Writing for The Atlantic, Katherine Wu delves into "a harrowing form of eligibility warfare," profiling 12 individuals who—despite following their state guidance on vaccine eligibility—have opted to keep their vaccinated status secret, fearful they'll be asked to justify their eligibility in intrusive ways.

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'Shot self-consciousness'

Amid the Covid-19 vaccine rollout, individual vaccinations "have become public spectacle," Wu writes, citing the influx of vaccine selfies on social media. "After a year of misery and chaos, they're digital proof of the relief and elation that comes with boosted immunity."

But "for every immunization that sparks public joy, there's perhaps another that blips silently by, shaded with guilt, frustration, or fear," Wu writes, noting that "many" people who have received early vaccinations "have chosen to hide them from even close family and friends."

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To learn more about these "covert vaccinees," Wu spoke to 12 of them under the condition of anonymity. According to Wu, their reasons for remaining silent on their vaccinated status "ran the gamut" from guilt over getting the vaccine before others to a desire to work from home a little longer. However, "they were united by what we might call shot self-consciousness—the worry about how their shots will be perceived by others."

'Drive…people into hiding'

Wu explains that although the country's vaccine rollout is picking up speed, "as long as vaccine demand continues to outstrip supply, the inoculated might hesitate to reveal their status and risk their eligibility being debated among those still waiting in the queue."

Part of the problem, Wu writes, is that since the start of the vaccine rollout—when vaccines were prioritized for clearly distinguishable populations, including health workers and nursing home residents—"states have splintered over whom to prioritize next." Some states are focused on communities of color, others on essential workers, and while many states are prioritizing older residents and those with preexisting conditions, age floors and qualifiable conditions "differ across county lines," Wu writes.

And all that "mixed messaging" has not only "made official priorities difficult to discern"—including for a friend of Wu's in Montana, who upon learning she was eligible for the vaccine thought it was "'glitch'"— but also "forced people to consider where they fall in each state's prioritization scheme…and to square that identity with their public image," Wu writes. "The fear that those two metrics don't match up is enough to drive many people into hiding."

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Further complicating the issue is that many conditions that make people eligible for an injection "aren't easily identifiable," Wu continues—and every week, new stories emerge of people "who have been accused of stealing or sequestering vaccines, or faking eligibility to filch a dose." As a result, she explains, "[a]s others anxiously await their turn, the inoculated have felt pressured to share not just whether they were immunized, but why."

For example, she cites a 64-year-old woman in Missouri she calls Leyva, who shared on Facebook in late January that she had received her first dose, only to be "surprised and saddened" when her longtime friend questioned her eligibility. Her friend, unaware that Leyva had Type 2 diabetes, which qualified her for the vaccine in her state, had thought she jumped the line.

Similarly, a woman in Wisconsin told Wu she felt guilt over taking a spare dose that would have otherwise gone to waste. "'I didn't take a vaccine from someone else who needed it more,'" she told Wu. "'But I did accept a vaccine before others who needed it more had the chance.'"

And still others are hesitant to disclose their vaccine status because doing so "means openly acknowledging the health condition that qualified them in the first place," Wu writes. Leyva, for instance, was reluctant to disclose her diabetes status, Wu writes. The same was true for two others Wu spoke with—a scientist in New Jersey, whose high BMI made her eligible for vaccines, and a lawyer in New York, who was eligible for the vaccine because of his HIV status. 

'A harrowing form of eligibility warfare'

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Citing Ruth Faden, a bioethicist at Johns Hopkins University, Wu writes about how troubling these "calls for vaccine justifications" can be. Wu explains Faden's perspective, "To be vaccinated mid-rollout is to be saddled with a public identifier, and an invitation for the world to vet it. It's a harrowing form of eligibility warfare"—especially when not all forms of disability are visible.

And while Wu notes that none of the experts with whom she spoke "thought that people should be duty-bound to share their immunization status," she pointed out that "more questions about immunization status" are heading our way. According to Wu, "[e]mployers, airlines, even entire countries have already begun to explore the notion of tracking people's shots"—a troubling trend that could easily exacerbate "socioeconomic, racial, and ethnic inequalities" given how vaccination rates tend to lag in vulnerable communities.

But some experts, like Faden, predict that vaccine scrutiny will ebb as supply meets demand, Wu writes. And for their part, all of Wu's "covert vaccinees" said "they would eventually share the good news," Wu writes. "At some point along the march to a protected majority, they will unveil themselves as vaccinated—not as outliers, but as one of hundreds of millions" (Wu, The Atlantic, 3/11).