I was just looking at the Mass vaccination rollout plan. Among the comorbidities that get one moved up the list is smoking. I’m sorry, but NO. I am a former smoker. It’s a choice. One shouldn’t get moved up the list for that.
Hang on, is it people who smoke? Or people with underlying health conditions, which may or may not be caused by smoking? Because the only article I can find is this, which (despite the tone of the article) actually suggests the latter.
Can you cite this please?
I’m reasonably sure what you read in turn misread or misinterpreted something.
Even taking the OP at face value, moral judgment is rarely one of criteria for determining medical priority.
Like it or not, if smokers are more susceptible to COVID, and therefore more likely to catch it and 1) spread it, while possibly 2) being a petri dish for a mutation, it is in the best interests of the general public to vaccinate them.
I am one of the biggest anti-smokers you will find, and I am OK with vaccinating smokers first, if it brings a more abrupt halt to the pandemic for everyone; hell, I would support legislation that REQUIRED a vaccination in order to be allow to continue to buy smoking paraphernalia.
You move up the list based on the number of these you have. Smoking is one of them. I admit I might be misinterpreting this, but it looks to me like smoking counts as a health issue in determining elligibility.
It really isn’t about moral outrage. I’m not all that anti-smoking. But AIUI, we don’t put alcoholics at the top of the list for liver transplants, either.
Actions have consequences. I didn’t quit smoking because I hated it.
But OP, if you move away from the current ethical model of prioritizing according to medical need, and treat according to whether someone “deserves” treatment based on life choices, why is is just smoking that you think should be considered? For example, obesity is often dependent on life choices, with all the health implications that go along with it. Maintaining general cardiovascular fitness is certainly largely a choice.
I don’t think this is an apt comparision. In the case of transplant, behavioral choices have a very large effect on the expected benefit from the treatment. I don’t think that’s the case with vaccination. Someone with comorbidities (whether due to smoking or other factors) is expected to benefit far more from vaccination that somebody without those comorbidities, even if they continue to smoke.
That looks pretty clear cut. It does bump smokers up a notch.
Not sure how I feel about that, my gut feeling matches yours, but Rivkah has a point.
Alcoholics don’t spread kidney disease, smokers can and will spread COVID so vaccinating them ahead of someone without any of the issues makes sense.
I’m surprised by Pregnancy, has the testing declared the vaccinations safe for the fetus yet? Just 2-3 weeks ago they’re were recommendation to hold off if pregnant I thought.
However, alcoholics in recovery do get transplants. More importantly, your liver disease does not affect me; your COVID does. It is in MY best interests that highly susceptible people are vaccinated first, when you consider that my ultimate, very best interest is not to be personally vaccinated, but to eventually eliminate COVID-- it’s not impossible: we eliminated smallpox, and island nations or states have eliminated rabies, while some countries have to all intents and purposes eliminated polio.
It’s pretty simple. Vaccines aren’t a reward. They’re a public health tool.
YEAH!
wish I’d put it that way…
No, this I disagree with. Any benefit from herd immunity will only accrue when a large proportion of the population is vaccinated; and the risk of harm from vaccination is negligible. So the greatest benefit accrues to the person receiving the vaccination, who is immediately and directly protected from harm. Although I’m at low risk, purely selfishly I would prefer to be vaccinated as soon as possible.
As a public health matter, i.e. unselfishly, of course I agree with you.
I’m not aware that there’s evidence that people with comorbidities spread the disease more. So in the quest for herd immunity, it’s a numbers game not a type game.
And alcoholics in recovery is more analogous to former smokers than current ones.
Well, here you’re echoing an earlier discussion which got bogged down in the semantics of the word “reward”. Vaccines do benefit the person receiving the vaccination.
The earlier discussion was whether people who have demonstrated irresponsible behavior such as going to unmasked mass gatherings should be prioritized for vaccination. If we assume their behavior cannot be modified, then from a public health perspective we should prioritize them for vaccination. In other words - they have no comorbidities, but the priority would be based on their expected future behavior.
Here I would not prioritize them for vaccination, because despite the public health benefit, we would effectively be rewarding this type of behavior because of the significant benefit that accrues to the person who is vaccinated. I think we should attempt to modify irresponsible behavior through punishment rather than reward.
If you get COVID, you’re more likely to suffer ill effects with many of the co-morbidities.
Smokers in particular would be more prone to coughing and for longer which is a great way to spread the virus. So in that way, smokers are more dangerous to not have vaccinated for the overall public health.
No, it’s not. Future drinking has a very large effect on the expected benefit from a transplant. Future smoking has little effect on the expected benefit of vaccination.
If smokers suffer more serious consequences, then they’ll be tying up ICU space more than I am likely to if I get infected.
I hate smoking, but I don’t care if smokers get vaccinated before I do.
And ICUs–and the medical workers who staff them–are the crucial problem right now. Ensuring that the bulk of the population who are most likely to have severe morbidity and end up needing intensive care, intubation, and ECMO support are immunized to at least the degree that they don’t require long hospital stays tying up critical ICU beds with an ultimately low probability of recovery means those resources are more available to younger people who may have severe disease but are more likely to survive, as well as giving medical workers a break so we don’t have a glut of critical workers who are burnt out and unable to perform.
This is an overall harm reduction issue, not a “you made your bed, now lie in it” reprobation, notwithstanding the issue that the tobacco industry–with the tacit approval of governments who collected taxes and failed in their duty to inform and protect the public from harms–practiced deceptive marketing, outright lied and constructed false medical research about health consequences, and deliberately engineered their products to be as addictive as possible.
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