The status will be based on the honor system for coronavirus protection, with no evidence required that someone meets the new requirements for the underlying conditions.
(Rick Egan | The Salt Lake Tribune) Julyn Shepherd fills syringes for Utah County residents to get COVID-19 vaccines at a former Shopko store in Spanish Fork on Wednesday, January 27, 2021.
Instead, the state relies on the honor system. It is an effort to get shots in the arms as quickly as possible, but it will almost certainly lead to abuse as people find that there are relatively few obstacles that prevent them from jumping forward in line.
“People may be lying about whether or not they have one of these underlying health conditions,” Gov. Spencer Cox acknowledged Thursday at a news conference, where he asked Utahns to comply with the rules.
Requiring procedures as proof of eligibility would not only “significantly slow down the process of administering vaccines to the arms of these peoples,” Hudachko said, but would also place an unnecessary burden on health workers who would be responsible. to provide this documentation ”
This shift toward more widespread vaccine access occurs as the number of deaths in Utah from coronavirus approaches 2,000. But the seven-day average for the positive coronavirus testing rate has dropped, both in the traditional state measure (which still stood above 10% last week) and in its new methodology, which hovered around 6% last week. The number of fully vaccinated Utahns with two doses exceeded 225,000 weeks, with a likely total of 250,000 people over the weekend.
What happens elsewhere?
As states begin to make it possible for larger groups of residents to be vaccinated, they have taken different approaches to the question of whether procedures are needed to vaccinate people from a priority group.
While it remains to be seen to what extent the honor system will be implemented here, Margaret Battin, a professor of philosophy at the University of Utah, said she wondered if the community influence of The Church of Jesus Christ of Latter-day Saints Last Days could affect policy success.
“Church teachings … I think they would tend to discourage behavior like making rope,” said Battin, who is also an adjunct professor. in the U. program of ethics and medical humanities in the Department of Internal Medicine. “Everyone who‘ does good ’and‘ chooses the right ’, this kind of moral teaching could play a role in the behavior of many people in this state that might not be as true in a more heterogeneous state as New York. “
Hudachko said the decision was made primarily based on feedback from the vaccine and health care providers that requiring paperwork would create “significant bottlenecks.” He said he has not been able to make comparisons on which approach is more effective and noted that several states have not yet started vaccinating people with underlying health conditions.
Who gets the vaccine next?
Utahns 16 years of age and older with certain serious and chronic health conditions are eligible to receive the COVID-19 vaccine. The following is a list of these health conditions that meet the requirements, according to the Utah Department of Health:
• Recipients of solid organ transplantation.
• Certain cancers.
• Immunocompromised people (with a weakened immune system) from blood, bone marrow or organ transplants; HIV; long-term use of corticosteroids or use of other medications to weaken long-term immunity.
• Severe kidney disease or dialysis, or with chronic kidney disease in stage 4 or 5.
• Uncontrolled diabetes.
• Severe obesity (body mass index over 40).
• Chronic liver disease, including chronic hepatitis B or C.
• Chronic heart disease (does not include hypertension).
• Severe chronic respiratory illness (other than asthma).
• Neurological conditions that affect respiratory function, including Down syndrome, multiple sclerosis, Parkinson’s disease, cerebral palsy, quadriplegia, or hemiplegia.
• Stroke and dementia (Alzheimer’s, vascular, frontotemporal).
• Asplenia, including splenectomy or spleen dysfunction, including sickle cell disease.
Although the honor system poses its own problems, Jim Tabery, an associate professor of philosophy at the U., said he believes launching vaccines as planned is the “ethically appropriate path.”
“Viously, obviously, when you’re thinking about something like this, your mind naturally goes to vaccine line jumpers or freeloaders,” he said. “There could be something, but the question is, what system are you thinking of creating to eliminate them? And, in fact, would it be a better system?”
Requiring people to jump through hoops to prove they have an underlying health condition could be “terribly invasive” for people with disabilities, and could also raise equity issues for access to the vaccine. For example, people in severely affected color communities may not have access to a health care provider to get proof of their condition or may have difficulty getting a job to get an appointment.
“If you are dealing with someone [in that situation] who has diabetes and you’re saying, “To get the vaccine, we also need some kind of confirmation that you have diabetes,” you basically ask them to go see a doctor who doesn’t have access, ”he said.“ And so it will most likely ensure that someone does not have access to a vaccine. “
Up to this point, it has been “relatively simple” for vaccination providers to determine eligibility in Utah, Hudachko noted.
Still, Salt Lake County Health Department spokesman Nicholas Rupp said there have been some cases where people have tried to “trick the system” and have been sidelined at a vaccination site.
“Fortunately, it’s not a widespread problem,” he said. “We’ve had more people who really misunderstand their eligibility, but even these aren’t widespread.”
The county has not taken any position on the use of an honor system, but Rupp said the health department will follow the state and governor’s directions “and encourage people to be honest so the vaccine can pass first to those who are really most at risk of serious illness. “
(Rick Egan | The Salt Lake Tribune) A remote social waiting area for Utah County residents to receive COVID-19 vaccines at a former Shopko store in Spanish Fork, Wednesday, January 27, 2021 .
Announcing Thursday that the vaccines would be open to people with underlying conditions immediately, rather than the date set for March 1, Cox noted that those who now meet the requirements have the highest risk of hospitalization and death due to of COVID-19.
And he urged Utahns who are not eligible not to schedule appointments.
“We have so many more vaccines coming soon, but we are giving priority to these people, again based on age and these underlying comorbidities, because they have the highest risk of hospitalization or death,” he said. “So if you move up the line, it means there’s someone who won’t get the vaccine as soon as they can and it’s very possible that they could end up hospitalized or, worse, die.”
Those who follow the rules “can sleep well at night knowing they haven’t fooled the system, that they were willing to give it to those who needed it most,” he added.
As the state opens vaccines to more people, Tabery said the most ethical thing those who are not yet eligible for them can do is wait their turn.
He noted that there are legitimate questions about equity within the vaccine launch. But if, for example, a grocery store employee felt he should have been included in the last round of inoculations, the way to deal with it is to contact state leaders to express that concern, not because someone take care of your hands things.
“If someone was in a situation where they were in the hospital or the pharmacy and the pharmacist or the nurse would say,‘ Hey, we have an extra dose. This will be lost if you don’t use it, then it would be wrong not to take it, ”he said.
It is likely that many people will make these ethical calculations during this phase of state deployment, but Battin indicated that the social stigma and disapproval of people who cut the line will be the main defense against this behavior.
Tabery said he anticipates there will be times when people will cut the vaccine line and that when they are identified, news will be given.
But he is confident that most Utahns “will follow these rules.”
“I think there’s a kind of community mindset underlying the state of Utah, which serves well in situations like this,” he said. “And so I’m sure there will be line cutters. I’m sorry to have found myself in a situation where they felt they had to do it or they could do it. But I think they will surely be the exception, not the rule ”.