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People With A BMI Over 30 Now Qualify For A COVID-19 Vaccine In Some States

ARI SHAPIRO, HOST:

If your body mass index is over 30, you now qualify for a coronavirus vaccine in a growing number of states like New York and Texas. That's because obesity has been found to increase the risk of severe COVID-19 illness. People who are overweight are used to facing stigma. And now that obesity qualifies people to get a vaccine, they may be seeing a different kind of judgment for getting a vaccine ahead of others.

Emma Specter writes about this for Vogue with the headline, "Millions Of Americans Qualify For The COVID-19 Vaccine Based On BMI. Why Should We Apologize For It?" Emma Specter, welcome to ALL THINGS CONSIDERED.

EMMA SPECTER: Hi. Thank you so much for having me.

SHAPIRO: So you're not a medical expert, but you're writing about this from a cultural perspective. What prompted you to write this piece?

SPECTER: Honestly, it was a very personal experience of realizing that my own BMI qualified me to get the vaccine and feeling, you know, initial hesitancy and then trying to investigate that hesitancy and thinking, well, why shouldn't I get this if I, you know, live in the zip code I live in and I'm eligible. Why would I not take that opportunity? And I had a feeling other people might feel the same way. I reached out - they did. That's pretty much how it came together.

SHAPIRO: So why did the people you talked to, including yourself, feel this sense of hesitancy?

SPECTER: I think, frankly, for so many of us, it comes down to internalized fat phobia, which you are very capable of having, you know, even if you live as a fat person, which I do. We live in an incredibly fat phobic society, which, you know, if you don't know, you should know. I think most people know that. It's very hard to exist in a fat body, you know, at the doctor's office, at work, just walking down the street.

It's - people often talk about it as one of the last remaining acceptable biases because they're able to frame it in terms of health concern or, you know, a lot of these sort of arbitrary aesthetic or moral judgments that really just come down to often disdain for fat people. So I think when you're on the receiving end of that for much of your life, it gets in your head and it - you know, it's hard to tell yourself I deserve something as should be basic as health care without that voice in your head saying, do I?

SHAPIRO: A doctor you spoke with told you that doctors are among the worst groups in terms of perpetuating fat phobia. And you yourself say that you've experienced worse medical care from doctors than you believe you would have if you had a smaller body. So tell me about the paradox of now being prioritized for the vaccine, which is in such high demand.

SPECTER: It feels really weird. And I think, you know, that initial discomfort I had - even though rationally I feel that I, like all people, am entitled to health care. I have a long history of, as I wrote in the story, of avoiding medical appointments when I know I should, you know, go and get this thing looked at or, you know, go for a routine checkup because I have, I think like almost every person I know who identifies as fat - you know, doctors say occasionally offhanded, occasionally intentional things.

And it's not just doctors, you know? It's the entire experience. It's putting yourself in a vulnerable position. You know, you're in a gown, you're sitting there, you're exposed. And I personally have had comments like, oh, you know, probably well-meaning, but just sort of encouraging me to go for a daily walk when I'm literally getting a pelvic exam - just things that have made me feel like, OK, am I being seen as a person here or am I being seen as a fat person?

SHAPIRO: And so in the context of all of that, tell me about how you reconcile being prioritized for the vaccine and, as you say in the headline, not apologizing for that.

SPECTER: I - you know, if it was - if I got to choose who got the vaccine, I would redirect it to an essential worker who needs it more. Luckily, in New York, restaurant workers and delivery workers have finally qualified. But, you know, I would prefer to see someone living in a harder-hit area of New York who can't work from home the way that I do get the vaccine. But I, as I wrote in the story, I didn't make the rules, New York did. And I'm not going to quibble.

SHAPIRO: So we're speaking to you a few hours before you get your first dose of the vaccine. How are you feeling about the decision to go take advantage of this opportunity?

SPECTER: I'm feeling great. You know, I've had several friends get the vaccine, qualifying for BMI as well, you know, several various comorbidities this week. And knowing that they've all had really easy experiences and been totally fine is really comforting.

SHAPIRO: Emma Specter is a journalist for Vogue. Thank you for talking with us about your piece.

SPECTER: Thank you so much for having me.

(SOUNDBITE OF SAIB'S "SAKURA TREES") Transcript provided by NPR, Copyright NPR.