The Shortcomings of BMI As a Vaccine Eligibility Metric

Should we really be putting high BMI in the same category as pulmonary disease and cancer?

Virginia Sole-Smith
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Image: Andriy Onufriyenko/Getty Images

On February 14, New York State released a new set of eligibility criteria for the Covid-19 vaccine. While the initial phases of the vaccine rollout focused on older adults, first responders, and other essential workers, the vaccine is now available to an estimated 4 million more New Yorkers who have a chronic health condition associated with an increased risk of contracting the virus or experiencing its severe consequences. On the list, which matches federal guidance from the Centers for Disease Control and Prevention: cancer, pulmonary disease, heart disease — and obesity, defined as a body mass index (BMI) of 30 or higher. But one of these things is not like the other.

People living with compromised immune systems are clearly more vulnerable to a lethally contagious virus. So too are people with lungs, hearts, and other organs already working too hard, who may not have the reserves needed to fight off the virus once it takes hold. But people living in bigger bodies don’t automatically experience limitations as a direct consequence of their weight. They are more vulnerable to Covid-19 for a different reason: stigma. And we should be clear that this is what we’re vaccinating…

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