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Who should get the vaccine first? Who is ‘essential’?

By Heather Robinson

This week, as the US government launched the largest vaccine distribution program in the country’s history, rabbis and Jewish ethicists were united in support of the rollout to battle the coronavirus pandemic, stressing that vaccination is consistent with Judaism’s highest value: preserving life.

These authorities also agree with the government’s tiered priorities for the distribution of the vaccine.

Rabbi Shoshana Knapp, left, and Rabbi Elliot Dorff

Recommendations by the Centers for Disease Control and Prevention for the distribution of the vaccine list several groups in order of priority:

• healthcare workers and nursing-home residents;

• other essential (non-healthcare) workers;

• adults 75 years of age and up, along with those who have high-risk medical conditions; and

• the general population.

Rabbis and Jewish ethicists seem to agree with that.

From both a “purely ethical” and utilitarian perspective, “you vaccinate the most the vulnerable first — the elderly in nursing homes,” said Rabbi David Wolpe, the religious leader of Sinai Temple in Los Angeles, a Conservative synagogue. Wolpe can see the argument, too, for prioritizing “frontlines workers who are forced out of their homes day after day.”

Several praised the decision to prioritize the vaccination of essential workers in healthcare, agriculture, education, law enforcement, transportation, firefighting, food distribution and sanitation.

“Both the government’s guidelines and Jewish law as I interpret it would have us save as many lives as possible,” said Rabbi Elliot Dorff, professor of philosophy at American Jewish University in Los Angeles. “I presume . . . non-healthcare essential workers will get the vaccine before the elderly and those with medical conditions because people who stock grocery shelves and do other essential things to enable us to live need to be protected to do their jobs in the name of the communal good. . . . People can die of starvation as much as from COVID-19.”

Dorff said that seniors living independently and those with medical conditions like him (he has asthma) can take steps to try to avoid becoming infected, such as isolating until they can get the vaccine, but “essential workers have no choice but to endanger themselves to do their jobs.”

Wolpe noted that under the guidelines, “people who do what we used to call menial jobs but we now understand to be essential jobs,” such as janitors and sanitation workers, will “get precedence over people who have more money and can afford to wait. I think that’s a good thing for us to think about.”

Peter Salk, a virologist and son of the late Jonas Salk, the pioneering scientist who developed the vaccine for polio at the University of Pittsburgh in the 1950s, spoke of the heavy toll of the pandemic on the African American, Latino and Native American communities. He points out that these sectors of society tend to be disproportionately represented among both essential workers and virus victims, and less likely to have the financial option of staying home to work.

From an ethical perspective, Salk believes that it is important to understand that past mistakes on the part of America’s medical establishment have contributed to people’s distrust. He cites as the1932 Tuskegee study in which African Americans were observed without their consent to assess the effects of untreated disease on a population.

“Community leaders who are trusted will be most effective and needed now at helping people understand how these vaccines work,” honestly communicating any potential downside to taking them, and imparting “the positive impact they can have for an individual and . . . the community,” he said.

The Jewish authorities consulted for this story bump up against more than one poll, which show conflicted views about sectors of the Jewish public on taking the vaccine, both in America and Israel.

The rabbis uniformly advocate for taking the vaccine, but do not address the concerns of those who are skeptical.

Rabbi Shmuel Herzfeld of Ohev Sholom, an Orthodox synagogue in Washington, DC, participated in the Moderna vaccine trial, posting video of himself receiving the shot to the video-sharing platform TikTok.

“The value of preserving life is the essential, axiomatic value of Judaism. Over the next few months, we encourage our communities to go — to run — when it’s their turn to get the vaccine.”

“I wanted to try to make a difference in whatever way I could to help those on the front lines fighting this virus,” Herzfeld said.

“It was important to me as a person of faith to embrace the gifts G-d has given us.

“I believe the scientists are holy people, and all the workers up and down the line who made the vaccines possible are incredible holy agents of our Creator.”

Other rabbis echoed Herzfeld’s point about preserving and protecting life — one’s own and that of others.

“You can overturn virtually every law in the Torah to save life, and there’s no question that vaccination is overwhelmingly life-saving,” said Danny Schiff, a Reform rabbi and foundation scholar at the Jewish Federation of Greater Pittsburgh.

“Vaccination does two things — it preserves your life and the lives of others. We also have a responsibility to each other.”

Rabbi Shoshana Mitrani Knapp, a New York-based spiritual leader and counselor ordained in the Conservative movement, said the idea expressed in Leviticus — “You shall love your neighbor as yourself” — is consistent with the imperative to be vaccinated.

“When Cain asks, ‘Am I my brother’s keeper?’ the answer is ‘Yes,’ and this is foundational.”

As the COVID-19 vaccine rollout begins, public health authorities hope that enough Americans will take the vaccines to achieve herd immunity. While the exact threshold is unknown, experts estimate that 75-85% of Americans will need to be vaccinated for that to be achieved. By some recent polls, as high a proportion as half of all Americans has said they have reservations about taking the vaccine.

Allowing for medical exceptions, the Jewish value to preserve life would support mandating COVID-19 vaccination, if necessary, according to all rabbis and Jewish ethicists consulted for this piece.

Some felt, however, that in a culture that prizes individual freedom, mandates could backfire.

Salk believes that, if successful, the vaccines will sell themselves to the American people.

“People getting vaccinated [for COVID-19] will be protected from getting ill to a great extent; I think it will be obvious from the reality on the ground,” said Salk. “There are always going to be some who have a different point of view, but most will want to be vaccinated.”

Salk added that the gradual pace of the rollout may have the added benefit of making people “want [the vaccine] more.”

Rabbi Yisroel Altein of Chabad Outreach in the Squirrel Hill neighborhood of Pittsburgh said, “The key is that the [coronavirus vaccine] is safe, and that obviously is up to the medical community. Seeing as that is what they are saying, I think it will be widely viewed as a way to protect everyone.”

Rabbi Mark Wildes, the founder of Manhattan Jewish Experience who works with Jewish singles in their 20s and 30s in New York, thinks that younger Americans will respond positively to opportunities to get the vaccine.

In addition to caring about older people and wanting “to do the right thing,” said Wildes, the young people with whom he works “want to go to work, to play sports, to date, to socialize, and if the vaccine is going to allow that, they are going to be flocking to it.”



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