Do smokers now have priority for getting the COVID vaccine?

Hand with lit cigarette - covid vaccine smokers
Photo via Roman Pavlyuk/Flickr (CC BY 2.0)
  • This story is regularly updated for relevance. Last updated: April 26, 2021

Several states are now prioritizing smokers in the rollout of COVID vaccines around the United States.

Federal guidelines currently recommend that the early phase of vaccine distribution prioritize Americans who are over 65 and those at high risk from the virus. In New Jersey and Mississippi (and Massachusetts), however, this pool has been expanded to include smokers under the age of 65. 

Several other states are also including smokers in the next phase of the COVID-19 vaccine rollout, according to a Kaiser Family Foundation analysis shared by CNN.

The decision by states to prioritize smokers over many essential workers, including teachers, has received backlash. The CDC listed smokers as among the most high-risk groups, however, and recommended that they be included in phase 1C of the vaccine rollout.

States can make individual decisions about how to open eligibility in their jurisdiction. In at least one state, you would be considered for a vaccine if you had smoked 100 cigarettes in your lifetime. That means, theoretically, if you smoked for a couple of months while in college but hadn’t touched a cigarette in years, that would qualify you for the vaccine.

Also included in phase 1C are people between the ages of 65-74, high-risk individuals between 16-64, and some essential workers. Depending on the state, teachers, as well as frontline warehouse and retail workers, may also be included. 

As noted by CDC spokesperson Kristen Nordlund, each phase does not need to be completed before moving on to the next phase. “While ACIP makes recommendations, we understand that there will be a level of local adaptation. The phased vaccine recommendations are meant to be fluid and not restrictive for jurisdictions,” she told CNN. “It is not necessary to vaccinate all individuals in one phase before initiating the next phase; phases may overlap.”

The decision to include smokers before essential workers in some states has frustrated teachers. Teachers have been expected to continue working, often in crowded in-person settings, throughout the pandemic. Learning that their health will not be prioritized over the health of smokers stung for many educators. 

New Jersey Gov. Phil Murphy (D) defended the decision in a news conference on Jan. 15. 

“I get it, I understand the optics here, and that attacking folks who took up the habit of smoking and are now addicted may be politically expedient,” he told reporters. “But at this time we are stuck in a position where we have to prioritize a limited federally distributed vaccine doses based on medical fact and not on political want. We need to save lives. And we need to protect our hospitals, by the way, from a patient surge.”

Teachers are “on-deck,” according to Murphy, for the next round of COVID-19 vaccines. Smoking cigarettes is already one of the leading causes of death in the U.S., though that’s certainly not the case for 2020, and it puts people at high risk of severe complications from COVID-19. A study in the European Respiratory Journal that originally argued otherwise was eventually retracted because some of the authors of the study had financial ties to the tobacco industry.

But not all smokers are eligible. In Illinois, you’re good to get vaccinated if you smoke cigarettes but NOT if you smoke marijuana.

On April 19, though, President Biden declared that every adult in the U.S., whether they’re a smoker or not, was eligible to receive the vaccine.

Sources: CNN, Kaiser, Poynter 

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