Should ER doctors like me really get the COVID vaccine first?

It feels strange to get priority for something that everyone needs and deserves. Early in the pandemic, I took care of a young man who was a combat veteran. He expressed his sympathy and admiration for what we were doing in the ER and bought pizza for everyone working that day. “I’d rather be shot at by a sniper than do what you’re doing,” he said. “At least I could see where the bullets were coming from.” Although that is a kind and appreciative sentiment, it cannot possibly be true. I have yet to confirm this with anyone I know who has experienced both snipers and the medical care of COVID-19 patients, but my own imagination leads me to believe I would prefer to avoid combat, if forced to choose. There have been a few moments where I have been worried for my own safety, but I do not live most of my working hours in fear of death, as I probably might if confronted with a constant threat of gunfire. But then again, we usually do not fear what we have come to know. There isn’t clear data on the risk of catching COVID-19 that doctors with adequate personal protective equipment take on, compared with the general population. But work, at this point in the pandemic, to me feels as risky as going to the grocery store.

I’m not the only medical provider who feels they perhaps don’t deserve to be among the first to get the vaccine. In the U.K., doctors and nurses will go after the elderly and their caregivers. I would rather that someone I love who is high-risk (my parents, for example, are in their mid-70s) get their dose before I get mine. Others feel they would rather see vulnerable members of the population they serve—the elderly, those with other illnesses that increase their risk of death, the occupationally at-risk—be earlier in line. “If you want to help me, I think what I need for you to do is unclog the ICU,” one doctor told NPR, arguing that the vaccination program should target people on Medicare and Medicaid before doctors. There is also the argument that, from a public health point of view, it is the behaviorally vulnerable—the people who go to bars, host group dinners, travel to see family over the holidays, attend church without masks—who should be vaccinated first. If we want to eradicate the disease, attacking the reservoir where it proliferates would make a lot of sense. But the people who have been staying home in lockdown might be mad if the careless get it first.