We have begun discussions about the first distributions of a Covid-19 vaccine. Apparently, the vaccine will be distributed to the states in proportion to their populations. The states will determine how they will administer any vaccine within their borders, but the CDC has issued non-mandatory guidelines about the distribution stating that the first priorities ought to be healthcare workers, those in nursing homes and similar institutions, essential workers, and other at-risk populations such as the elderly.
We are still in the early stages of considering these guidelines, but so far they have evoked little controversy. It’s hard to believe that won’t change. For example, isn’t there always contention about immigrants these days? Someone is going to hit the outrage button and say that some state’s priorities will give the vaccine to an early tranche that includes illegal immigrants and surely that should not happen. Someone is going to say that vaccines should be given to states only in proportion of their legal population.
Sooner or later someone will also question other distribution priorities. Some might say that epidemiologists should establish vaccination priorities for the fastest and widest establishment of herd immunity. A certain sort of economist will say that the vaccinations must be done “rationally.” It seems “rational” to give the vaccine early on to the elderly, a group of which I am a member, since we aged are apparently among the most at-risk for dying from Covid-19. However, someone like me might expect to live ten years more if I don’t get the disease. Giving me the vaccine could be said to save ten life-years discounted by the likelihood that I would get the disease and recover without being vaccinated. Giving the vaccine to a forty-year-old could save 45 life-years discounted by those same factors. After these calculations, it might be more “rational” to inoculate the younger person first. On yet a further hand, another sort of economists might contend that early vaccinations should go to those who contribute most to the economy or who will help re-open the economy or society most quickly, but I am sure that such economists will disagree with each other and how to calculate these matters.
What is beyond dispute, however, is that somebody must make such decisions. We might argue about the criteria and what expertise and level of government should be called upon, but there seems little doubt that government, be it federal or state, will be the decisionmaker. And so far it seems accepted as proper that government is buying doses and is planning for their distribution..
The world was different with the mass inoculations of the polio vaccine sixty-five years ago. President Eisenhower and his Secretary of Health, Education, and Welfare contended that the free distribution of polio vaccine was socialized medicine and that even government involvement in the distribution of the medicine was socialism.
“Socialism” has been thrown at all sorts of policies again recently; will the epithet be evoked by the vaccinations? The national rhetoric often proclaims that freedom requires a free market. Where are those now, or are these free marketeers, who when they get together wear caps with Milton Friedman ears on them and vow never to sing We All Live in a Yellow Submarine, just biden’ their time until they say that vaccines should go to whoever can pay the most for them? The free market should control, goddamnit!
Surely they see that this vaccine is setting us on a dangerous path to socialistic hell. I count on them to protect me from it.