Polarizing rhetoric on vaccine delivery
In an age of heightened political and racial tensions, it’s not surprising that the highly charged question of COVID-19 vaccine distribution would be politicized and racialized. Over the weekend, claims that the Centers for Disease Control and Prevention was de-prioritizing older Americans for vaccination because they were "too white" were met with outrage from conservative Twitter and consternation from many others. The plan has now been adjusted, and reports that the original proposal amounted to anti-white racism in the name of social justice were dramatically exaggerated. But the controversy is a reminder that progressive rhetoric on race and justice tends to be polarizing and counterproductive.
Health care workers and nursing home residents were always going to be first in line for the vaccine. The debate was about whom to prioritize next: people over 65, who are at especially high risk of dying from COVID-19, or workers in non-health care essential jobs — from police officers to grocery store employees — whose work puts them at high risk of exposure.
It’s not an easy question. The need to protect the elderly, who make up about 80% of COVID-19 deaths in the United States, is obvious. (I also have a personal stake in the issue: my mother is 84.) However, essential workers cannot avoid exposure by staying home, and their health is vital to society’s functioning.
Non-binding guidelines from the CDC’s Advisory Committee on Immunization Practices posted online listed various factors to decide which groups should be prioritized. One of the categories was "mitigate health inequities" — and on this point, people over 65 received a lower score partly because "racial and ethnic minority groups [are] underrepresented" in this population.
The backlash was boosted by a jarring comment from University of Pennsylvania ethics and health policy expert Harald Schmidt. "Older populations are whiter," Schmidt told The New York Times earlier this month. "Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit."
That sounded a lot like a ghoulish idea of redistribution: let more old white folks die because their privilege allowed them to get old in the first place.
In reality, this approach would hurt not only white Americans but older African Americans (who are at especially high risk for COVID-19) and Hispanic Americans (who are now slightly more likely than whites to live to an advanced age).
There is no question that Black Americans in particular have faced historic and even current barriers in health care access. (It’s difficult to disentangle race from economic disadvantage in understanding this problem.) It is also true that Blacks and Hispanics have been especially affected by COVID-19; priority vaccination for high-risk communities is not racist.
But once you start suggesting that we need to "level the playing field" with people’s lives, you’ve lost the plot.
To be sure, claims from the right that the CDC proposal amounted to "kill whitey" were absurdly hyperbolic — and hypocritical, given recent right-wing arguments that the pandemic’s death toll was not that bad since few young people were dying. ("Kill Grandma" was apparently fine until Grandma turned out to be white.)
However, the backlash resulted in public pressure that led to a better result. The current approach — to prioritize both essential workers and older people — gets it right. Vaccinating older people will save the most lives; vaccinating essential employees will ensure that vital services will not be disrupted and protect people with fewer options to protect themselves.
Meanwhile, one lesson from the controversy is that preoccupation with "racial justice" can lead down a very wrong path.
Cathy Young is a contributing editor to Reason magazine.