As I watched the vaccine rollout take place over the past month, all I can say is that I am not surprised. I watched hospital executives who never see patients jump the line, doctors having their healthy nannies vaccinated, and health systems trusted with vaccine doses have essentially no plan. It’s like we didn’t have 9 months to figure this out. All I can say is that this is the America we live in. Before I continue, I should point out that I am a radiologist who does not have much contact with COVID-19, and I would gladly push my parents to the line in front of me if I could. Most of my argument below is based on my MPH and doctoral training in public health and not my MD. My over-riding belief has always been that the people most susceptible to the virus should be at the very front of the line. I perform procedures on potential COVID-19 patients, but I made sure that the nurses and front-line workers had access to the vaccine before me. We put health care workers first because of a social duty to them and because the Pfizer and Moderna vaccines must be stored at very cold temperatures and require 2 doses. To avoid wasting doses, it is an ethical decision to prioritize people who will definitely show up at the special distribution centers that provide these vaccines for the second dose. This makes health care workers an easy first choice because they are the distributors. Athletes currently performing for us despite risking their health would definitely get the second dose which would reduce waste, and for utilitarian reasons, it would require an extremely small portion of the available doses to supply this very small population who are obviously swapping the virus back in forth on camera. Economists would say that this would keep these massive industries in operation, protect a huge amount of advertising revenue, and serve millions of Americans who don’t care about these athletes’ health anyway. We have chosen to throw these people in front of the virus with their consent, so it seems reasonable to protect them since we promote the practice. Americans have already disrespected health care workers by not wearing masks and clearly losing control of the pandemic, but they were never willing to give up sports to protect society. Whether or not you agree with this, this is the America that we live in. This is not the crux of my argument to vaccinate athletes, however. I want to devote this small number of doses to see if the vaccine actually works! Athletes are already constantly tested. They even know what strains each of them have to know if they are getting it from teammates or the outside community. We have learned that athletes break their own rules anyway without much penalty from their leagues. My sad lasting memory of the 2020 baseball season is the player who knew he was positive but decided that his personal need to be photographed with his teammates with the World Series trophy was more important than protecting his teammates’ families and his cancer surviving manager. Several athletes don’t seem to care that people are posting pictures of them at parties without masks on, an unfortunate but very real representation of their generation’s culture. Since these athletes are both being tested and breaking the rules already, the ones who are breaking the rules basically want to be guinea pigs. While they probably don’t deserve a vaccine, this is the best way to test how well the vaccine works. An example of strong leadership in the last 9 months comes from Nick Saban, who trusted his players enough to allow them to go home for the holidays and then come back to play in (and win) the national championship. Some sports personalities like Hank Aaron have been very public in getting vaccinated as role models, and if our sports heroes are more important than our health care heroes, the same effect could happen on a larger scale if active athletes got the vaccine. We do not know if having the virus previously confers the same immunity as the vaccine. We do not know if having the vaccine keeps us from spreading the virus. We do not know if the vaccine will require a later booster (or new formula due to mutation). More studies will be needed to find these answers, but athletes are already constantly tested and exposing each other to their lung contents as I noted before. This column would not be complete if I did not remind everyone to strongly consider getting the vaccine when it is available to them. For the logistics to work out, my opinion is that a single dose vaccine such as the Johnson & Johnson version will probably be necessary to reach the population needed, but none of this will help much toward returning things to normal if most of us don’t agree to become vaccinated. I could explain the molecular biology of the Pfizer and Moderna vaccines and try to convince you why this technology is probably safer than any other vaccine in the history of mankind, but this doesn’t really matter anyway. All that you need to know is that the risks of getting COVID-19 vastly outweigh the risks of any approved vaccine. We can fight against feelings of conspiracy or demographic bias by becoming properly educated about the vaccine. In the meanwhile, you already know how to beat the virus. Wear masks, practice physical distancing, and practice appropriate hand hygiene. Non-medical interventions are still the best first step. Cory Michael is a radiologist. Source
