or one of his counterparts in the G7 said that only 25 people could get even one dose.
Read: Why kids might be key to reaching herd immunity
I spent most of my life researching HIV, much of it to expand access to AIDS treatment around the globe. All I can see right now is the world repeating the sad history of access to life-saving AIDS drugs. I am alive today because, when the treatment came out in the mid-1990s, I was able to get access to them, first in a clinical trial, then at the pharmacy with a prescription from my primary-care physician.
Access to antiretroviral medicines wasn’t even on the world’s agenda until the 21st century, when South African, Thai, and Brazilian activists, politicians, and other leaders challenged rich nations to step up and address the obvious injustice. Initially they heard hemming and hawing about the frailty of health systems in the developing world; the need to focus on basic health care before thinking of such “fancy” interventions as antiretroviral therapy; and, in one of the most odious excuses, from the head of the U.S. Agency for International Development, a notion that Africans couldn’t tell time, which meant they’d never take their pills as scheduled on a daily basis. But activists in the global south persisted, with leaders including Nelson Mandela rebuking the rich nations of the world for leaving people to die.