On January 29, Stacey Griffith, one of SoulCycle’s most popular and glamorous instructors, received the coronavirus vaccine, something that might have passed without incident had she not been 52, extraordinarily fit and aligned with an expansive notion of what it means to be an educator. Taking advantage of the fact that teachers were now eligible for inoculation, Ms. Griffith applied for an appointment in mid January, she said, and two weeks later drove from Manhattan to a school in a largely Hispanic part of Staten Island where the city had assigned her to get her first injection.
Perhaps unaware that vaccine access has been a source of great tension — and that the privileged are conniving their way toward safety as the less fortunate remain behind — Ms. Griffith posted news of her triumph on Instagram. The outpouring of anger that followed quickly prompted her to apologize to her nearly 65,000 followers for a “terrible error in judgment.”
However enraging it might be that a celebrity spin teacher could secure a shot weeks or months ahead of her turn — and however dispiriting it is that there are celebrity spin teachers — the problems around the unfair administration of the vaccine extend beyond individual acts of selfishness, entitlement or obliviousness. The distribution system has been too porous to safeguard against terrible judgment and the human inclination to take whatever might be had. In essence, it seems too easy to cheat.
Last month, as the vaccine began to make its way into the world, a Manhattan internist told me that a member of his staff asked if he would find a workaround to get his husband, who was not in medicine, immunized. While the doctor had no intention of doing so, he was concerned about the ways that the system could be exploited. He soon realized that anyone in a similar position who was unethical enough, could simply provide a letter to a family member or friend claiming that person as an employee and expect that no one on the other end would verify the accuracy of what was stated.
It turns out that elaborate, performed deception isn’t necessary to game your way to protection. In New York City, you are supposed to arrive at a vaccine appointment with proof of age and residency in the state, and if you qualify because of what you do for a living, you should have evidence that you work in the field you say, either by way of a letter, a pay stub or similar form of documentation. But all too often people show up at a clinic only to find that no one asks to see it.
This is precisely what happened in Ms. Griffith’s case, she told me. She came with a recent pay stub that made it very clear that she did not work for the Department of Education, but no one bothered to check it.
The lax approach is in part the result of a public health system that has been overwhelmed by the process of disseminating the vaccine, and in part because of a fear among city officials that making access too burdensome risks even further deepening inequities. Recent data, for example, showed that nearly half of people who received at least one vaccine dose in New York City and whose race was noted were white; 15 percent were Latino, and 11 percent were Black. One health department official I spoke with equated the notion of implementing higher thresholds to the problem of voter identification laws.
Currently more than 150 million people — almost half the population — are eligible to be vaccinated. But each state makes the final decision about who goes first. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring or early summer. The vaccine hasn’t been approved in children, although studies are underway. It may be months before a vaccine is available for anyone under the age of 16. Go to your state health website for up-to-date information on vaccination policies in your area
You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a health department vaccination site or a local pharmacy once the shots become more widely available.
That is to be determined. It’s possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year. We have to wait to see how durable the protection from the vaccines is. To determine this, researchers are going to be tracking vaccinated people to look for “breakthrough cases” — those people who get sick with Covid-19 despite vaccination. That is a sign of weakening protection and will give researchers clues about how long the vaccine lasts. They will also be monitoring levels of antibodies and T cells in the blood of vaccinated people to determine whether and when a booster shot might be needed. It’s conceivable that people may need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.
A state form that is also part of the process, asks you to “attest’’ that your job requires in-person contact with others. But that standard, too, is easy to elide. This has meant that therapists who have only been seeing patients via Zoom have been able to get vaccinated as well as academics who perhaps haven’t been in physical classrooms for months. I have listened to people in both professions agonize over the decision to get inoculated or not. Some were encouraged by department heads to get the vaccine when it was available — who could say when there would be another chance given the chaotic nature of the distribution effort?
A number of medical ethicists have more or less endorsed this position, arguing that there is no assurance the dose you refuse will go to someone needier (in some parts of the country, unused vaccines have had to be thrown away). In some cases, institutions tasked with dispensing vaccines do not have the capacity to transfer unused samples elsewhere.
Still, there are clear social consequences to the individual choices people make. Over the next two months, the city will spend upward of $8 million to promote the Covid vaccine. Ads will appear in local community papers, on television, in subways and outside check-cashing sites, according to the health department. Some effort should also be spent on a campaign shaming anyone who is planning to finagle their way to the front of the line. As it happened, Ms. Griffith got her vaccine at a moment when the United Federation of Teachers estimates that a few thousand of its members had vaccine appointments with the city canceled because of shortages in supply.
Across the country, the pandemic has kept millions of children from going to school in person. Ms. Griffith’s outdoor classes for the weekend, however, are fully booked.