Vaccination Priority? Government Officials Should Wait Their Turn | Opinion

For most of the past year, Americans have been asked to sacrifice in the name of public health. To stay home, remote school our children, postpone weddings, skip holidays, and even miss funerals. But we've watched as the same rules didn't seem to apply to those in positions of power.

The White House and Trump campaign repeatedly held large indoor gatherings without social distancing or masks, the president and his staff didn't quarantine after coming in close contact with infected people, and even after becoming infected himself, Trump failed to take recommended steps to protect others. Meanwhile, members of Congress have had shouting matches over masking rules, planned and hosted in-person welcome receptions for new members, and left Americans languishing for months under the financial burdens of the pandemic without reaching agreement on an aid package.

Then came the December 13th announcement that senior officials across all three branches of government were slated to receive COVID-19 vaccinations "pursuant to continuity of government protocols established in executive policy." The details were scarce, but the plan seemed to be for top officials at the White House, Congress, and Supreme Court to get first dibs, just as state and local policymakers and hospital leaders struggle to decide which health care workers and residents of long-term care facilities will be offered the first wave of shots.

The outcry was swift. Here we had yet another brazen display of line-cutting and self-interest at the expense of others, after failing to take basic precautions, seen time and again as Trump and members of his administration have gotten access to COVID-19 treatments unavailable to the vast majority of patients. In a surprising display of good judgment, the president reversed the plan within a few hours, tweeting that "[p]eople working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary."

Good, but we'll see how long it sticks. So the question stands: should the country's top officials get special access to scarce COVID-19 vaccines? Where should they fall in the queue – and should their irresponsible behaviors bump them down the list?

Various reasons were offered for the initial announcement prioritizing federal officials, including promoting public trust, protecting staffers, and continuing essential government operations. It's true that having trusted, highly visible leaders get their shots publicly to encourage others to get vaccinated could be helpful given the reported numbers of Americans who say they definitely or probably won't do so. Vice President Pence is slated to get his first shot as this piece is posted, although whether he counts as 'highly trusted' depends on who you ask. But in any event, we need only a handful of Washington politicians to play that performative role. Those outside the beltway, from pop stars to local religious and community leaders may be even more critical to this effort. Besides, it goes a long way to see those in power wait their turn.

Of course, continuing government operations is key, but the past several months have shown that the government can carry on during the pandemic. There are plenty of ways to govern while remaining vigilant. Skip the holiday parties and wear a mask. Don't cut the line in front of health care workers who can't avoid patient contact and vulnerable nursing home residents who've been devastated by this virus, both in terms of deaths and separation from their loved ones.

It's not that those in the highest echelons of government aren't important. Of course they are – especially when they have life-time appointments (RIP RBG). And Dr. Fauci is right to suggest that unique national security considerations may call for vaccinating Biden and Trump immediately. But outside a few special cases, it's tricky business to prioritize people based on their importance to society.

Many agree that we have to protect those health care professionals working tirelessly to care for patients with COVID-19 and other ailments, as well as those responsible for food, janitorial, and other critical hospital services, especially as wards again reach capacity around the country. Yet as vaccine supply increases but remains inadequate, we're going to have to figure out who else counts as "essential" – and who is more essential than whom. Already, the lobbying has begun, with teachers, firefighters, police officers, food and agricultural workers, and others all making legitimate claims. Most government leaders, on the other hand, should be expected to keep Zooming for a while longer. They should wait till their number is called for vaccination because they're over 65 or otherwise at high risk of severe COVID-19, or until there are enough vaccines to go around for the rest of us.

As for officials who've routinely flouted public health guidance, they clearly breached their heightened obligations as leaders and role models – and their basic obligations as decent human beings who care about the well-being of others. They should volunteer now to step aside so that others may be vaccinated first. But it wouldn't be right to force them to do so. For one thing, allocation will be complicated enough without adding this additional wrinkle. How much should they be docked for each violation? Should we go down the list a certain number of slots for each time they failed to wear a mask or participated in a crowded event? Who would keep track and how could this ever be enforced? Should we do the same for others who've refused to follow the rules? Perhaps more importantly, we move onto dangerous ground when we start considering withholding beneficial medical interventions on the basis of moral judgments about an individual's behaviors and choices. Let these officials get their vaccines when their group is up, but by all means, let them know they should have done better.

Washington's leaders haven't experienced the pandemic in the same way as many of their constituents. But they should stand side-by-side with us, masked and six feet apart, in line as we await our vaccines.

Holly Fernandez Lynch, JD, MBE, is the John Russell Dickson, MD Presidential Assistant Professor of Medical Ethics at the University of Pennsylvania's Perelman School of Medicine.

The views expressed in this article are the author's own.