Smokers prioritized for COVID-19 vaccine in New Jersey. Teachers 'feel devalued' by the decision.

Korin Miller
·7 min read

Some New Jersey residents are incensed after state officials prioritized COVID-19 vaccines this week for smokers over educators and public transit officials. On Thursday, New Jersey Gov. Phil Murphy opened up COVID-19 vaccination eligibility to smokers, who were categorized as part of a group of “individuals at high risk.”

Reaction on social media was swift.

As of now, people in the following groups are eligible to be vaccinated in the state of New Jersey, according to the state’s COVID-19 Information Hub:

  • Health care personnel

  • Long-term care residents and staff

  • First responders

  • Individuals at high risk

It’s the “individuals at high risk” category that has raised questions. In addition to individuals 65 and older, this includes people with the following health conditions, per the state:

  • Cancer

  • Chronic kidney disease

  • COPD (chronic obstructive pulmonary disease)

  • Down Syndrome

  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies

  • Obesity

  • Severe obesity (BMI ≥ 40 kg/m2)

  • Sickle cell disease

  • Smoking

  • Type 2 diabetes mellitus

While the state just opened up vaccinations to first responders and high-risk individuals, it says online that additional frontline essential workers will be next, followed by “other essential workers” and the general population.

Other states haven’t prioritized smokers, but some have deprioritized teachers. Alabama notably recently bumped teachers down in the line of priority for the vaccine. While teachers are part of the state’s phase 1B vaccine roll-out behind frontline health care workers and long-term care residents, other essential workers like first responders and those who are ages 75 and up have been moved up ahead of them. Meanwhile, some states like Maryland plan to open up vaccinations to teachers as early as Monday.

Many teachers in New Jersey are “angry” about the decision and “feel devalued,” Donna M. Chiera, president of the American Federation of Teachers New Jersey, tells Yahoo Life. “It’s a mixed message from the state,” she says. “We’re told that we need to get students back in classes and we need to normalize the education system, but we need to do it safely.”

“We understand that smoking is an addiction and that it’s not easy to quit, and that these people are more at risk if they do get the virus,” she explains. “But you can’t say that opening schools is a main priority if you keep moving teachers down the list.”

Chiera says she’s also heard from many people in higher education who are frustrated that they are in group 1C for vaccination, behind lower-education teachers, who are in group 1B. “They were already annoyed to have to wait in line for all of 1B, and now we’ve expanded 1B so that they may have to wait until May or June to get vaccinated,” she says. “It’s very disconcerting to everyone that we’re told education is valued and that we need to open up schools and universities, but we’ve now lost the tool of vaccination to do so safely.”

"We’ve said from the beginning the educators should receive priority access to the vaccine. It’s an important step toward a safer return to in-person learning,” Steven Baker, director of the New Jersey Education Association, tells Yahoo Life. “We have been in constant communication with state officials regarding educators’ access to vaccination. We have reiterated to them the need to do whatever is necessary to expedite that access even in light of revised federal guidelines from the Trump administration and a slow federal roll-out of the actual vaccine.”

Baker is hopeful that under the incoming Biden administration, there will be “much better presidential leadership.”

“Our schools are too important to wait one day longer than necessary,” he says.

A vaccine "mega" site at a former Sears store in Morris County, New Jersery, where health officials hope to vaccinate more than 2,000 people per day in the coming weeks once the vaccine arrives. (Kena Betancur/AFP)
A vaccine "mega" site at a former Sears store in Morris County, New Jersery, where health officials hope to vaccinate more than 2,000 people per day in the coming weeks once the vaccine arrives. (Kena Betancur/AFP)

Worth noting: The Centers for Disease Control and Prevention (CDC) does not mention smokers in its breakdown of priorities for the COVID-19 vaccine. Under the CDC’s guidance, smokers would likely be vaccinated after phase 1C, along with other members of the public.

New Jersey’s move to prioritize smokers is even controversial among the medical community. “That is an unfortunate decision,” Dr. Richard Watkins, an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University, tells Yahoo Life. “People choose to smoke, and it has a very negative impact on their health.”

Watkins says it’s “doubtful” that vaccinating smokers early will make a meaningful impact on the pandemic, but the same isn’t true for other groups. “Vaccinating teachers protects them and children,” he says. “For transportation workers, it’s similar in that it protects them so that the system can continue to operate and protect the riders.” Watkins says that people who work in stores should also be prioritized above smokers.

But prioritizing smokers is rooted in science, Dr. Michael Steinberg, medical director of the Rutgers Center for Tobacco Studies, tells Yahoo Life. “The strongest evidence we have is that current smokers are at increased risk of developing severe disease if they are infected with the virus,” he says. “The evidence of whether smokers are at higher risk of actually contracting the virus is less clear.” Smokers may be at greater risk of contracting the virus because they can’t wear a mask while smoking, and some may smoke in groups, he points out.

Prioritizing smokers also falls in line with the overall goals of vaccinating the public. “The aim of the vaccine is to reduce the damage this virus is doing by preventing severe disease and keeping people out of the hospital,” infectious disease expert Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. “Smokers, whether people like it or not, are at higher risk for complicated COVID.”

If the goal of the vaccine is to prevent severe disease, then “it is optimally targeted at those who are at higher risk for hospitalization and death,” Adalja says. He also adds this: “The early rollout of the vaccine in the U.S. is not really designed to limit spread but to prevent severe disease by targeting those at highest risk for hospitalization and death.”

It’s “difficult” to try to compare the risk between higher-risk groups, like smokers vs. educators vs. transit workers, Steinberg says. “We just don’t have enough evidence to be able to distinguish which factors impart the highest risk,” he says. “Hopefully, as the vaccine distribution improves, we will have enough vaccine in a short time to vaccinate all high-risk people as soon as possible.”

Overall, Steinberg recommends that smokers do their best to quit, whether they’re prioritized for the vaccine or not. “As always, we would suggest that the best advice for smokers, both regarding the pandemic and beyond, is to stop smoking as soon as possible and take full advantage of tobacco treatment resources available in your community.”

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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