Who goes first? Vaccine rollout forces stark moral choices

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Susan Crowley, a 75-year-old retired attorney, sits outside her home in Hood River, Ore., on Jan. 23, 2021. Crowley submitted public comments to Oregon's vaccine advisory committee to criticize the state's controversial decision to vaccinate its teachers and early childhood care givers ahead of its oldest residents. Teachers in Oregon are eligible for the vaccine this week, two weeks ahead of the state's oldest residents and more than a month ahead of those between age 65 and 70. Oregon's decision underscores the difficult moral dilemma facing local and state public health officials as they weigh which populations need the vaccine most urgently amid a nationwide dose shortage. (AP Photo/Gillian Flaccus)

HOOD RIVER, Ore. – As COVID-19 surged, retired attorney Susan Crowley did some simple math and discovered a chilling fact: people over 60 made up 91% of coronavirus deaths in Oregon. So the 75-year-old was shocked when the state started vaccinating teachers this week before senior citizens in a push to get children back into classrooms.

“I look at these figures and I am literally afraid. It’s not just a question of missing beers with my friends. It’s a question of actually being afraid that if I am not careful, I will die,” she said. “The thing that is so upsetting to me is that seniors don’t matter, the elderly don’t matter. And it's painful to hear that implication.”

Democratic Gov. Kate Brown has defended her decision, choking up in a recent news conference because she said she “knows of families where 12- and 13-year-olds are attempting suicide” because of social isolation. Meanwhile, her sister, a cancer survivor, is being asked return to her Minnesota classroom without a vaccine, Brown told The Associated Press.

“No matter what you do, people aren't happy,” she said. “The teachers in Minnesota are furious at the governor because they are doing seniors first. And here, the seniors are furious at me because I am doing teachers first. There are no right answers, and there are no easy decisions.”

With a mass vaccination campaign underway, the U.S. is facing a moral dilemma as officials from California to New Jersey decide who gets the shots first. Everyone from the elderly and those with chronic medical conditions to communities of color and front-line workers are clamoring for the scarce vaccine — and each group has a compelling argument for why they should get priority.

It has local health officials and volunteer advisory committees doing ethical gymnastics the likes of which haven't been seen since the military's rationing of a new wonder drug — penicillin — during World War II or the decision to give white men first access to life-saving dialysis machines in the 1960s, when the new technology was in short supply.

Hospitals and medical professionals make such moral decisions when triaging emergency room patients in a disaster or ranking recipients for organ transplants, said Courtney Campbell, an ethics professor at Oregon State University. But what's happening now is on such a large scale that ordinary people — not just public health officials — are reckoning with questions of who is most important to society and why, he said.

“We’re being asked to emphasize some of our shared national values. ... We’re being called to treat other persons as equals, and that means equals in the sight of the law, but also moral equals, so that matters of privilege or wealth or socioeconomic status get leveled out,” he said. “This is a time when we get tested as to whether we're going to walk the talk.”