SEATTLE (AP) — When Seattle’s largest health care system got a mandate from Washington state to create a mass COVID-19 vaccination site, organizers knew that gathering enough volunteers would be almost as crucial as the vaccine itself.

“We could not do this without volunteers,” said Renee Rassilyer-Bomers, chief quality officer for Swedish Health Services and head of its vaccination site at Seattle University. “The sheer volume and number of folks that we wanted to be able to serve and bring in requires … 320 individuals each day.”

As states ramp up vaccination distribution in the fight against the coronavirus, volunteers are needed to do everything from direct traffic to check people in so vaccination sites run smoothly. In return for their work, they’re often given a shot. Many people who don’t yet qualify for a vaccine — including those who are young and healthy — have been volunteering in hopes of getting a dose they otherwise may not receive for months. Large vaccination clinics across the country have seen thousands trying to nab limited numbers of volunteer shifts.

It’s raised questions at a time when supplies are limited and some Americans have struggled to get vaccinated even if they are eligible. But medical ethicists say volunteers are key to the public health effort and there’s nothing wrong with them wanting protection from the virus.

Ben Dudden, 35, of Roanoke, Virginia, volunteered at a mass vaccination clinic in the nearby city of Salem on a day off from his part-time job at the Roanoke Pinball Museum. His wife, a nurse practitioner who was administering doses, encouraged him to volunteer in case he could get vaccinated.

He spent that January day helping people fill out questionnaires, not knowing if he might get the coveted dose.

“It wasn’t an official thing like, ‘Everybody who needs a vaccine come this way.’ I kind of had to ask,” Dudden said. “At end of the day, I found whoever was in charge of that.”

He got what he was hoping for and still wants to volunteer again.

“It was a little bit of a selfish thing — ‘I’m gonna get the vaccine if I do this’ — but for me, it wasn’t the only factor,” Dudden said.

At the Seattle vaccination clinic, Swedish Health Services considers volunteers part of the state’s Phase 1 vaccination group. About 5,000 have been inoculated, and about 1,000 of them have come back to work again, Rassilyer-Bomer said.

During their shifts, volunteers are handed colored vests matched to their skill level and experience. The majority wear orange for general tasks, which includes sanitizing clipboards, asking people to fill out forms, taking temperatures and monitoring the newly vaccinated to ensure no dangerous side effects.

Some may question whether it’s fair for volunteers to get to the front of the line for what’s often clerical work.

Nancy Berlinger, a bioethicist at the Hastings Center, a research institute in Garrison, New York, said the bottom line is that volunteers are interacting with the public and there’s nothing wrong with them wanting protection.

They also go through training and other obligations.

“There would be easier ways to game the system,” Berlinger said. “If that was really your goal, this could take more work I think than some other routes I can think of.”

While many volunteer shifts are several hours on weekdays, Berlinger said that doesn’t necessarily mean only people of a certain class or demographic can sacrifice that much time.

“That could apply to students, it could apply to people who are unemployed, people who are retired. It could be people who are family caregivers,” Berlinger said.

On a chilly January night in suburban Phoenix, Lou Ann Lovell, a 67-year-old retiree, got the Pfizer vaccine after volunteering from 10 p.m. to 6 a.m. at a state-run site at State Farm Stadium, where the Arizona Cardinals play. Her daughter persuaded her and other relatives to volunteer.

Lovell committed before realizing those 65 and older would be eligible for vaccines days later. Still, she’s glad she did.

“For the first time, I felt I was part of something that was really important and big,” said Lovell, who would like to volunteer again. “You stand there and see all these headlights and people are just continually pouring in there.”

The stadium and another state-run site in metro Phoenix require a combined 3,900 volunteers a week. HandsOn Greater Phoenix, a nonprofit handling online volunteer recruitment, opens 1,400 to 2,000 spots a few times a week, and interest hasn’t waned, CEO Rhonda Oliver said. Between 10,000 and 15,000 people try to sign up every time new spots open, she said.

Volunteers who have nabbed shifts say they shouldn’t be lumped in with those who believe they’re entitled to a vaccine.

In the Seattle area, three King County hospitals came under fire last month after revelations that donors, board members and some hospital volunteers used their connections to get shots. The King County Council approved a measure calling on state lawmakers and Gov. Jay Inslee to make it illegal to grant special access to the vaccine.

Berlinger said there’s a clear delineation between a connected official and a volunteer at a vaccine clinic getting a shot.

“The volunteers we’re talking about at registration centers are people who are part of the public health effort. They are performing a crucial role,” Berlinger said. “It’s easier to help people who already have privilege. The thing about COVID is we have to push away from that and we have to say, ‘No, we must allocate vaccine and vaccination.’”

Lovell, the retired volunteer in Arizona, said critics should target the healthy 20-somethings she saw trying to get the vaccine the night she volunteered.

“If you want to volunteer, volunteer and work,” she said. “If you say, ‘I don’t want to do that,’ then wait until your number comes up.”

Terry Tang reported from Phoenix.