The vaccine rollout across the U.S. has been less than ideal, but finally, it looks like there is a dim light at the end of this long, dark tunnel. Jabs are going in the arms of frontline workers, and as more vaccines are administered, states across the country are opening up the eligibility requirements, allowing more and more people to get vaccinated so that eventually the general public will be able to socialize and consort once more—not quite as we once did, but something close to it. In New York, where I live, I am now qualified to get the vaccine because of my BMI—a measure of body size using your weight and height—which is an outdated, racist, and embarrassing metric that, for once, is working in my favor.
This news filled me with a brief sense of relief, understanding as I do that every person vaccinated breaks a possible chain of transmission, and that also, we are all going to have to do this eventually. It just happened to be my turn now. But the nagging sense of guilt around why I qualified to get vaccinated was exacerbated by other conditions that would make me ostensibly less worthy or deserving of getting vaccinated now. This feeling, as explored by Emma Specter in Vogue, is one of both guilt and shame, a feeling that an apology is owed to someone, even though the rules clearly state that now is my time. I work from home and I live alone. I am generally low-risk, much more so than restaurant employees, delivery people, and other at-risk groups, all of whom I’ve heard, anecdotally, have had a difficult time getting an appointment. “I’m not saying it’s bad that you are getting vaccinated,” someone said to me. “But I wouldn’t necessarily make the same decision if it were available to me.”
Arguing against this line of thinking feels pointless—at this juncture in the pandemic, it is difficult to change anyone’s mind—but gesturing towards public health officials and their guidance is not. As the PSAs I see on television tell me, everyone who is eligible for the vaccine should get the vaccine when they’re able. The vaccination is available to me because of a comorbidity that I know to be bullshit—one that has made me feel bad about my body in ways both large and small for most of my life—but taking it feels, just for a second, like this bullshit has finally worked to my advantage. That isn’t my fault. I do not make the rules. Yet the tenor of the conversations I’ve had about deciding to do it now instead of “waiting” until more people who are higher-risk than I am have been inoculated has led me to believe that there is a moral high ground that I am somehow missing.
Any judgment, anger, or other emotions masquerading as moral superiority should actually be directed towards the massive failure of our government, and the way its neglect has disproportionately affected Black and Latinx communities. BMI, as has been stated many times, is bunk. But it is on the list, and I am listening to the authorities, and if I can get the vaccine now, then I will.
Eradicating the bogeyman of guilt attached to the presumed morality play of waiting or not to get the vaccine isn’t easy, especially when the reason I qualify is because of my BMI—a medical status that essentially declares to the world that I am fat enough for people to be concerned. Though BMI is not a good or effective measure of individual health, it is still assumed to be as such by many people, including but not limited to my mother, who reacted in the way I expected her to do when I told her I was getting vaccinated.
“You’re obese?” she asked, concerned. “Are you working out? Are you eating healthy? Are you taking care of your weight?”
Her concern sounded like judgment, but I recognized it to be care. Still, I was short with her, allaying her questions by assuring her that I am fine and that she does not need to worry. Defending myself against an outdated medical term that is an inaccurate measure of health is a battle that I wish to no longer endure, especially from members of my own family, but I understand that “love” looks different for everybody.
This conversation did not anger me as much as it did disappoint me, only because the stigma of being medically obese is such that the blame for that problem is placed squarely on my shoulders. Concerned doctors frowning at my weight and making pointed asks about whether I do any exercise are part of the reason I avoid going to the doctor, because explaining that I am merely “big-boned” to a medical professional becomes humiliating after a while. The body positivity movement’s only dubious claim to fame is that I can find a bikini that looks like the bikini for a skinny person in my size and sometimes, a plus-size model shows up on the cover of Vogue. Though I am able to acknowledge that this is some sort of progress, it is surface-level. No matter how many times a woman who is a comfortable size 14 shows up on the cover of a fashion magazine or in a major ad campaign, the discomfort with admitting that my body is not the socially-accepted standard does not disappear.
A useful op-ed in the New York Times lays out the argument for getting the vaccine without guilt when you qualify succinctly. Simply put: the doses need to go into arms because they expire. There is no reason to assume that the dose a low-risk, able-bodied, and healthy individual would get would go to someone else who is more at-risk, because that is not the way this thing works.
From the Times:
“If they call you to get vaccinated, you should go,” said Arthur Caplan, a bioethicist and the founding director of the division of medical ethics at New York University’s Grossman School of Medicine.
There are a number of reasons to get a shot if it’s offered to you. For one thing, there’s no reason to believe that if you forgo your dose, it will go to someone with a higher risk.
“As we’re finding out, that’s not really the way the vaccine allocation systems are being set up,” said Debjani Mukherjee, a psychologist and a medical ethicist at Weill Cornell Medical College. Many vaccines are being distributed by institutions that can’t transfer extra doses elsewhere or to specific populations, explained Kyle Ferguson, a medical ethicist at the Grossman School of Medicine.
Though I have lost over 20 pounds in the past year and a half, my weight for my height is still “obese.” The acceptable weight for my height, according to the medical community, is a number that I have never, ever seen on a scale. Truthfully, I fluctuate from the weight I currently am, in about 20-pound increments in either direction. My body is the biggest body of all my siblings and my mother, a small woman who runs 10ks and barely clears five feet. I have wondered for years and years why I look the way I do when my other sisters do not. After most of a lifetime of being concerned about this, and convincing myself that I can change the way my body naturally wants to be, I have simply tried to stop. There has never been a time where my body has worked in my favor—except for now.
A standardized vaccine rollout, with eligibilities and clear-cut paths for distribution on a national level, is a nice fantasy, but the reality is that each state will make its own decisions on who is eligible and when, and despite the efforts of Dr. Fauci and the CDC, vaccination uniformity between states does not exist. If a vaccine is available to you by means of eligibility for a pre-existing health condition, just get the vaccine. Herd immunity is the goal, and getting everyone vaccinated as soon as possible is necessary to achieving that goal. It seems that part of the faux-concern and the shaming around using an eligibility as dubious as BMI comes from the myriad stories of assholes jumping the line and not waiting their turn. This is not jumping the line; the vaccine is here for those who qualify, and if that happens to be you, do your part.