As a former teacher of medical ethics, I am struck by an already staggering inequity in distributive justice. In these initial weeks following the Food and Drug Administration’s authorization of the COVID-19 vaccine, it has been reported that hospital board members, spouses of physicians, cosmetic surgery receptionists and young firefighters have been receiving the vaccine ahead of the most vulnerable. The problem is multifactorial, and ultimately reflects uneven algorithms and the absence of federal leadership.

Pfizer, which has done a near-miraculous job in developing a safe and effective vaccine, asserts that the federal government hasn’t as much as issued shipping instructions for millions of doses currently sitting in warehouses. If left unaddressed for too long, the lack of transparency, combined with unbalanced sources of data and methodologies, threatens to cement health care inequalities in communities throughout the United States.

Guidance on distribution from the federal Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices seems inadequate at best. There is apparently little or no distinction of front-line COVID-19 workers from all other health care workers. Among health care providers, an older adult intensive care unit nurse should be getting the vaccine immediately, and the young, healthy clinician who injects Botox for a living should step aside.

Those of us who are not in the trenches should happily and vocally step aside. We must all do whatever we can to influence the new administration to effectively encourage and guide a rational and evidence-based public health policy.

Peter Pressman, M.D.
Yarmouth

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