Should I decline/refuse my second vaccine dose?
January 12, 2021 8:18 PM   Subscribe

I roughly fit the description of "a worker who [doesn't] qualify" from this article--I'm an employee of a medical center who does not directly interact with COVID-19 patients. I recieved my first dose of the Pfizer vaccine in late December, after patient-facing staff had all been vaccinated. Should I have declined the first dose? If my employer doesn't take the initiative and withdraw the offer of a second dose, is it unethical for me to accept it (scheduled in a few days)? Additionally, if you feel strongly that the answers to these questions are "yes," what other actions do you think it would be appropriate to take now to make amends for jumping the queue?
posted by pullayup to Law & Government (31 answers total) 3 users marked this as a favorite
I think you should accept the 2nd dose, so the use of the 1st dose wasn't in vain. Society may benefit if you don't catch or spread C-19. (Having said that, I understand the science is still out on whether immunized people can transmit C-19 without contracting it.)
posted by Larry David Syndrome at 8:24 PM on January 12 [87 favorites]

You didn't do anything untoward to get the first dose. If the second dose is indeed necessary, by not getting it, you've wasted the first dose. So, get the second.
posted by jonathanhughes at 8:24 PM on January 12 [77 favorites]

People's moral compasses on this will vary. If you're working in a workplace that handles COVID patients, you being safer will keep everyone in the building safer. You will still need two doses of some vaccine at some future point, so there's going to be one extra "wasted" dose if you don't take your second dose. Mistakes were made, not by you. Get the vaccine, donate to a food bank or do something else that you feel will make a small readjustment in health equities around you.
posted by jessamyn at 8:25 PM on January 12 [12 favorites]

Ideally you wouldn't have gotten one, but as of right now (but hopefully not much longer) the issue is still delivery, not supply; state and federal guidelines were needlessly complex and state and federal vaccination logistics plans needed to be much more complex than they were. Right now we need as many people fully vaccinated as possible, and I think we're all better off for you going through it rather than potentially creating additional confusion in the system (with "the system" being a bunch of different interlocking systems, from the one at your workplace to the one in your state).

I don't think you should worry about it morally, either; if we stopped worrying so much about "undeserving" people getting the vaccine we'd be further along in distributing it and probably wouldn't have gotten you roped into this in the first place, because we could have done something sensible like just checking for peoples' ages. I understand your scruples about this, and I respect them, but right now we all benefit from another fully vaccinated person on the streets. (If you want to do something nice to "make up for it" I think you absolutely should, because that's great! But personally I don't think you have anything to make up for.)

Last but not least—looking at your location, you're in my home state. We've used under 40% of the doses we've been allocated so far. The problem isn't you getting a dose you shouldn't have gotten—it might be on a sufficiently long timescale, but it isn't yet. The problem is we can't get the doses we have into arms. Your medical center probably has enough to vaccinate the people under its purview who are currently eligible to be vaccinated with or without you, and the vaccines need to be used.
posted by Polycarp at 8:33 PM on January 12 [22 favorites]

I am in public health. Please get your second dose! If you get your second dose, you will be immune (like...95%). That’s fantastic and a win.

There are lots of issues with vaccine allocation. None of them are solved, at all, by you not taking the vaccine (whether first or second dose). None of them can be solved, at all, by an individual making a specific choice not to get vaccinated when the vaccine is offered. Distribution needs to be arranged far before a vial is open. There are serious equity concerns — none of them are within your remit.

You didn’t do anything wrong. I’m glad you got the vaccine. You’re contributing to a greater public good, even though the circumstances aren’t what you want them to be.
posted by quadrilaterals at 8:33 PM on January 12 [52 favorites]

You may not interact with patients, but do you interact with health care workers that interact with patients? There is no evidence that any COVID-19 vaccine right now prevents transmission of the disease. You may not be at risk of catching the disease from patients, but that doesn't mean you're not at risk of catching it from your (vaccinated) coworkers.

As a heuristic approach, I admit I am not an epidemiologist or public health expert. I, frankly, have no idea how this whole virus thing works. The vast majority of qualified epidemiologists and public health experts are working on COVID-19 and vaccine distribution right now. That doesn't mean they're right, but it means I assume they know what they're doing when they prioritize people for vaccination and that I would go along with their recommendations by default.
posted by saeculorum at 8:37 PM on January 12 [1 favorite]

I'm believe every person who can be vaccinated (for anything) has a moral imperative to get vaccinated at the earliest opportunity available, heeding individual medical advice where appropriate.

The fact that it's covid and vaccines are limited isn't relevant. You have the opportunity to get a vaccine, get the vaccine, help protect yourself and your community to the best extent you can.
posted by phunniemee at 8:38 PM on January 12 [17 favorites]

My son works security at a hospital, so he's not even technically a "healthcare worker"... but the large hospital system has offered security staff the vaccine, because they do come into contact with patients... and right now, there's no guarantee whatsoever that someone doesn't have Covid. And ONE infection of a hospital staff member can spread it to dozens, especially with these much more infectious strains that have come about. (A different hospital in our region recently had to close an entire wing - huge numbers of staff and non-Covid patients had come down sick.)

