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The Ethics Of Crossing State Lines For A COVID-19 Vaccine

Jay LaPrete
Ohio State employee Lauren Chisholm, left, receives a Pfizer-BioNTech COVID-19 vaccination from Robert Weber Monday, Dec. 14, 2020, in Columbus, Ohio.

Ohio is officially opening up COVID-19 vaccinations to all adults today, Monday, March 29th. Many Pennsylvanians are planning to cross the border to receive their shots and Ohio’s Department of Health says providers should attempt to vaccinate any individual, regardless of their county or state of residence. But experts say it’s unclear whether crossing state lines, or “vaccine hunting,” is an ethical practice. 

Michael Deem, assistant professor at Duquesne University’s School of Nursing and Center for Global Health Ethics, says there are arguments both for and against vaccine hunting. While getting shots in arms means a quicker path to broad herd immunity, there are concerns about inequities in the vaccine roll-out process.

“The sorts of individuals who would be able to travel across state lines to receive a vaccine are probably going to be resource-rich in terms of health and time,” Deem told WESA's The Confluence, “Persons who may not have ready access to Internet or can’t take time off work to travel an hour or two, maybe eight hours across state lines, will more than likely not be able to vaccine hunt.” 

If a Pennsylvania resident crosses state lines for a daily commute, Deem says vaccine hunting could be OK, as that worker could be regularly exposing residents in the state they work in to COVID-19.  For states like Texas, for example, that have recently lifted mask mandates and capacity restrictions, it may benefit the community to cross state lines for a vaccine to further protect from risk. Plus, he says, no one is actively stopping individuals from traveling to another state for a shot.

“Viruses don’t respect county lines, they don’t respect state lines, and they don’t respect international boundaries,” Deem says. “The truth is, whether one is well off in terms of time or resources or not, anybody who does get vaccinated incrementally increases the benefit to public health.”

While there are underlying public health benefits to vaccine hunting, Deem says it’s important not to overlook those who need the vaccine most. 

“One concern we might have is whether states that are vaccinating non-residents are neglecting certain communities or subpopulations in their state who have historically have been underserved by health care."

Many states, including Pennsylvania, do not require those who have secured a vaccine appointment to prove their eligibility. Deem says the health care system’s decision to operate on good faith, however, makes getting the vaccine for those who may not be able to prove their eligibility much easier.

“It’s an imperfect system,” Deem says, “I myself would argue that it’s probably better to remove obstacles to persons who may be marginalized, socially disadvantaged, or not resource-rich, ensuring that they get vaccinated, or at least have access to the vaccine, rather than put in a lot of constraints to ensure that people are not jumping in line.”


Listen to the full discussion on The Confluence here.



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