A vaccine system for the fortunate few

I joined Team AstraZeneca on Tuesday morning. I thought the moment would arrive with a sense of instant giddy relief or maybe tears as the last year crashed over me all at once. Instead, it was surreal, a strange and suspended feeling laced with a sense of guilt that there are a lot of people—grocery store and factory workers, teachers and daycare providers among them—who needed to be sitting in that vinyl chair more than me.

Over the weekend, my doctor’s office (a large group practice) emailed with a link to book a vaccination appointment for patients over age 55. On Sunday night, as soon as I heard Ontario was lowering eligibility for the AstraZeneca vaccine to 40, I used that link, answered “yes” to the question about whether I was 55—figuring that as soon as they updated the website, that question would be defunct and I would qualify—and booked myself an appointment.

Almost immediately, I felt buyer’s remorse.

I emailed the office after booking to say I had done so because of the change in eligibility, but I was happy to wait and they could cancel my appointment if they wanted to prioritize patients by health status or exposure. At the same time, uneasy about taking an easy-to-get “captive” dose rather than having to chase one down in the wild, I added myself to the wait list for several pharmacies, thinking I might cancel with my doctor.

By Monday morning, however, my doctor’s office had confirmed my appointment and I could see plenty of slots remaining there for the rest of the week, so I justified to myself that I wasn’t “taking” a spot from someone with greater need.

Last week, I had prepared as though I was readying for a military invasion for the day and hour when my hometown of Sault Ste. Marie was opening its first batch of vaccine appointments to the age group my mom and stepdad belong to. After some inevitable website meltdowns, between me and my husband and the two of them, we got them booked for April 24.

I expected it would be intensely emotional for me when they got their first doses, that I wouldn’t realize the hum of worry that I’d been carrying for a year until it started to fade. I figured my husband and I might get our first vaccines in June. Instead, because of the abrupt change in AstraZeneca eligibility, other people’s reluctance to take that vaccine and a stroke of luck with my doctor’s office, I ended up getting my shot four days before my parents got theirs.

But while my doctor’s office is where I got my vaccine, that does not explain how I got it in the first hours that I qualified. This whole experience has highlighted what a chaotic, labour-intensive and fundamentally unfair system (I use the term very loosely) Ontario and some other provinces have for booking vaccines, particularly the AstraZeneca shots that have suddenly become more widely available. To make this work and buy yourself some peace of mind, you need a lot of advantages that are most likely to be available to the people least at risk from this virus.

The first is information—lots of it, accurate and fast. Reporters are to scuttlebutt what seagulls are to French fries on a boardwalk under normal circumstances, let alone when a deadly pandemic is raging. When anything changes with vaccines, restrictions or cases, I either see it myself within minutes or one of my similarly plugged-in friends texts it to me.

To land a COVID vaccination appointment, you need to know you qualify in the first place—based on criteria that seem to change by the hour—then figure out who’s administering them and how to get yourself in the queue, ideally before everyone else in your age group is trying to do the same thing.

The Ontario website that lists pharmacies administering AstraZeneca is no more helpful or efficient than a phone book (on Sunday, it listed a pharmacy 500 metres from my house that supposedly had it, but when my husband walked in to ask about an appointment, they told him they didn’t have any vaccines and never had); for every location offered, you have to call or register online individually. I had friends and colleagues trading tips on where to find elusive appointments or short wait lists, and my husband and I still spent several hours on the task with mixed success. This would be difficult to outright impossible with language barriers or tech limitations, and provinces like Nova Scotia prove it doesn’t have to be such a ridiculous crapshoot.

Making this work also requires flexibility. There’s the time to do the admin work that might buy you some luck with an appointment, a flexible work schedule and child care arrangements that allow you to take whatever spot you can find and access to safe and convenient transit to get to the location that pops up first. I drove to my appointment, knowing that my husband was working from home watching our child as she navigated online school and that my employer was fine with me missing an hour or so of work to get this done.

As we have seen from the howls of injustice and Ontario municipalities taking matters into their own hands when it comes to the essential workplaces where sick leave is needed with deadly urgency, that kind of flexibility is not the reality for many of the people most at risk.

It is a maddening truth that people like me who need the vaccine least have the easiest time getting it and avoiding the virus in the first place—but then, that indefensible inequality only mirrors the entire pandemic.

COVID hasn’t changed our patterns of privilege and power; it has only laid bare what’s always been true. There are the lucky ones who are generally safe and secure and empowered, and there are the more precarious, who are least able to insulate themselves from the greater risks they bear—often directly to the benefit of the rest of us. There are the people whose screams of protests over police overreach or the asinine closure of playgrounds were (rightly) heard, and there are the voices of essential workers begging for paid sick leave, PPE, mass testing and prioritized vaccination, somehow muted by those who could make better decisions.

Before I went ahead with my own appointment, I read several of the smart articles floating around in which medical and ethics experts weigh in on whether you should hold off on getting a vaccine if you know you are low-risk. They seem to universally arrive at the conclusion that you should go when called because that benefits everyone on the slow march to herd immunity. But at least one expert offered an interesting additional thought: if you feel badly about getting a shot ahead of someone else, then let that propel you to help others land themselves the same protection.

Those of us who knew all the angles to work to get an appointment, who had no problem getting time off work and getting ourselves there, and who feel very lucky but also a little bit wrong about how all of this has gone down need to use that energy and capability to help other people land their own vaccine selfies.

None of us are safe until all of us are safe, and we have seen it demonstrated in brutal fashion lately that some voices carry much more than others with political leaders. Those of us with loud and lucky voices should just refuse to shut up about all this until everyone is safe.