Plus all the reasons above. IMO, it'd be less ethical to NOT complete your immunization.
posted by stormyteal at 8:44 PM on January 12 [12 favorites]

Some places are throwing perfectly good vaccines out because they can't find enough people to give them to that satisfy the stringent requirements.

I think if you're approved to get it and have it set up to do so, you should get it.
posted by vegartanipla at 8:45 PM on January 12 [16 favorites]

I totally get your ethical concerns, but here’s the deal. If you don’t get your second dose now, will you need two more down the road? Would you end up with three possibly? Don’t mess with the schedule. I don’t think hospitals should have vaccinated their employees who weren’t in those frontline groups(and I’ve seen lots of people making excuses for them), but now that you’ve got one shot, please get the second.
posted by bluedaisy at 9:06 PM on January 12 [9 favorites]

Please get your vaccines. The faster people are vaccinated, the better. You don't know that declining your second dose means someone more deserving will get it. We all need it eventually. Please be proactive and don't waste your first dose by skipping your second.
posted by shadygrove at 9:11 PM on January 12 [6 favorites]

You gotta be kidding me. Just take it!
posted by katiec at 9:12 PM on January 12 [8 favorites]

Maybe you should not have been offered the vaccine, but that is a decision being made at a higher level than you, and refusing the first dose would have helped no one, and now that you have received one dose, don't waste it. You did nothing wrong in accepting the vaccine when it was offered to you -- you didn't bribe anyone, you didn't lie about yourself to move up the line -- and you are doing something right by taking dose two now. Take it with no fear that you are acting unethically, because you are not.
posted by jeather at 9:35 PM on January 12 [7 favorites]

It would actively be unethical for you to decline the second dose.
posted by kickingtheground at 9:36 PM on January 12 [35 favorites]

If you refuse the second dose, get sick, and then cause other people to get sick, any noble principles you might have aren’t going to bring comfort to those people on their way into their graves.
posted by sideshow at 9:46 PM on January 12 [3 favorites]

I'm a grad student employee of a medical center that isn't vaccinating non patient facing staff at this time. If they were offering vaccines to us, I'd probably raise a little bit of a ruckus up the email chain about priorities being out of whack despite being highly tempted to get one. But your situation is different: now that you have received shot one, you need to get shot two on schedule so that a physician isn't confused on how to dose you later.

If you want to feel less bad about it, ask your regular cleaning crew / FedEx delivery guy / on campus coffee shop employee if they want / have gotten theirs already, and ask the folks distributing shots if they've had extra injections at the end of day, and if the answer's yes, try to get Essential Contracted Workers A in touch with Vaccine Distributors B somehow.
posted by deludingmyself at 9:48 PM on January 12 [2 favorites]

People widely not getting the second dose may result in a vaccine-resistant strain of Covid, so I'd say hell yes, get the second dose.
posted by coppermoss at 3:12 AM on January 13 [6 favorites]

I attended a virtual town hall put on by my county health department, and they very clearly stated that if you qualify enough to get vaccinated (without lying, obviously) to please, please, please get vaccinated. Working where you do, I bet you have an increased risk of being exposed to the virus, and also of transmitting it to fragile populations.
posted by tchemgrrl at 3:23 AM on January 13

I am waiting on necessary health treatments right now until the docs/dentists/med staff around me can all be vaccinated. Please take the dose.
posted by aetg at 3:57 AM on January 13 [1 favorite]

Get your second dose. Vaccines in arms are what count, not letting your finer moral sensibilities waste half a vaccination. You, vaccinated, won't end up having some unexpected genetic vulnerability that puts you in the ICU taking up a bed.

Vaccine distribution is a structural problem. Policies need to be in place to minimize queue jumping, but those need to be policies, not "every individual should decide whether they feel they deserce a vaccine that is offered to them" (it's not as if you bribed a nurse here; they offered it to you).

Take the vaccine and thank your stars.
posted by Frowner at 3:57 AM on January 13 [4 favorites]

I'm a physician who doesn't interact with covid patients, had zero qualms about getting the vaccine as soon as it was offered to me, and if you've already had dose 1, it would be actively unethical for you to opt out of dose 2. It's not clear from your wording if you are working in a non-clinician patient facing role (like the front desk) but if you are, you should assume that you are dealing every day with asymptomatic carriers. That's why universal precautions and mass vaccination matters.

