January 26, 2022

When the COVID vaccines received their Emergency Use Authorization in December 2020, I was glad my elderly parents could finally emerge from their home quarantine.  Many of my same-age friends had been long awaiting their turn to get the jab.  Personally, I felt no urgency.

In California, first vaccine priority was given to front-line health care workers (HCW) and nursing home residents — and I observed from the sidelines the rollout process with line-jumping.  Walgreens pharmacy staff administered vaccines to staff and residents at nursing homes while hospitals were allocated vaccines to distribute to their HCWs.  On the first day of vaccine distribution, Stanford Hospital medical residents protested being left out of the initial allotment of 5,000 doses.

Based on priority, a young internist on active hospital staff became vaccine-eligible in mid-December, an elderly community physician (courtesy staff) in mid-January.  A few days later, vaccines were made available to the 75+ general public.  Hospital translators and billing personnel who hadn’t stepped into the hospital for ten months could get vaccinated prior to the elderly.  With vaccine clinic appointments quickly snatched up in wealthy neighborhoods, wealthy residents drove several hours to access shots in other neighborhoods where demand was lower. 

Teachers in wealthy Los Gatos line-jumped to get shots at a nearby hospital after providing 3,500 meals for hospital staff. A few weeks later teachers line-jumped the 65+ group by demanding vaccines as another condition prior to returning to the classroom. As the parents revolted against distance learning in January my local school board’s promise to reopen in February got pushed back to mid-April to allow each teacher to be fully-vaccinated. In one weekend, vaccine distribution sites gave first priority to any K-12 teacher so any teacher wanting a vaccine could get vaccinated that weekend.

Many in my family and workplace pressed me to get the vaccine, but I persisted in not preceding my 80+ parents in the queue.  In any case, I had been working steadily through the pandemic so the arrival of the vaccines wasn’t a “magic bullet” for me.  Other than those jumping the queue, many agreed that those at the highest risk of hospitalization and death should be prioritized to be offered the vaccine first.  After all, COVID deaths would fall if the elderly were vaccinated first.  Whether the vaccine provides a public or private benefit continues to engage debate.

Some family members pushed the public benefit from my taking the vaccine, while I contend that the private benefit of any elderly personally gaining 95% protection supersedes an unlikely transmission event arising from healthy me.  Scientific studies confirm that asymptomatic spread of respiratory infections is rare — a JAMA meta-analysis of 78,000 people in households measures an asymptomatic index case transmission rate of 0.7% compared with a symptomatic transmission rate of 18%.  In the 10-million-resident Wuhan study, they found 300 asymptomatic cases (0.3%), and no re-infections of their close contacts.  When others fall ill, I almost never get sick, so I’m unlikely to transmit. 

After my parents got vaccinated, I followed.  Within five hours of my shot, I had a severe headache and was unable to multitask.  I retired to bed early, and the next morning, every joint was achy and stiff, making me wonder if this is how I’d feel at age 100.  My headache persisted along with difficulty concentrating.  For the next six weeks, I was fatigued, with my body wanting to sleep at 6 rather than 9 P.M.  When the 28-day mark passed, my brain was still processing slower, and I wondered if I’d ever return to my usual self.  My antibody test was positive, and I wasn’t planning another shot.