As the vaccine’s rollout continues across the country, eligibility is expanding to include younger age groups and people with medical conditions, including a high body mass index (BMI).
Yet on social media, many BMI-graders are grappling with “vaccine guilt,” feeling that they might be taking doses of the vaccine away from someone who might be more “deserving.” After a viral Twitter thread highlighted the potential health risks of COVID-19 that people with obesity face, many weighed in on the discussion.
PA has a BMI 30+ in group 1A, which was a blessing, but oooh, the otherwise polite and “apolitical” vaccine targeting groups had a few words about fat people “skipping the line.” I’m going to take the second dose this Sunday. I struggled with guilt and shame, comments like this help a lot 💗
– PittsburghBirdNerd (@BirdPittsburgh) February 24, 2021
Thank you for these words. I am eligible, but have felt just as unsafe / guilty about getting it before the first responders, teachers, and essential workers.
My partner also noted that I have a hard time defending myself in medical settings, even for routine things, compounding other risks.
– Tobias Tobak (@tobiasfunction) February 24, 2021
fat people count as 1B in Texas – I definitely felt really weird and should keep it a secret that I have an appointment to get vaccinated but I think it needs to be normalized and talked about safely
– holy velvet (@saturnvelvet) February 24, 2021
Infectious disease experts and registered dietitians agreed that it is important for people with obesity to receive the COVID-19 vaccine as they become eligible for it. TODAY Health also spoke with a clinical psychologist who offered some advice on how to deal with feelings of “vaccine guilt.”
Why are people with a high BMI considered a priority for COVID-19 vaccination?
Used to indicate a person’s weight and whether or not they consider themselves underweight, overweight, or obese, having a high BMI does not necessarily mean that someone is at additional risk of contracting COVID-19.
However, there is data that indicates that people who are overweight or obese are at risk for more severe cases of COVID-19.
“Much of the vaccine eligibility focuses on people who are at the highest risk of complications if they become infected with COVID,” said Dr. Marybeth Sexton, an infectious disease expert, hospital epidemiologist and assistant professor of medicine at the Emory University in Atlanta. “You are trying to protect the individual, who may be at risk of being in the hospital or intensive care unit or even dying, and you are also protecting the health care system … If you can prevent people who are more likely you need to be in the hospital so you don’t get sick in the first place, then you really help the stability of the hospital system. “
Dr. Gabrielle Page-Wilson, an endocrinologist and assistant professor of medicine at Columbia University, said that people who are overweight or obese are being prioritized in the same way as older people and other high-risk people, referencing a recent study that showed people with obesity are twice as likely to be admitted to the hospital and 48% more likely to die from coronavirus.
“What we do know is that obesity is associated with increased mortality and severe illness from COVID-19,” Page-Wilson said. “When we say serious complications, we mean things like being intubated, having sepsis, we mean things like needing renal replacement therapy or having kidney failure and requiring hemodialysis … (Being overweight or obese) in itself is a factor in risk, and you really need these people to rank high on the eligibility list. “
Kirstin Kirkpatrick, a registered dietitian and manager of wellness nutrition services at the Cleveland Clinic Wellness Institute in Cleveland, Ohio, said that BMI is not always an exact tool as it is only based on weight and height and it does not distinguish between the weight that can be muscle or fat. However, BMI tends to be the most measurable weight assessment, which is why Kirkpatrick said that is why it is used to determine vaccine eligibility.
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“The BMI is the best assessment we can give at the national level,” he said.
Page-Wilson said that because many studies were calculated using BMI, people who are eligible for the vaccine because of their BMI should get it when they can.
“You may have a high BMI due to increased muscle mass, or you may have a high BMI but no comorbidities, but simply having that BMI potentially puts you at higher risk for COVID-19-related complications and mortality, and that makes you eligible, “Page-Wilson said.
How can people deal with ‘vaccine guilt’?
Jessica Stern, a clinical psychologist at NYU Langone Health, said that anyone eligible who feels guilty about getting the vaccine should remember that getting vaccinated makes those around them safer.
“Remember, it is not necessarily your responsibility to decide if you are eligible or if you deserve the vaccine (if you fall into an eligible category),” Stern said. “… Responding to this is very much a community team effort, and just as we have to work as a team to take safety precautions, it is a common effort to get the vaccine so that we can protect each other and ourselves. If someone is getting the vaccine, they are not just helping themselves. They are helping the community. “
For those who might see their eligibility questioned or debated on social media, Stern recommends acknowledging that vitriol tends to come from a place of “fear, hopelessness and anxiety” as millions wait for the vaccine.
“It is not absolutely acceptable for someone to be a victim of that, but I think that if someone is receiving that and is receiving a sense of judgment or hatred, the best thing (that can be done), although easier said than done, is to remember not it’s about them, it’s not personal, “Stern said. “If you are getting the vaccine (when eligible) … remember that you are following the rules and guidelines and that someone’s frustration with you is not personal.”
Most importantly, remember that eventually everyone should get vaccinated.
“If you feel like you are not sure whether to take the vaccine when it is offered to you, remember that you are actually using a valuable vaccine that you would not otherwise use,” Stern said. “You are actually doing good service to everyone around you by making sure nothing goes to waste.”
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