Post #1061: A brief note on vaccination priorities.

Posted on March 17, 2021

I have been tracking the progress of COVID-19 vaccination in Fairfax County. As shown above, today (3/17/2021) they are scheduling appointments for those who signed up on 2/1/2021.

Separately, I’ve been reading the many negative comments that are posted on every Washington Post article about vaccination.  Many of them are from people who have a very good reason to be vaccinated, or who have been seeking vaccination for an extremely frail or elderly family member.

I think I have finally been able to put two and two together.  At least, in so far as Virginia’s approach to COVID-19 vaccination goes.

Here goes:  Within the general vaccination program, run by the county, there is no prioritization within qualifying groups.  Once a group of individuals qualifies, then its strictly first-come, first-served. 

And so, once vaccination was opened up to all elderly (and those under 65 with specific comorbidities, and some front-line workers), then all those people were eligible, period.  Didn’t make any difference if you were age 65 or age 95.  Or healthy or frail.  The only thing that mattered is when you signed up.  Full stop.

And so, I think that a lot of the negative comments really reflect the crudeness of that approach.

Families with frail elderly members are put out by having to wait.  In an ideal world, the frail elderly clearly should have been given priority within the current vaccination phase (1b, in Virginia).

But if you think about it, it would have been hard to do any sort of prioritization.  All of the information on (e.g.) medical conditions is, at best, self-reported.  And how would you trade off advanced age, say, against specific comorbidities?

So, practically speaking, once public health authorities decided on certain rough cuts — over age 65, having a job that falls into a well-defined category, having any of a CDC-maintained list of comorbidities that raise risk of death from COVID-19 — that’s as much as they could do.  All the finer points within those groupings got lost.

And that, I think, is what drives a lot of the publicly-stated discontent with the existing vaccination program.  There are a lot of people who, in a perfect world, would have been given priority.  But in the real world, they weren’t.  Instead, within the main County-run program, people who qualify under some phase of vaccination are being vaccinated strictly in the order of sign-up.  And that’s just the way it is.