An unidentified man smokes a cigarette during the coronavirus pandemic. (Shutterstock Photo/Sergii Sobolevskyi) Smokers Can Get Vaccines
An unidentified man smokes a cigarette during the coronavirus pandemic. (Shutterstock Photo/Sergii Sobolevskyi)

If you live in Pennsylvania and smoke, you can now get the COVID-19 vaccine. Yet some front-line workers still aren’t eligible in the state’s phased rollout.

Will Foster was surprised to learn he can now get the coronavirus vaccine.

The Kutztown man is 38. He’s thin, and he doesn’t have any of the underlying health conditions that could increase his risk of getting very sick if he gets the coronavirus. But he has smoked for the past 20 years.

“That’s absurd,” Foster said when he found out he was eligible to get the vaccine. “Just because I smoke shouldn’t give me priority over others.”

Smokers are in Phase 1A of the state’s vaccine rollout plan, along with people age 65 and older and those 16-64 with high-risk health conditions.

That puts smokers ahead of non-healthcare front-line workers, such as police officers, firefighters, teachers, grocery store workers, and postal workers. And some of those workers aren’t happy about that.

The change follows the recommendations of the Centers for Disease Control, which the state has followed throughout the vaccine rollout, and “aligns with the overall goal of maximizing benefits and minimizing harms caused by the virus,” said Maggi Barton, a spokesperson for the state Department of Health. This move allows the state to get the most vulnerable people.

Why Do Smokers Get Priority in the Vaccine Rollout?

“Getting vaccines to all Pennsylvanians is primary in our mission,” Barton said, “but we must take care of the most vulnerable now to prevent future hospitalizations and save lives.”

Barton said those aged 16-64 with comorbidities are among the groups with the highest number of coronavirus-related cases, hospitalizations, and deaths. The CDC lists smoking as a comorbidity. 

Smokers are at risk of suffering some of the most severe complications of the coronavirus, said Dr. Amit Mahajan, an American Lung Association volunteer medical expert. Mahajan is medical director of Interventional Pulmonology and Complex Airways Diseases Program at Inova Medical Group in northern Virginia and the greater Washington, DC, metro area.

“Over time, whenever you inhale anything in your lungs, it causes inflammation, Mahajan said. “Chronic inflammation can cause damage. Even though a smoker might be feeling great and not have any obvious health issues related to smoking, their lungs are still inflamed and they could still have serious issues if they contracted COVID-19.”

States have prioritized the order of eligibility based on risk factors as a way to reduce hospitalizations, Mahajan said.

Hospitals—especially intensive care units—across the country are overwhelmed.

There are currently 3,887 people hospitalized with COVID-19 in Pennsylvania. Of those, 770 are in an ICU and 446 are on ventilators. Only 22% of ICU beds are available statewide.

Who Qualifies as a Smoker in the Vaccine Rollout?

Who exactly is included in the “smoking” group? Heavy smokers? Vapers? Marijuana smokers? Long-term smokers?

At this time, only smoking tobacco cigarettes is considered a comorbidity, not vaping, Barton said. If you vape, you aren’t eligible for the vaccine yet.

That was the only stipulation to the “smoking” category reported by the department.

Mahajan said marijuana smoking probably isn’t included, either, as it does not damage the lungs nearly as much as cigarette smoke. 

How Do Smokers Prove They’re Eligible for the Vaccine?

People who are eligible for the coronavirus vaccine because of an underlying medical condition are not required to provide proof, according to the state

The HIPAA privacy rules come into play, Mahajan said. A person does not have to disclose their qualifying medical condition to the healthcare professional giving them the vaccine.

“It’s going to be a challenge,” Mahajan said. “These are guidelines set forth by the CDC yet every institution chooses how they approach them. There are going to be problems. Some of this information needs to be clarified, so there aren’t so many questions.”

Not Everyone Agrees With the CDC Guidelines, Even Smokers

Labor unions representing state police troopers and correctional officers said first responders should get priority.

A leader of the Pennsylvania State Corrections Officers Association said the decision to put smokers ahead of corrections officers is “repugnant.”

“Our members are overworked, exhausted and are working massive amounts of overtime due to COVID-19 illnesses within their ranks,” John Eckenrode, western region vice president of the Pennsylvania State Corrections Officers Association, told The Associated Press. “The mental anguish of passing the virus to their loved ones also takes a tremendous toll.”

Public safety could be stretched to the brink if too many first responders are infected, said David Kennedy, president of the Pennsylvania State Troopers Association. 

“The commonwealth should immediately reject this tone deaf recommendation and vaccinate first responders so they can focus on doing their jobs,” he said in a news release.

Long-time smoker Suzy Donchez agreed. The Lenhartsville resident said she isn’t more worried about getting the coronavirus just because she is a smoker. And she shouldn’t get preference because of her addiction either.

“I can wait until very last to get the vaccine,” Donchez said.

Foster said he had no plans to get the vaccine anytime soon, and would simply wait until everyone was eligible for it.

Health Experts Recommend that Smokers Take Extra Precautions

The American Lung Association supports efforts to protect the health of all Americans, Mahajan said, and urges people with high-risk conditions to take extra precautions and talk to their doctors about getting the vaccine.

Now might be a good time for smokers to think about quitting, he said.

The PA Free Quitline, 1-800-QUIT-NOW, is available for anyone who needs help quitting, Barton said. 

The ALA is urging Congress to pass the “Quit Because of COVID-19 Act” which would provide comprehensive tobacco cessation coverage to all Medicaid and CHIP recipients.