What Comorbidities Qualify for Covid Vaccine? That Depends.

After Covid-19 vaccines from Pfizer and Moderna were approved for use in late 2020, anecdotes proliferated about rich people finding ways to jump the distribution priority line.

“I heard a lot from friends in Miami about people flying in, because they were giving it to everybody,” the writer Carole Radziwill said in an interview. “There was a lot of that in January.”

But a month later, as access expanded in places like New York to include those with pre-existing conditions (like cancer, severe obesity or cardiovascular disease), it began to seem like anyone could get a vaccine if they were willing to hunt one down or stretch the truth about their medical history.

Holly Peterson, who has written several novels about wealth in New York, heard about visibly slender people from her social set getting their vaccines early by citing, without much credibility, high B.M.I.

Which seemed to her like “the equivalent of knocking over an old lady for a taxi and feeling good about yourself,” as she put it in an interview.

The generous phrase “including but not limited to” when one is asked to verify an “underlying condition as defined by the New York Department of Health” on the state’s comorbidities information sheet has been, for some, an open invitation to invoke a mild circulatory or mental ailment — a “fauxmorbidity”— to justify an early shot. (To be fair, most comorbidities are invisible, and federal law protects the privacy of patents’ health information. Plus, the more people who are vaccinated, the better.)

That people are publicly airing their vaccination status has made some who are waiting for eligibility to broaden uneasy. “It’s broadcasting status, that you got the vaccine ahead of others,” said Erik Maza, the style features director at Town & Country. “We should all consider taking up the Garbo challenge and stay off social media for a spell instead of broadcasting every waking second of the day, including your vax shot.”

“Those people seemed just fine when they were splashing in bikinis in Turks and Caicos at Christmas,” said the writer Jill Kargman. “What’s funny is that many of them just post their vaccination selfies to green circle Close Friends.” (She was referring to Instagram Stories, which can be tailored to a trusted few.) “On some level, they know it’s tone-deaf for a wide audience but have their group where they feel safe,” she said.

Occasionally, those posting on Instagram have said that they were trying to say to others that the vaccine is safe and effective. But even though true, this can sound a little sanctimonious to Bruce Bozzi, the host of “Lunch With Bruce,” a weekly Sirius XM show on RadioAndy. “I mean, come on. You’re not Joe Biden. You’re not the queen,” he said.

Three psychiatrists interviewed for this article said their patients all seemed to understand that attention deficit disorder and mild anxiety do not meet the state definition of an “intellectual” or “developmental” disorder sufficient to place them in the Centers for Disease Control and Prevention’s Group 1C, whatever they might have mulled as their cursors hover nervously over qualification forms at 3 a.m.

But maybe sweating it is beside the point.

“They don’t need me to get a vaccine,” said Dr. Roger Emert, an allergist and immunologist at N.Y.U. Langone Health. “I have patients who brought stacks of medical info when they went to get vaccinated. No one ever asks to see it.”

And Dr. Emert did receive a number of requests for inhalers from people who he said “haven’t needed to use one in quite a while.”

“I’ve never had so many people happy to be told they’re obese,” said Edward Goldberg, a gastroenterologist with a private practice on the Upper East Side.

In recent weeks, the Johnson & Johnson single-dose vaccine went to market. That increased the number of available vaccines, while some people in previously eligible groups continued not to take advantage. And given that the government will have a vaccine surplus by the end of July, people may feel emboldened, or less psychologically burdened, about jumping the line.

Dr. Goldberg believes that the New York State Department of Health’s amorphous definition of pre-existing conditions enables it to sidestep thorny (and not always clear-cut) issues about wealth inequality during the rollout and avoid getting slowed down by a rapidly mutating virus.

“At this point, the goal is to get as many people vaccinated as possible,” he said.

He sees no issue with giving a note to a patient who had a melanoma five years back. Cancer is cancer. Elevated blood pressure is fine too, even if it’s sometimes less a reason than an excuse.

Dr. Emert said much the same thing. Dr. Patricia Wexler, a cosmetic dermatologist, argued that the ordering of the line never made total sense to begin with.

She is fully aware that people in her age group are more vulnerable. But they also are more likely to be retired and are less likely to go out. “Young people are the super-spreaders!” she said.

Some young people get around the fauxmorbidity issue by volunteering at a vaccine site.

That was what Angus O’Brien, a 25-year-old actor in Brooklyn, did in early February.

He signed up through the NYC Medical Reserve Corps’s website. Soon after, he was at the Bushwick Educational Campus, serving as a “flow monitor,” helping to move the line forward.

While there was no guarantee in advance he would get a vaccine, it seemed to be well known among the volunteers that most people who help out would get a leftover shot, Mr. O’Brien said. “It was basically treated as a given when I got there,” he said.

Allie Marconi, 31, a marketing director for Copperstate Farms, a cannabis company in Phoenix, Ariz., got a Pfizer shot by volunteering at a mass vaccination site at the State Farm Stadium, where the Arizona Cardinals play.

In an interview, Ms. Marconi said that she volunteered mainly to get a vaccine. But it was a great experience, nevertheless. “I wanted to go back, but I didn’t want to take the slot from another volunteer who could get vaccinated,” she said.

Ms. Radziwill said that while inventing fauxmorbidities to get a shot is unseemly, she believes the real issue is the rollout, which has made it almost impossible for the elderly and people living without Wi-Fi, often underprivileged and at risk, to make appointments.

“I get that people are eager to shame those who are gaming the system,” she said, “but let’s shame the people who set up that system.”

source: nytimes.com