Massachusetts companion rule for COVID-19 vaccines sparks concerns

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Massachusetts is rolling out a plan to get more of its seniors vaccinated for COVID-19 — a caregiver who brings someone 75 and older to mass-vaccination sites like Fenway Park can get their own shot during the visit.

It’s a creative way to help older adults navigate unfamiliar settings, as the state tries to reach speed a rollout that’s given first doses to about 12% of residents — putting it in the middle of the pack in the U.S. Yet it’s sparked concerns that other older adults will be bumped farther back in line, especially as younger, healthy people attempt to enlist senior companions through online posts.

Vaccinations are going so fast in Alaska, meanwhile, the state abruptly decided to open eligibility this week to all teachers, not just those 50 and older.

In New Jersey, Gov. Phil Murphy opened up vaccinations to the people with chronic conditions but had to play defense over his decision to give smokers priority — COVID-19 is a respiratory disease — as teachers wait in the “on-deck circle,” as the Democrat put it. He said the focus is on saving lives.

“It’s a false choice to compare smokers versus someone else,” Mr. Murphy told CNBC last week. “Anyone who is under 65 who is the most vulnerable, including if you’re an essential worker, an educator, you’re eligible right now.”

The campaign to immunize Americans against COVID-19 is entering a new, tricky phase, moving beyond health care workers and nursing-home residents and into priority groups that can vary by state.

The coronavirus doesn’t know or care who it infects but state efforts to prioritize vulnerable groups are causing an inevitable mix of praise, confusion and controversy, as states size up their rollouts and lawmakers and Joe Public debates what’s fair.

Sometimes, like in New Jersey, the science bumps into the social or political views on equity. Prisons are hotbed of transmission, so some states are giving inmates priority, and thus risking ire from law-abiding folks who cannot schedule an appointment.

Texas started inoculating prison staff, but not inmates, and the Pentagon paused plans to give shots to Guantanamo Bay detainees amid vocal GOP backlash.

But Republican leaders are still unhappy about a Homeland Security Department statement that said “all individuals, regardless of immigration status, to receive the COVID-19 vaccine once eligible under local distribution guidelines.” House Minority Whip Steve Scalise said the Biden administration is “making Americans wait to get the vaccine behind people who came here illegally.”

The vaccination push started in December with health care workers and nursing-home residents getting first dibs on shots from Pfizer-BioNTech and Moderna, given their exposure to the virus and vulnerability to sickness and death. A federal panel known as the Advisory Committee on Immunization Practices recommended a check-down list of people to prioritize moving forward, though states are free to accept or modify the guidelines.

Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine, said governors need to “explain again and again that the issue is not merit but who is at greatest risk of dying.”

That includes people who smoke tobacco or use vaping devices.

“Follow the science,” Mr. Caplan said. “The politics leads to craziness — no to smokers, but yes to diabetics and the obese? Why, because smoking is less popular?”

He said on prisons, “governors need to show some courage and stop pandering to stigma and bias and insist on public-health science.”

Some state provisions aren’t that controversial but might take some explaining. Washington state is unique in prioritizing “multi-generational households,” citing widespread fears that younger members of households transfer the virus from frontline jobs to grandpa and grandma at the dinner table.

Any parent and child are technically in separate generations, but the state says it is focused on such older people as someone over 50 who lives with and cares for a grandchild or lives with someone working outside the home.

The companion rule in Massachusetts, meanwhile, spawned Craigslist ads from people willing to transport people 75 and older to a vaccination site so they could get vaccinated, too.

The Boston Herald reported that one post read: “I can pick you up in my car and transport you to and from the site free of charge. I can also get Covid tested before we meet. I would also be willing to pay you $250 for your time.”

The post was later deleted.

Massachusetts Gov. Charlie Baker said people should be careful.

“We have heard some pretty disturbing reports of some people trying to take advantage of this program already,” the Republican governor said at a press conference. “Some are posting online trying to get seniors to bring them to a vaccination site or in some cases are asking somebody to be paid to drive someone.”

“If you’re 75 or older and need assistance, you should only reach out to someone you know or trust to bring you as a companion — a child, companion, spouse, neighbor or caregiver,” he said. “Don’t take calls or offers from people you don’t know well or trust, and never share your personal information with anyone.”

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