Why I Choose to Be Vaccinated

Recently, I strolled over to a local chain drugstore to get my seasonal influenza shot. There was little waiting and no out-of-pocket expense, thanks to my comprehensive (albeit costly) medical insurance.  Back in March I received two doses of the Pfizer-BioNTech vaccine for COVID-19 exactly three weeks apart, without any side effects to speak of; a third “booster” jab is in the cards for this autumn.

During my lifetime I’ve been inoculated against smallpox, polio, tetanus, diphtheria, pertussis, typhoid fever, hepatitis A and B, shingles and pneumococcal disease, among others. I’m fairly certain that, so far, I’ve never suffered from smallpox, polio, tetanus, diphtheria, pertussis, typhoid fever, hepatitis A and B, shingles, pneumococcal disease, or even the flu. Nor have I endured an acute reaction from any of these treatments.

Months before the COVID-19 vaccines were available to me, I began protecting myself by wearing a mask whenever in close proximity to people outside my household; for almost two years I’ve rarely logged a temperature above 98.3 degrees Fahrenheit! Upon returning from Japan in February 2020, I was bewildered by the resistance in North America to the use of cheap, almost weightless masks, which seemed a likely reason why East Asian countries had limited the spread of the novel coronavirus quite well. The opposition to COVID-19 inoculation is a more complex matter altogether.

Ever since Edward Jenner pioneered immunization against smallpox in the late 18th century, fear has spawned powerful vaccine foes. Long before Robert F. Kennedy, Jr., became the contemporary face of the movement, the National Anti-Vaccination League rose to challenge Britain’s compulsory-vaccination laws.  But the safety and efficacy of medications have improved tremendously over the decades.  Often featuring some ludicrous claims, the central thesis of most “anti-vaxxers” – that the injections are more dangerous than the diseases they’re meant to prevent – has never been less valid.

(It’s a credit to medical science that the last time I inquired, a virologist said the risk of getting infected with smallpox from inoculation was greater than by living unvaccinated because the once-dreaded disease had been virtually eradicated – by vaccines!)

On the other hand, is it illogical for informed people to reject questionable Chinese, Russian or Indian vaccines — or even hold out for an mRNA vaccine from Pfizer-BioNTech or Moderna when only those from AstraZeneca and Johnson & Johnson are offered?  As for me, I would gladly accept the first one available and approved by credible regulatory authorities.  Yet this obviously high comfort level has a rather old backstory that needs telling.

Perhaps my earliest childhood recollection is of a trip to Atlantic City with my sister Reissa, my mother’s young sister Ruth, and my parents.  All I remember of it was watching my mother and father ride off in the motel’s golf cart, presumably to tour the property.  My attempts over the years to reconstruct the trip became a Rashomon-like experience, as all of the participants recalled certain details differently.

However, everybody agreed on why our Atlantic City vacation ended so badly.  It was the late 1950s or early 1960s, and Reissa, Ruthie, Mom and I had all been immunized for polio – but not my father. Dad fell deathly ill, although he was fortunately spared the paralysis often associated with that sickness.  I heard that Uncle Ralph drove down from Montreal to bring the children home while Mom waited as my father recovered well enough to return.

When asked why my dad alone was unvaccinated, my late mother always gave me the unsatisfactory answer that he was too busy with work.  Since then, he has confessed to believing that he really didn’t need it.  “I thought I was a big shot, and it almost killed me,” he stated, having learned the proverbial hard way.   And so earlier this year, at the age of 88, he rolled up his sleeve twice for Pfizer-BioNTech jabs without hesitation.

Obama Cares!

In late March, I received a letter notifying me that United Healthcare had discontinued my existing Oxford health-insurance policy, whose contract year was set to end on August 31. Because of the Affordable Care Act – commonly known as Obamacare – I would have to choose from new Oxford products or other legally compliant plans offered on New York State’s health-insurance exchange. The A.C.A. made sole-proprietor and small-group policies for businesses owned by a married couple effectively obsolete.

Tempted as you might be to take this as yet another horror story of healthcare reform, please read on first.

No fan of Obamacare, my health-insurance broker advised me to keep my Oxford policy as long as possible and switch to an exchange plan at the end of the summer. (The termination of my current policy before the calendar year was over is a so-called qualifying event, permitting me to enroll outside of the customary period.) But I decided to register on the New York State of Health website right away and start researching what was on offer, aware of the imminent March 31 cutoff to sign up. Here is some of what I learned about the Health Republic New York EssentialCare Platinum Plan:

The monthly premium for me is $515.81 in 2014, compared to $520.64 (through August 31) for my Oxford Exclusive Metro Plan/Liberty Network, both of which are restricted to in-network providers;

The deductible is zero and the maximum of out-of-pocket expenses is $2,000, versus a $2,000 deductible and a $3,000 cap on out-of-pocket costs under the Oxford policy;

The copayments to visit a primary-care physician and a specialist are $15 and $35, respectively, compared to $25 and $50 for the Oxford plan;

The copay for a three-month supply of my costliest asthma medication – Advair Diskus (100/50) – is $90, and I could get it filled at the neighborhood Walgreens, versus the $275.55 I last paid OptumRx, United Healthcare’s captive pharmacy-benefit manager, to have it dispensed through the mail.

President Obama Sings the Affordable Care Act Into Law

President Obama Signs the Affordable Care Act Into Law

By the time I had contacted my most important doctors, and found that all of them accepted Health Republic insurance, it was early April and well past the enrollment deadline. I wanted to wring my broker’s neck for not advising me to switch at the earliest opportunity. But a fortuitous email from New York State of Health soon appeared in my inbox, alerting me that because I had begun my registration before March 31 I was entitled to select a policy on the exchange by as late as April 15. Without delay, I terminated the Oxford plan and joined Health Republic, effective May 1.

It is premature to review the new platinum policy, although my limited experience with it (several interactions with customer service and one prescription filled) has been satisfactory. But, on paper, the benefits of Obamacare to those like me who have lost sleep from health-insurance insecurity are great. I realize that some people have been inconvenienced and even disadvantaged by the A.C.A., yet strongly believe they are far outnumbered by those of us who have gained. To the disgruntled I say: try being a little more charitable. I do not begrudge the beneficiaries of Medicare because my late wife paid into the program throughout her career only to receive nothing back. But I do resent the Republican/conservative “messaging” to the effect that people who had trouble getting health insurance under the old regime somehow did not deserve it. And if the doomsayers are correct about Obamacare, why hasn’t it wreaked havoc in Massachusetts, which adopted a similar (indeed, seminal) program years ago?

Most of all, I salute President Obama, who evidently cared enough to spend precious political capital and stake his legacy on reforming a deeply unfair and dysfunctional healthcare system. The A.C.A. may be far from perfect, but for tens of millions of Americans it is a vast improvement over what we had to endure before.