Health & Fitness | March 5, 2021 1:32 pm

Do People With a High BMI Deserve to Get the Vaccine Earlier Than Others?

Body mass index is a flawed, outdated unit of measurement

bmi covid vaccine
Don't feel guilty about getting vaccinated if your BMI makes you eligible.
PeopleImages/Getty Images

A number of states, including New York and Texas, are including body mass index (BMI) as an early qualifier for receiving the COVID-19 vaccine. Those who meet the technical threshold for obesity are meeting eligibility requirements for groups 1A or 1B all across the country and showing up to receive their first dose.

The development, though, has revived an age-old question: Why the hell do we still care about BMI? And should the much-maligned metric really hold sway as we battle the greatest health crisis of our time?

Body mass index, remember, is calculated by dividing a person’s weight by the square of their height. Here’s a handy chart. It was invented 90 years ago by an insurance company, as a way to quantify the health and risk of contracted employees. Why can’t we trust it? Well, there are nationwide statistics that directly dispute the system’s findings, alongside some anecdotal (and somewhat hilarious) reasons.

According to research published in 2016, 54 million Americans classified as “obese” by the BMI chart actually display healthy cardiometabolic measures. BMI can’t accurately account for blood pressure, blood sugar or cholesterol — it just makes a blanket assumption of someone’s health based on what it thinks their body looks like, like a criminal sketch artist imagining a visage.

People waiting on line for the COVID-19 vaccine in Los Angeles.
rfan Khan / Los Angeles Times via Getty Images

There are some famous examples of BMI gone wildly wrong. For instance, Usain Bolt and Michael Phelps are on the cusp of being overweight, according to BMI. LeBron James and Tom Brady are obese. The process blatantly disregards the fact that a unit of muscle, on average, weighs 18% more than the same-sized unit of fat. Plus, it’s important to remember that BMI was conceived by white men, using models of white male bodies. This further affects the metric’s efficacy across different cohorts.

When it comes to vaccination, then, that means some people are qualifying for an earlier jab by virtue of their BMI score. And that number could mean very little. This has contributed to a growing phenomenon known as “vaccine guilt,” where people who qualify earlier than an older relative, or a frontline worker, question their right to an earlier dose.

For now, though, BMI is the best we’ve got for finding people who legitimately are obese. And obesity has been connected to more severe cases of the virus; nearly 18,000 of the half-million Americans who’ve died from COVID-19 were overweight.

We can all agree that BMI sucks. COVID has a real knack for exposing outdated, inefficient systems. It’s been doing so for a year now, and whenever this pandemic ends, we’ll have a lot of cleaning up to do, across all sorts of industries. But for now, if you hear your name called, go get that dose. Don’t feel bad about it. If this summer is going to be as epic as we’re all hoping, we simply need to keep this vaccination line moving.