NEW YORK — Edward Goldberg’s phone would not stop ringing. A concierge doctor on the Upper East Side of Manhattan, Goldberg had been fielding calls from patients who went to St. Barts or Aspen — the wisdom of public health officials be damned — and came back with COVID. All that faith in private air travel as a means of inoculation had failed them. But that was only part of the New Year’s onslaught. Many healthy people were calling, too, because they had an urgent desire for the coronavirus vaccine. It didn’t matter that their work, in so many cases, put them merely on the front lines of winning market positions — the vaccine was here, so surely there was a way to gain access to it immediately. Yet another contingent, still, was calling Goldberg’s office, inquiring about membership in his practice, operating under the assumption that they would then be fast-tracked for the vaccine. Concierge medicine involves the payment of annual fees — in Goldberg’s case, $20,000 a year — for what is essentially unlimited access to a doctor’s care. When asked how quickly someone might receive a vaccine, Goldberg is left to explain that New York state is levying huge penalties against any medical outfit that tries to game the protocols for distribution. “What Cuomo did really protects me when it comes to these pushy concierge types because I can say that I cannot risk the fines and loss of license,” Goldberg told me. In December, Gov. Andrew Cuomo threatened sanctions of up to $1 million (and the revocation of the right to practice) against doctors, nurses, urgent-care providers or any others who delivered the vaccine unethically. On Monday he went further, proposing a law that would criminalize the administration of the vaccine to anyone trying to jump ahead in a line that prioritizes health care workers. But entitlement breeds nothing if not persistence. At a different concierge practice — that of Alexander Goldberg (unrelated to Edward Goldberg), who is also known as Dr. Hamptons for his oceanfront house calls, and who offers everything from “lip enhancement” to “pain management” — temerity is also running high. “I’ve had people calling me left and right,’’ Dr. Hamptons’ son, Mark, who manages the empire, explained. “I say that we don’t even have the vaccine yet, and then they say, ‘Well, I’m the first guy you’re giving it to when you get it,’ and I say, ‘Yeah, uh-huh, sure.’” It was inevitable that in an era marked by inequity and radically conflicting interpretations of truth that the rollout of the COVID-19 vaccine would be marked by so much delusion on multiple fronts. On the one hand are the rich, who are accustomed to finding workarounds whenever they want something that is in short supply and see little need for a different approach when it comes to protecting themselves from a disease that has largely devastated the underclass. When you are living the good life, you want to preserve it. For every 100,000 people lost to deaths of despair — attributable to poverty, joblessness, addiction and so on — there is at least one Silicon Valley billionaire putting millions of dollars into life-extension research in the hope that he can reach the age of 200. At the same time that there are so many desperate to resume the business of going to Paris or Reykjavik for the weekend and hosting dinner parties for 35, there are the skeptics who believe that the vaccine is trouble. In a survey of 1,117 Americans conducted in early December, a quarter of respondents said they would not take the vaccine when it became available to them, while another quarter said they were not sure. Some have voiced reasonable concerns about the speed with which the vaccines — from Pfizer and Moderna — were approved. But others have fallen prey to circulating conspiracy theories: The vaccine was going to sterilize you or alter your DNA or leave you with a microchip that would allow Bill Gates and the government to discover what you were really doing when you told your wife that you were going to Home Depot. A little over a week ago, Lara Devgan, in what has now become something of a pandemic ritual, posted a video of herself getting the vaccine on Instagram. Devgan is a doctor but not a pulmonologist or an internist. She is a Park Avenue plastic surgeon with a skin care line sold at Sephora that includes something called Hyaluronic Serum for $245 a bottle. While it might have seemed odd that a cosmetic surgeon was getting a vaccine so soon — and publicizing it — she thought of her gesture as a public service. (She also works in emergency rooms doing post-trauma reconstructive surgery.) Some of her patients — those who have had cosmetic fillers — were worried that the vaccine would cause temporary facial swelling. This is indeed a very rare side effect. But the tabloid press had hyped it, and now Devgan was hearing from people who said they might skip the vaccine altogether because they preferred not to have laugh lines. Although one approach might be to skip collagen in the first place, Devgan wanted to show the world that you can have it all. “As someone who performs injectable facial fillers — who likes them and uses them myself — I believe the vaccine is safe,’’ she told me, “and the concept about worrying about how your face looks is not a reason not to get the vaccine.”


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