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The Fifth Shot

How can immune-compromised people protect themselves?

On April 12, I had my fifth Covid-19 vaccine. I know this deserves an explanation. Most people are on their third vaccine with a fourth one now available for the old and the immune-compromised. I am in the latter group, which means that for nearly all of the pandemic I have been forced to think ahead of the Centers for Disease Control, whose warnings and recommendations seem to come in the middle of, rather than before, surges in the Covid-19 caseloads. Late actions, for me, are worse than useless.

Sadly, I have had to lie to get additional shots, which are necessitated by the fact that I suffer from an entire catalog full of autoimmune conditions, which in turn require me to be on a corresponding array of medications to keep my immune system from overreacting to perceived threats. These medications mean that my body’s reaction to immunization is less than what it is for a healthy person because the medications that keep my rheumatoid arthritis and other conditions in check also suppress my immune response to vaccines. To stop taking the autoimmune medications risks my life; to not have enough antibodies to fight a Covid-19 infection risks my life as well. Despite this being a well-known fact, at least in the medical community, it is not possible for immune-compromised patients to just ask for additional shots before the CDC says they can. I’d already had two shots and a booster, but to get the fourth and fifth shot I was on my own.

This particular story began two months ago. With an in-person speaking engagement fast-approaching, I set out to get vaccinated again. In early March I sought my fourth shot. The pharmacist at the CVS told me (what I knew he would tell me) that no fourth vaccination has been authorized and hence could not be provided. My antibody reaction had been weak to the booster in the first place; I knew that if I wanted to complete the speaking engagement, I needed another vaccine shot.

The only way to not die, it appeared, was to lie. At the first pharmacy that I visited, I found the busiest-seeming woman in the world behind the counter. I told her I needed a booster. When she asked for my vaccine card, I glibly told her that I had lost mine. In this moment, I tried to fake the entitlement of the people who refuse vaccines, or even those who pretend that getting a vaccine is a favor they are doing for us, the immune compromised. Clad in my pink “Bakersfield California” sweatshirt, I became the sort of woman who would think nothing of misplacing a vaccine card.

“You don’t have your vaccine card?” the busiest woman in the world asked me once again.  “Do you remember if you received it at this pharmacy?” she pressed. Now exasperated in addition to being busy, she tried to word things a bit differently. “Do you have any other documentation showing that you were vaccinated?” My answer to all the questions was no. Deciding that she needed further guidance from the invisible pharmacist, she retreated into the recesses of the pharmacy, beyond the counters that mark the boundaries between those who need the drugs and those who dispense them.

Various family members—as well as my best friend and a number of acquaintances—all managed to get Covid-19 at this time. Naturally, this made me wary and then worried and then panicked.

My fate was anticlimactic. Having entered all the information on my driver’s license into their computer, they announced that they had no record of me at all (a curious fact, since I had had prescriptions filled there). Nevertheless, this was important information, and, armed with it, I began to formulate my new plan. I headed to the next pharmacy. About eight blocks away was another branch from the same chain. Now that I knew they had “no record of me” I was free to be an entirely unvaccinated client. An old white gentleman sat at the frontline counter having frustrating interactions with his computer.

With my voice at the lowest volume possible, I told him I was there to receive a Covid-19 vaccine. In his loud voice, he asked me whether I had ever received the vaccine before. His incredulity at my unvaccinated status was a surprise—and unnecessary, since all off this took place in a state that has only a 55 percent vaccination rate (one of the lowest in the country).

It took a full ten minutes before a woman brought him the vaccine dose. She smiled and apologized and explained that they had received a new batch of vaccines which had to be defrosted just for me. Then the old man proceeded to administer the vaccine, annoyed at the fact that I was wearing a sweatshirt that would not roll all the way up my arm. We got through this problem and finally I got the shot. That was the fourth shot. I got a new vaccine card.

I would not have gone back for the fifth shot had it not been for a series of unfortunate Covid-19 infections. Various family members—as well as my best friend and a number of acquaintances—all managed to get Covid-19 at this time. Naturally, this made me wary and then worried and then panicked. When your entire sphere of interaction is determined by the health risks incurred, death dangles before you with persistence and prominence. This in itself creates within you the dirty secret of your own lack of health (something to be apologized for in a society that worships youth and fitness) and encourages a perspective on the world beyond that is ranked and tabulated based on costs that others do not have to compute.

Lying to get Covid-19 shots is one of them. In this third spring of Covid-19, Americans, even those who have been reliably careful in earlier seasons, have decided out of collective exhaustion to move ahead as if the pandemic were no more. I get this and I even envy it. To declare the pandemic “over” is, however, a decision that is unavailable to those in my condition, even as it provokes a deep sadness regarding the seasons of endless care and isolation that lie ahead when a pandemic never ends but simply gets demoted in the hierarchy of concerns.

No one knows exactly how my body would respond were I to contract the disease. When I first asked my pulmonologist whether I would make it, she paused a whole twenty seconds before telling me that I would likely make it. Not exactly reassuring. And faced with these uncertain odds, you would probably get a fifth shot, too.

Lately, I am battling a case of FOMO; not a fear that I’m missing out on some fun event but rather on a potential treatment. Some of my similarly suffering friends in other states are receiving infusions of “Evushield,” a prophylactic treatment that reportedly reduces infection risk by another 77 percent. When I emailed my doctor’s office I was told they did not have sufficient doses for anyone other than cancer and transplant patients. Among the ranks of the desperate and ailing in this the age of Covid-19, they also suffer who stand and wait and lie to have a chance against this persistent virus.