Medical privacy has become the latest casualty of vaccination efforts, as friends, co-workers and even total strangers ask intrusive questions about personal health conditions.
When Helena Jenkins, 23, recently asked to leave work early for a vaccination appointment, her boss at a Nashville retail store was incredulous.
“Well how did you get that?” he asked.
Ms. Jenkins was embarrassed, but answered truthfully. “Um, my weight,” she stammered, referring to the fact that, in Tennessee, a body mass index of 30 qualified her for vaccination in early March. “I had a moment of ‘ugh,’” she said later. “It made me so uncomfortable, but it didn’t click until afterward that I definitely didn’t have to answer that.”
As public health officials push to get more at-risk people vaccinated, many of the newly qualified are discovering an unwelcome side effect of vaccination: Intrusive questions about their personal health.
The majority of states now have expanded vaccine eligibility to include people with underlying health conditions that put them at risk for complications from Covid-19, such as high blood pressure, a compromised immune system or obesity. As a result, the demographics of the vaccine waiting lines have shifted from mostly older people and now include many seemingly healthy people in their 20s, 30s and 40s. Young vaccine recipients say their friends and co-workers are intensely curious about the appointment process, and as a result, often ignore boundaries about personal health that they never would have crossed in the past. Some of them ask directly: “What health problem allowed you to qualify?”
When Amy Coody, 43, a mental health worker in Montgomery, Ala., told her friends and colleagues she had a vaccine appointment, she was shocked when it felt like people were judging her and assuming she had taken another person’s spot in line. Ms. Coody knows that she looks young and healthy, but she qualifies for two reasons — her work takes her into hospital settings, and she also has an underlying health condition that puts her at high risk.
“The hostility was definitely there,” she said. “They’d be like, ‘Wait, how did you get an appointment?’ I wasn’t prepared for that kind of reaction. It took me off guard so I eventually stopped telling people I planned to get the vaccine.”
Vaccine supply issues resulted in the cancellation of two of her appointments, and the shaming even made her debate rescheduling. “I would never want to step in front of somebody who needed it,” said Ms. Coody. “Then I realized, I do need it. There are a lot of patients in hospitals waiting for care. I thought, it’s about them. It’s not about me and my shame or anybody else who doesn’t understand the situation.”
Getting policed about a hidden health issue isn’t new to Ms. Coody, who has a condition called dysautonomia, a disorder of the autonomic nervous system that can cause her to suddenly pass out. She said the vaccine shaming she has experienced was similar to when she’s been confronted after parking in a handicapped space, even though she has a tag that allows her to park there.
“People come up to me and say, ‘You’re young and you obviously don’t have an illness so why are you taking a handicap spot?’” Ms. Coody said. “Even though it’s none of their business, I feel the need to defend myself. If more people realized there are invisible illnesses out there, maybe they might be a little more respectful about it.”
Even total strangers waiting in vaccine lines have felt justified in interrogating someone who looks young and healthy. Those on the receiving end of the questions say the implication is that they must have cheated and jumped the line.
Joanna Hua, 23 and a graduate student at Georgetown University, was standing in line for her second dose recently when an older woman she’d never met confronted her. “She looked at me and said, ‘You look very young to be getting the vaccine,’” Ms. Hua recounted. “She asked me, ‘How did you end up being able to qualify for one?’”
Ms. Hua said she was taken aback by the question. She told the woman truthfully that she qualified because she worked in a grocery store, but she didn’t mention that she also qualified based on her weight. She said another young woman in line near her also nervously explained her reasons for qualifying.
“I felt an instinctive need to justify myself,” said Ms. Hua. “It felt almost accusatory and invasive to ask about it. I think there is some sort of idea going around that people are just taking advantage and trying to get a vaccine whenever possible. I don’t doubt that some people do that. But to have a stranger come up and ask you?”
Tanmoy Lala Das, a medical and doctoral student in New York City, has been helping with vaccination efforts in Manhattan, giving shots to patients and helping as a patient navigator. He said overall the experience at vaccination centers has been upbeat, and everyone is collegial and happy to be there. But he has, on occasion, heard people asking others about personal health issues while waiting in line for their shots.
“I’ve overheard people ask, ‘So what brings you in today?’” Mr. Das said. “The less stigmatized conditions people are open to talking about. They’d laugh and say, “Oh, you know, diabetes.’ I think the ones who are more sensitive, they say, ‘Oh, I just got a spot.’”
It doesn’t help that many people know someone who has jumped the line by claiming to be a teacher or a smoker or lying about a health condition. In New York a fitness instructor got vaccinated by claiming to be an educator, and in Florida two women even “dressed up as grannies” to get the vaccine.
“I think in New York, people are trying to figure out these dynamics of are you getting the dose because it was left over, or a condition that qualifies you or did you lie about something,” said Mr. Das. “The honest reality is I know people who have cut the line and lied about things — 29-year-old people who have gotten vaccines who don’t have pre-existing conditions. But I think most people are not lying. The goal is to vaccinate everyone.”
Rhonda Wolfson, who lives in Toronto, said that in places where the vaccination process still is age-restricted, it has created a different privacy problem, casting light on the fact that a person is above a certain age. Ms. Wolfson qualified for a pilot vaccination program in Ontario for people aged 60 to 64, and she realized that talking about her vaccination would reveal her as a sexagenarian to people who thought she was younger.
“I have one friend in her 40s, and she knows I’m older, but she doesn’t know my exact age,” said Ms. Wolfson. “She’s never asked, and I’ve never offered. I spoke to her last week and in my excitement I mentioned, ‘OMG, I got vaccinated.’ I could almost hear her pause, ‘Oh, you’re that age.’”
In some circles, the stigma of early vaccination is even more concerning because it could dissuade at-risk people from getting the shot. In the gay community, for instance, a young person who gets vaccinated in the early group might be seen to be immunocompromised.
“In the gay community there is this assumption that if you are getting the vaccine right now you must be secretly H.I.V. positive,” said Mr. Das, who is gay. “It has become an assumption in the community that if you’re a gay and you post a picture of the vaccine card, you’re positive and haven’t told us. I always talk to my friends and tell them, ‘Don’t assume things.’”
Mr. Das said he is hopeful that any stigma or medical privacy issues associated with early vaccination will disappear once vaccine appointments are open to everyone. President Biden has urged all states to expand medical eligibility to the general population by May 1, and many states, including Alaska, Arizona, Georgia and Mississippi, have already made the change.
“The sooner we get to vaccinating everyone, I think this question of ‘Oh, what qualified you?’ will stop,” Mr. Das said. “Once that goes away hopefully these barriers will break down, and people won’t keep asking these very personal questions.”