Don’t Worry About COVID-19 Vaccine Frauds

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Something I’ve realized about myself in the past decade or so is that I’m kind of weirdly obsessed with fairness and I always have been. I remember as a kid telling my parents that something wasn’t fair, and they gave me the standard parent answer of “Well, life’s not fair.” And I hated that response. I felt, and still feel, like it’s the epitome of lazy, hopeless thinking. Like…no, life isn’t fair, but shouldn’t we try better to make it fair? 

I’ve realized that this staunch position of mine affects how I interact with the world. It’s why I have, at times, gotten unreasonably angry in situations where I feel that someone is cheating or gaming the system, like even someone in a car who isn’t merging correctly. I get really annoyed. Back when I lived in London I remember waiting in a long line at the post office, and behind me a man was moving one by one up the queue saying “in a rush, mind if I just go ahead thanks so much” without really bothering to wait for an answer from the uncomfortable people. When he got to me he tried the same thing at which point I said “No, I’m also in a rush and so is everyone else in line.” Because fuck that! Amusingly he tried to charm me by complimenting my lovely accent and asking if I was a Canadian, at which point I said “Thanks but I’m an American, we’re actually much meaner.”

Anyway I say all this because after realizing that a lot of my reactions are based on this weird obsession with “fairness,” I’ve done some reflecting to see whether or not I can or should change some of my behaviors. Because every now and again I learn that what I think of as “fair” actually isn’t the best way to do something. Like, situations in which it’s actually irrational to insist upon complete and total fairness. Case in point: vaccine distribution.

Last month I talked about who deserves to get the COVID-19 vaccine first, and why it seems “unfair” but it’s actually better if people like prisoners get high priority. That was something that was tough even for me to accept, and it’s still tough! But it’s unmistakably true. 

One thing I didn’t mention in that video is that it’s also true that we should not be overly concerned with whether or not people are actually in the “correct” group to get vaccinated. As in, in this phase of vaccine distribution we’re giving them to anyone with preexisting conditions that increase their risk of dying from COVID-19. But how do we verify that? Do you need a note from your doctor? Do you have to show your medical records? Do you need to come in looking like you’re at death’s door?

New York governor Andrew Cuomo this week signed an executive order increasing penalties for vaccine fraud — people who try to cut the line to get a vaccine before they’re supposed to. Great, you may think. Those people suck! But, let’s think about this.

The order slams a $1 million fine on any healthcare professional who gives a vaccine to someone before they should get it, and will also cause them to lose their license. So, right away we’re not necessarily punishing the person who gets the vaccine too early but the doctor who gives it to them. Why is that a problem? We certainly don’t want doctors knowingly committing fraud, sure, but this plan makes it so that the average line-cutting asshole will not be afraid to try to cut this line, because there don’t currently appear to be penalties for them. But doctors will be afraid of line-cutting assholes, and so they’re going to up their security measures. In fact, Cuomo is doing it for them by demanding mandatory certification of all people seeking a vaccine. 

That’s going to significantly slow down vaccine distribution for a number of reasons: honest people will be genuinely confused about when and how they can get a vaccine, what they need to have on hand in order to get the vaccine, and whether they qualify at all. People will wait for hours only to be turned away for not having the correct forms or identification. And now all vaccine providers are going to spend precious time researching people to make sure they’re in the right group when they could be spending that time jabbing needles into arms.

It’s like the difference between going to buy some beer at a liquor store in the middle of nowhere Oregon compared to one right next to a college campus in Boston. Trust me, I spent 8 years in Boston and if you and your entire party show up to the liquor store without three forms of ID you’re going home empty-handed. In rural Oregon they ask if you want weed with your beer.

Meanwhile, we have vaccines going bad because we cannot physically give them out fast enough.

In fact, in DC last week a pharmacist had two doses of the vaccine that they literally were going to have to throw away because some first responders never showed up for their appointment and the vaccines don’t last long at room temperature. So, instead of throwing them away the pharmacist waved down two random people walking by and offered them the vaccine, which they gladly accepted. Would that pharmacist be charged a million dollars and lose their license if they’d been in New York under Cuomo’s executive order? I guarantee they would have thought twice about giving them to non-priority people instead of throwing them in the trash.

It kind of reminds me of the plane-boarding experiments. Many airlines seat passengers from the back of the plane to the front, assuming that if people aren’t standing in the aisle in front of you as you’re boarding, you’re more likely to reach your seat more quickly. But studies with humans and with simulations have conclusively shown that it’s actually faster to just have passengers board randomly. That’s how Southwest flies, and even though I hate waiting in lines, I hate the perceived lack of “fairness” even more. It stresses me out to fly Southwest, because what if I bought my ticket months ago but other people get all the good (window) seats?

Some data suggests that the fastest method of boarding a plane is to line up everyone by their seat number but staggering them, so that the first person is the last seat in the back by the window, and the second person is in the window seat two rows up from them, and so on until you get to the front of the plane, at which point you do the same on the other side, and then you do the middle seats the same way, and then the aisle seats the same way.

But how on earth would you convince every single passenger on a plane to line up in exactly the correct order? It can be done…Southwest’s process actually does have little stalls for you to line up in and arrange yourself with your fellow passengers so that whoever bought their ticket earlier (or with more perks) goes in first. But people are people, and they will show up late, line up in the wrong spot, bring too much carryon luggage that needs to be taken back to the flight attendant to check, and so on. Policing the order would become a much heavier burden and probably end up taking more time than simply letting everyone board randomly.

I think the same is true of the vaccine schedule. As much as I hate the idea of randomness in this process, the process will be smoother if you simply accept that some people will sneak in early. As I talked about in my video about who “deserves” vaccines, Andrew Cuomo’s approach to punishing suspected frauds will be a pyrrhic victory: sure, he might prevent some people from getting the vaccine before they should, but  by doing so he’s going to make a whole lot of people get the vaccine way, way later than they should.