Getting the COVID-19 vaccine: Where should we stand in the waiting line?

My former college roommate came down with COVID-19 in Los Angeles the same week that I received the first dose of the Pfizer vaccine here in New York. 

He had been very careful to mask and distance, but COVID-19 is exploding in L.A. County, where he lives, and he somehow acquired it, even though contact-tracing did not reveal where. We are the same age; he has diabetes but I don’t, and he is borderline obese. I wish he would have been in line to receive the vaccine before the illness struck him but the rollout is still in its earliest stages.

I was not in the initial group of emergency room (ER) and intensive care unit (ICU) staff to receive the vaccine, which was fair. Any doctor, nurse or respiratory therapist who is on the COVID-19 frontlines should get the vaccine well before I do, and they did at NYU Langone Health. And at NYU, the line for the vaccine on the day I received it included all frontline workers. There is no space in the war on COVID-19 for posturing or backbiting and, although it is all too common in this heavily charged atmosphere, I have not seen it played out at my medical center. The vaccine rollout so far has been well-organized, smooth and science-based, clearly lacking in rank-pulling or VIP favors.

In my office, I try to see COVID-19-positive patients by Televisit only, and we pre-screen everyone for symptoms and take temperatures at the time of the visit. But every now and then I see a patient who ends up testing positive for the virus, so I am glad that I wear an N-95 mask, shield, gown and gloves for each encounter.

Health care workers should be at the front of the vaccine line because they are putting their health at risk and because they could spread COVID-19 unwittingly among their patients. Right up there with them should be populations at risk for complications and death, beginning with the elderly. The Centers for Disease Control and Prevention (CDC) is correct in stating that nursing home residents and staff also should be at the top of the list, when you consider that 39 percent of all COVID-19 deaths occur in long-term care facilities. Luckily, the states are following through with this.

But COVID-19 deaths do not stop at the nursing home door. In fact, many of my elderly patients have complained that they are the same age with the same types of underlying health conditions as nursing home residents. Why should the rest of the elderly (those under the age of 75) have to wait?

Gov. Greg Abbott (R-Texas) and Gov. Ron DeSantis (R-Fla.) agree and are going against CDC guidelines, which would have so-called essential workers receiving the vaccines after those over the age 75. But CDC’s own data shows that around 80 percent of the deaths from COVID-19 occur in those over age 65, so Texas and Florida are right to expand the group of elderly who get the lifesaving vaccine next.

Not only that, but the CDC’s determination of what constitutes an essential worker is, in some cases, somewhat questionable. Few would argue that police officers and firemen are not essential — that they put their health on the line every day and can frequently encounter COVID-19 and potentially spread it; in fact, I would put them in the same group as emergency health workers. But why should members of the media and lawyers receive the same designation? Why should members of Congress be lining up to get the Pfizer and Moderna vaccines as self-appointed role models? Surely the public already gets the message from health care workers all over the country that the vaccines are safe and crucial to take.

I was proud and honored to receive the revolutionary Pfizer Messenger RNA vaccine, as was every health care worker with whom I spoke. Pfizer has added this historic vaccine to its other monumental contributions to vaccine science against both smallpox and polio in the late 19th and early 20th centuries.

Afterward I developed a sore arm, headache and some transient fatigue but I was back to baseline a day later — whereas my pal in California has remained fatigued for several days from his encounter with the actual virus. Luckily, his breathing is good, his oxygen saturation is high, and he hasn’t had to be hospitalized, whereas others like him have not been so lucky.

I am more convinced than ever that immunization is the greatest public health weapon we have. The faster we get this and other COVID-19 vaccines to everyone in the country, the faster we will emerge from the pandemic.

Marc Siegel, MD, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID: The Politics of Fear and the Power of Science.”