In December, the data wonk Nate Silver sparked controversy when he not only critiqued the preliminary vaccination prioritization guidelines from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) but managed to do it in a way that disparaged the entire public health profession. Silver, criticizing the guidelines for not prioritizing vaccination of adults 65 and older over people with high-risk health conditions, argued that “scientific evidence” should have made the prioritization simple, straightforward, and obvious. Public health officials and experts responded on Twitter to explain some of the ways in which the decision was more complex than Silver believed.
As it happened, Silver’s comments came out before the ACIP had released its final prioritization, which ended up being closer to what Silver wanted anyway. Meanwhile, since the ACIP list was only a guide, each state has created its own rollout strategy, which has then been filtered through the vicissitudes of implementation. In mid-February, California changed its approach to make disabled people and those with high-risk conditions eligible after outcry against an initial plan to prioritize age first. And so the controversy over who should be vaccinated and when continues as individuals, advocacy groups, and experts in a wide range of fields argue about the ethics involved.