Your allocation concerns are valid but don't let yourself be gaslit into taking the responsibility for bad roll out. If you can, talk with the people making the allocation decisions -- my medical center has been holding weekly town halls -- and ask them the hard questions that article brings up.
posted by basalganglia at 4:05 AM on January 13 [13 favorites]

you bear no personal responsibility for the lack of equity or reason in the vaccine distribution - i have defintiely had some questions about how people i know who have posted that they received the vaccine qualified under whatever schemes they did, BUT its impossible to balance that (jealousy?) with the stories about the ineffective and inefficient rollout of the vaccination process. . . .i just cant be upset that some of the maybe not perfectly right people are getting it when it seems like they and many more should be (its 2021 and i have a lot of other things to be upset about)?
posted by Exceptional_Hubris at 4:31 AM on January 13 [3 favorites]

There are issues with vaccine supply and distribution. Even with good take up and well-functioning supply chains there are complicated, no obvious right answer decisions to be made at a population level about the optimal order to distribute a 2-dose vaccine to 'beat' the virus fastest particularly given the new mutations. There will undoubtedly be some 'weird feeling' cases about who specifically receives the vaccine when, and some mistakes both ways (earlier than planned and later than planned).

At an individual level I'd say don't over think it. The following feels like a good course of action to me (1) do not actively barge your way to the front of the line, no bribery and corruption (2) if you are offered the vaccine take it, both 1st and 2nd doses (3) encourage your friends and family to take the vaccine when they are offered it (4) if you know you should be receiving the vaccine about now but haven't been offered it yet find out what's happening and don't miss out.
posted by plonkee at 4:34 AM on January 13 [1 favorite]

I have not read the thread here, but I want to make a point about the vaccine:

Its overall benefit to all of society is directly proportional to the number of people who receive it. Full stop.

Trying to work out if it's ethical to vaccinate any one person before any other is a futile trolley problem puzzle, and is certainly not something to worry about in an individual case. If a vaccine is available, your duty to the human race right now is to receive it.
posted by rum-soaked space hobo at 4:36 AM on January 13 [3 favorites]

Please, please, please don't refuse your second dose. Though you are just one person, the worst thing you could do is contribute towards applying selective pressure on the virus that will encourage it to mutate in consequential ways.

You didn't do anything wrong, at all, by accepting the first dose when it was offered to you! You would be doing something wrong by refusing the second.
posted by superfluousm at 6:28 AM on January 13 [1 favorite]

Please don't give it another thought. Get the second shot. The more people vaccinated, the more people vaccinated, period. As someone said well on Twitter recently, better for 1000 people to get it in the "wrong" order than a single dose go to waste.
posted by lampoil at 7:28 AM on January 13 [1 favorite]

To put this more broadly: we Americans (I am presuming you are in the US because you linked to that Times article) and other wealthy nations are getting this vaccine well ahead of poorer countries. Should we individually decline to be vaccinated until every doctor and elderly person elsewhere in the world is vaccinated? While the inequities here suck, I think you're already on this path and need to squash your guilt and get the second shot and not try to take a principled stand that might not accomplish anything.

But, here's a way to offset some of your guilt: donate to a food bank or relief fund that serves the demographic of people in your community hit hardest by Covid. Even if you aren't wealthy, I'm sure you can afford $10 or $25. Pay it, literally, forward.
posted by bluedaisy at 10:31 AM on January 13 [1 favorite]

It is beneficial for as many people as possible to be vaccinated .
Since you had the first shot, you should get the second one.
Walking around with only a partial vaccination doesn’t seem to help anything.
We might find out more later but until then it is a waste of resources for you not to get the second shot.
posted by calgirl at 10:44 AM on January 13

If your institution is anything like the ones in my area, they had thousands of vaccine doses ready to go a couple weeks ago and weren't allowed to give them to anyone lower on the list. Just thousands of vaccines sitting in freezers doing no good at all. So they took the most expansive possible interpretation of the rules and used that to vaccinate some more people.

For good or ill, one of those people was you. Possibly that was an inefficient allocation of vaccine, but it's already done. Now that one's in your arm, it's doing a little bit of good. Don't throw that little bit of good by not taking the second dose.

For the record, the CDC's guidance on early vaccine access explicitly included "all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials", including "Contractual staff, Dietary and food services staff, Environmental services staff [and] Administrative staff." Are you any of those? Then it's not at all clear to me that you jumped the line.
posted by BungaDunga at 11:01 AM on January 13 [6 favorites]

While I think we're at a point of emergency where getting everyone a first dose ASAP is a higher priority than fully vaccinating people who are not at high risk, the distribution system is such a mess right now that you declining the second dose will cause confusion that could lead to an increase in inefficiency, so just go ahead and get it.
posted by metasarah at 11:08 AM on January 13 [1 favorite]

Take the vaccine, and if you're a tiny bit worried that it might make you a tiny bit selfish, look around you at all the monstrously selfish people who have continued life as normal or who are gleefully seeking vaccines despite not meeting the criteria (hi, in-laws!) and sleep sweetly.
posted by zeusianfog at 4:39 PM on January 13

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