States are developing and implementing their phased rollouts of who gets the COVID-19 vaccine. In addition to including those with Down syndrome in the first groups, at least one caregiver, when needed, should be included as a +1.
In a true miracle of modern immunology, a vaccine for the awful coronavirus has been developed within a year of the virus being discovered. Check that, vaccines have been developed–plural, not just one.
But, having developed multiple vaccines does not result in an instantaneous supply sufficient for everyone who wants to get the vaccine. As at the beginning of lockdown, when ICU beds and respirators neared scarcity, now the decisions on medical scarcity are how to ethically choose who takes priority over whom in getting the scarce vaccine?
States are rolling out their plans. The summary for the plan for my home state of Kentucky is available here, with the phased groups of people copied above. The goal is to save lives and the tiered phases seeks to address who should first get the vaccine to save the most lives.
Phase 1A includes the two groups most initially affected when the pandemic began: those who were in nursing home facilities and the health care workers caring for those who became infected.
Phase 1B next includes the first responders–those EMS personnel and public safety officials who run to the danger. The inclusion of K-12 school personnel can be inferred as a step to address a major toll of the pandemic: the loss of in-person instruction for school children. Unlike the multiple examples of those in nursing homes and the health care industry, I am not aware of similar multiple examples of school personnel being at an increased risk than those in the phases that come after 1B. I welcome any links to published studies that provide evidence for the prioritization of school personnel over the groups that follow. Otherwise, their inclusion risks criticism of being the result of the political power teacher unions have, given that, at least in Kentucky, often the school system is the largest single employer in any county.
Phase 1C addresses the population for my selfish concerns: individuals with Down syndrome. As detailed at length in multiple posts, consecutively published studies concluded that individuals with Down syndrome, particularly adults with Down syndrome, are one of the most at-risk group for dying from the virus. So, while not in the first two phases, at least those with Down syndrome are included in the last of Phase 1 categories because “Down syndrome” is identified by the CDC as a high risk condition:
Again, in my personal situation, I, too, am included in Phase 1C. As a practicing lawyer, I am an “other essential worker.” You do not need published studies to perhaps justifiably criticize whether all of us attorneys should be considered “essential.” Prosecutors, judges, defense counsel, in-house counsel for health care facilities, certainly. Plaintiff’s lawyers, tax lawyers, outside corporate counsel (a large part of my practice), well, maybe not as essential. However, just as high school personnel should likely be prioritized over elementary and middle school personnel according to the studies I’m aware of, the purpose of these plans are balanced by the equally justifiable goal of not making the perfect the enemy of the good. Granular distinctions could bog down the roll out, whereas broad designations helps more people, in total, to get vaccinated, which is the ultimate goal.
So, I’m in the same phase as my daughter. But, many, many other caregivers to people with Down syndrome likely are not. Again, while I’m glad the need to vaccinate those with Down syndrome is recognized as a priority, an improved Phase 1C would include a “+1” for each person with Down syndrome who needs a caregiver.
Vaccinating the person with Down syndrome is good, for that person. However, if their caregiver has to wait weeks or months to get vaccinated, then that risks that caregiver being infected and, in the worst scenario, succumbing to the disease, leaving a vaccinated person with Down syndrome bereft and without a needed caregiver. In a very true sense, needed caregivers to individuals with Down syndrome should also be considered “essential workers.”
If your state is still developing its plan, or if you wish to change an established plan, I encourage you to reach out to your state’s Protection & Advocacy to work to ensure those with Down syndrome are prioritized correctly given their high risk status, and seek to add a +1 for a needed caregiver.
Feel free to share in the comments a link to your state’s phased plan for the vaccine. I would be interested to see the various approaches.
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