**IF it's a case where hospitals have to choose between someone who is critical but vaccinated and someone who is critical but unvaccinated, I could see prioritizing the one who was vaccinated. Likewise, if there are any critical cases of, e.g., strokes or heart attacks against unvaccinated critical COVID-19 patients, and beds are full, it might make sense to prioritize the largely more unpreventable/unanticipated heart attack or stroke cases.** - Since there is a method for preventing serious COVID-19 complications, I think it could be acceptable in the above types of cases to prioritize those who took that measure. - I do understand, however, that if people have real fear over the vaccine, especially given the social history for some groups, it can get difficult, and it makes me so sad to think of them having to be turned away in any cases I mentioned. So I really feel quite mixed on this opinion. - Overall, though, I think that since there is something which can currently prevent complications of virus infection, it might be okay to prioritize vaccinated patients when it's necessary to choose. One could argue that strokes or heart attacks are also preventable through such methods as lifestyle changes, etc., but that's not all the time, and that's less of an immediately predictable and easily preventable thing than getting a vaccine in this current event happening right now. I think that would be my argument there. - Additionally, I think it's quite a different story in countries that haven't had much or even any access to vaccines. Prioritization might not make as much sense there. Further reading: https://www.washingtonpost.com/outlook/2021/08/23/refuse-covid-treatment-unvaccinated-triage/ https://www.forbes.com/sites/nicholasreimann/2021/08/19/vaccination-status-may-be-considered-to-get-icu-beds-at-dallas-area-hospitals-if-covid-spread-worsens/?sh=2ceb1e631620 https://www.newsnationnow.com/health/coronavirus/as-covid-cases-rise-some-hospitals-debate-prioritizing-the-vaccinated/

Triaging (or prioritizing patients based on urgency and chances of survival) has been within the hospital system for generations. In cases where hospitals are overwhelmed and there are not enough free beds, doctors are taught in school to prioritize those who have a higher chance of survival if they cannot save everyone. COVID vaccinations have been proven to reduce hospitalization and chances of serious complications [Moline et al. https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e3.htm], and COVID-19 deaths have been decreased by nearly 70% in individuals who choose to get the vaccine [Moghadas et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709178/] For the United States, where most people have adequate access to the vaccination and have had the choice whether or not to get it, it is perfectly fair to follow the convention that those with the better likelihood of survival and who have taken every precaution should be the first to be served. Their attitudes towards preventative measures mirror the criteria doctor's look for in transplant recipients as well (see: you are more likely to get a liver transplant if you are not an alcoholic). Overall, this convention is not new, and in a country where vaccines are widely available, it should not come as a surprise that triaging vaccinated patients would naturally come next.

Care will and should be determined by clinical need at the time, lifestyle choices such as not being vaccinated should not play a role in the decision. If the patient is sick enough for ITU they should get it regardless of vaccine status. Very rarely is there a situation where it’s one patient vs another, happens in theory but not so much in practice. The odds of 2 patients needing the only remaining bed and having exactly the same clinical need is even rarer and often in these rare cases the decision will be taken by multiple professionals in a team meeting who will consider as many factors as possible.

Covid 19 is a crisis. No one should be penalised for their actions in dealing with a crisis. Covid19 and it's long term effect is still be worked out or rather discovered. Every time you look on youtube you can find someone giving a new insight in what the research about the vaccines tells us. Usually this new information is positive and talks of how safe the vaccines are but this is not always the case. Some of the people casting doubt on the vaccines saftey are medical professionals. People are making the most intelligent decisions they know how to protect what is in important to them: whether it is their health or the health of those around them. I believe that when in a situation where the vaccinated and unvaccinated both are in dire need, then the medical staff should always go with the person with the best chance of survival. It's not right to penalise people, when you can find contradictory information to what appears to be the obvious course of action, without having to dig for it..