As debate rages around the world about who should be vaccinated first, Mexico has come up with its own unconventional approach — one with no apparent epidemiological foundation. The government of populist president Andrés Manuel López Obrador, who campaigned on the slogan "First, the poor," is prioritizing the country's most disadvantaged citizens, using the vaccine as a kind of reparation for years of marginalization.
Teachers in rural villages, some of the country's poorest farmers, elderly members of far-flung Indigenous communities: They will receive coronavirus vaccinations before almost any of Mexico's city-dwellers, who have endured the worst outbreaks. In many cases, the rural poor have been vaccinated even before the medical personnel in charge of administering the shots.
It's an approach that López Obrador's supporters embrace — proof that their president is on the right side of Mexico's profound class divide. But to many public health professionals, it is scientifically irrational, evidence that politics are distorting the vaccination drive. Most of the communities being prioritized have had relatively low coronavirus caseloads. Most are rural or semirural towns, where social distancing was never a challenge.
"This is a vision that has no basis in epidemiology," said Fernando Petersen Aranguren, the secretary of health in Jalisco state. "This has nothing to do with public health and doesn't focus on the need to break the chain of contagion."
Aranguren wanted to distribute doses in Guadalajara, Mexico's second-largest city, where more than 71,000 people have been infected with the virus. But the federal government, which has near-total control over vaccine procurement and distribution, instead gave him a list of small towns and villages it told him to prioritize.
But in the government's rush to get doses to the poor, many of the nurses and doctors in charge of the vaccination program — including the ones who attended to Hass — had not yet been vaccinated themselves.
"It's scary to be here, so exposed, without getting the vaccine, but what can we do?" said Silvia Garcia, one of the nurses assigned to San Pedro. "We can't refuse to work."
López Obrador has refused to be vaccinated until doses are made available in his Mexico City district. Critics have called the decision a theatrical show of humility. While waiting for the vaccine, López Obrador contracted the virus in January. The country's coronavirus czar, Hugo López-Gatell, fell sick this month.
Mexico's government has provided little economic assistance to the country's poor during the pandemic, even as unemployment has surged. Yet López Obrador's approval ratings, in several polls, remain over 60 percent — proof, some analysts say, of his political mastery.
Many of López Obrador's followers come from the country's poorest communities, traditionally neglected by the country's political elite. They are fiercely loyal to the president, who frames his social policies as a historic effort at narrowing the nation's stark inequalities. Even a vaccination campaign is an opportunity to showcase his progressive bona fides.
"The rationale is: 'We are doing it this way because it is time to make justice,' " said Xavier Tello, a health policy analyst in Mexico City. "The problem is that the government has not shown any evidence that supports the epidemiological calculus behind this decision. They have not shown any evidence of higher mortality rates in those places, and so they are wasting vaccines and diverting them from places where they are more needed."
