Why can't my son, my 40-year-old caregiver, get vaccinated?

In this week's Pandemic Problems advice column, a reader wonders about those excluded from vaccine eligibilty

By Nicole Karlis

Senior Writer

Published April 7, 2021 7:00AM (EDT)

Adult Son Talking To Father At Home (Getty Images)
Adult Son Talking To Father At Home (Getty Images)

Dear Pandemic Problems,

I am 72 and have recently had major surgeries. My son lives with me to care for me. But he is 40 years old, and can't get vaccinated. Why can't he get the vaccine as my caregiver? We were waiting to get it together, but I'm thinking of doing it before him. If I do, and I go alone to get the first Pfizer dose and he does not, is he safe from me? We have both been homebound.


Homebound & Waiting for a Vaccine

Dear Homebound & Waiting for a Vaccine,

I can't imagine what it must be like having to get through major surgeries during the pandemic. To go to the doctor, even with proper safety precautions being taken, is stressful enough. Major surgery requires hours under a doctor's knife, being physically cut open, and then a long recovery afterward. I'm sorry you're going through this. I'm glad your 40-year-old son is with you to help with your recovery, and I'm thrilled that you can tangibly feel an end to this hardship because you're eligible for a COVID-19 vaccine.

But is your son? No. In some states he might be eligible based on age, but if he's a healthy 40-year-old with no underlying or immune-compromising conditions, in many states he still isn't. Vaccine eligibility varies since it is determined by state and county governments. The Centers for Disease Control and Prevention (CDC) only made recommendations. And unpaid, at-home caregivers (sometimes called "informal caregivers") haven't been prioritized.

I can't stop thinking about the very question you're asking, Homebound & Waiting for a Vaccine: "Why can't he get the vaccine as my caregiver?" And the only answer I can think of is that it's because this country has a long history of undervaluing and taking advantage of caregiving labor in all its forms. The U.S. is the only country in the Organization for Economic Co-operation and Development (OECD) without a national statutory paid parental leave, after all.

Indeed, your son is one of an estimated 43.5 million unpaid family caregivers who provides an estimated $470 billion in care— yet none of these caregivers are paid in statutory time-off, tax breaks, cash . . . or vaccine eligibility. For a myriad of reasons, this is why paid family and medical leaves are such important topics of discussion in politics as of late. I wish all the caregivers taking care of their vulnerable children, spouses, parents and loved ones could get vaccinated with the people they take care of. Wouldn't that be nice? It would certainly be an effective strategy in getting more people vaccinated in a shorter period of time, which is the goal as new new variants emerge. And yet, that's not the case. 

Now, I don't think it's a hopeless case, and you could still try to get your son vaccinated anyway. In various vaccine hunter Facebook groups, I have heard stories of informal caregivers getting a doctor's note stating that they're a caregiver and getting vaccinated. My first bit of advice would be to find a Facebook group in your county/state via VaccineHunter.org, and see how people in your community have been handling this situation. You're certainly not alone. If that sounds like too much work, another option would be to find a volunteer with VaccineFairy.org and see if they can help you and your family navigate eligibility requirements where you live. Perhaps they can help with the possibility of getting a doctor's note.

You say that you're thinking of getting inoculated before your son, and I must admit I think that's a wise choice. As the CDC explains, the risk for severe illness with COVID-19 increases with age. As a 72-year-old you're more likely to have a worse outcome with COVID-19 than your 40-year-old son would. That's why vaccine eligibility has been determined by age. Eight out of 10 deaths in the U.S. have been in adults over the age of 65. I know you want to wait for your son, but I think the best thing for your son is to protect yourself first.

Now, if you get vaccinated, will your son be safe from you? Remember, people aren't considered to be fully vaccinated until two weeks after their second dose. So technically neither you nor your son will be completely safe until you're fully vaccinated. Once you're fully vaccinated, data continues to suggest that transmission from vaccinated people is unlikely meaning that you're unlikely to get infected and transmit the infection to your son — but that's not guaranteed. However, it's important to remember while the vaccines aren't 100% effective at preventing COVID-19, they are 100% effective at preventing hospitalization and death from COVID-19.

But if I'm being honest, I think it's a bit of a moot issue. By the time you're fully vaccinated your son will be eligible. President Joe Biden is recommending that all states expand vaccine eligibility to all adults by April 19.

I know this is hard, Homebound & Waiting for a Vaccine, but I certainly think you have the strength to get through this homestretch. Good luck. 


Pandemic Problems

"Pandemic Problems" is a weekly advice column devoted to answering readers' COVID-related questions — often with help from epidemiologists, philosophy professors, therapists or public health data — who weigh in on how to "do the right thing."  Do you have a pandemic problem? Email Nicole Karlis at nkarlis@salon.com. Peace of mind and collective commiseration awaits.

By Nicole Karlis

Nicole Karlis is a senior writer at Salon, specializing in health and science. Tweet her @nicolekarlis.

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