The Vaccine Rollout in My State Is Ableist

Given that the CDC has found those with underlying medical conditions to be 12 times more likely to die from COVID-19, you’d think these folks would be among the first to receive the vaccine — but in many states, you’d be wrong. By late January, only 19 states had prioritized adults under 65 with high-risk medical conditions in either of its top two tiers, and very few states explicitly mentioned adults with disabilities in their guidelines, leading to confusion about when those with disabilities were eligible.

While my own state of Oregon did prioritize a very small sliver of high-risk disabled adults, namely patients in congregant care settings or those receiving specific types of in-home care, the overwhelming majority of most high-risk adults are still not eligible. Still worse, when faced with the news the state wouldn’t be receiving the expected number of January doses, Oregon chose to bump seniors and high-risk adults further down the list in favor of vaccinating teachers first — even though a majority of Oregon schools have remained virtual-only for most of the pandemic. Not only does this decision leave people with high-risk conditions or disabilities without a vaccine, as some have pointed out, it makes it harder for the very small number of disabled folks who are eligible to get their shots.

Now some people may be asking, “Aren’t teachers worthy of our protection?"

Of course. The issue is not whether teachers are deserving; the issue is that this choice to vaccinate teachers doesn't exist in a vacuum. When there isn’t yet enough vaccine to go around, choosing to prioritize one group comes at the direct expense of another. In Oregon’s case, the choice to vaccinate teachers first comes at the expense of both seniors and those with underlying medical conditions — the groups most likely to die if they are exposed. We could have chosen for our schools to remain virtual until there was enough vaccine to go around. Instead, Oregon has decided that teachers have more value to our society than high-risk folks do.

That’s ableism.

To be clear, I don’t fault a single teacher who wants a vaccine because they work in a district that has forced them to return to in-person teaching. I do fault the system that refuses to keep schools virtual until there is enough vaccine to go around. The timeline for when we send our educators back to in-person teaching is something we can change, whereas the high-risk factors of seniors and adults with existing medical conditions are immutable. For those of us who belong to this category, there is no alternative option for us to reduce our risk. Either we receive the vaccine, or we will continue to die at disproportionate numbers to the rest of the population.

(And while we’re on the topic of ableism, let’s talk about language: The word “disabled” often gets used too narrowly, due both to stereotypes of what disability “should” look like, as well as the underlying ableism that causes people to feel resistance to the word “disabled,” because they assign negative/undesirable connotations to the word. While the vaccination schedules may have separated these terms for clarity sake, I’m using the word “disabled” to include those with high-risk medical conditions and those who are chronically ill.)

Yes, we all want schools to be able to reopen safely — that includes me too! There are a slew of legitimate critiques of the ways school closures disproportionately impact disabled students, single-parent families, families living under the poverty line, and communities of color. Being able to reopen schools safely should be a community priority, one placed far above reopening restaurants, bars, or gyms. But when it comes to decisions about vaccine prioritization, what we’re facing is a real-time example of "the trolley problem."

For those who are unfamiliar with this famous philosophy dilemma: Imagine you are watching a trolley car barrel forward down a steep set of tracks with its brakes out. There is a fork ahead in the track. On the current path of the trolley, there is one important person we deem truly “valuable” tied to the tracks. However if you were to pull the lever to switch the trolley’s path, there are five people who you find more expendable tied to that stretch of track instead. Do you pull the lever? Or in our own dilemma: Are we willing to prioritize reopening schools if we understand that the direct trade-off is killing more seniors and disabled adults?

As Christians, we serve a God who filled scripture with repeated commands to care for the weakest among us. Commands like we find in Psalm 82:2-3: “Give justice to the weak and the fatherless; maintain the right of the afflicted and the destitute. Rescue the weak and the needy; deliver them from the hand of the wicked.”

Or Proverbs 31:8-9: “Open your mouth for the mute, for the rights of all who are destitute. Open your mouth, judge righteously, defend the rights of the poor and needy.”

But what about when it feels like prioritizing the needs of the weak and the oppressed comes at direct opposition to our own needs? What happens when vaccinating seniors and other high-risk adults means schools remain closed even longer?

Philippians 2:3-4 urges us to de-center ourselves and our own preferences: “Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves." The passage continues, instructing each of us to look not only to our own interests, “but also to the interests of others.”

Yes, there are a myriad of valid reasons that schools should reopen. But are we willing to risk the lives of the most vulnerable members of our communities in exchange?

This is what disability justice activists mean when we say ableism kills. Ableism isn't just an inconvenience, or a concept to study if you want to be extra "woke." Disability justice isn't just about making disabled people feel more welcome or building more ramps. If you really believe disabled lives have the same value, this is where you prove it.

Because if you believe that sometimes it makes sense to prioritize "useful" people over disabled people — that sometimes disability justice is just too unreasonable to expect — then you don't actually believe in it at all.