Sandra Lindsay, the first person to receive the COVID-19 vaccine, takes the reader on her journey from humble immigrant beginnings in 1980s Bronx to national health equity advocate and winner of the Presidential Medal of Freedom. Sandra Lindsay immigrated to the United States from Jamaica in 1986 with ambitions of becoming a nurse and living the American Dream. In December 2020, she became the first person to receive the COVID-19 vaccine and was subsequently honored with the Presidential Medal of Freedom. Lindsay tells her inspiring story, from leaving a stable home in Jamaica only to experience years of struggle in the Bronx, NY, as a single mother and struggling student. Her tenacity led to a successful thirty-year nursing career, including her leadership as the director of critical care at Northwell’s Long Island Jewish Medical Center during the country’s worst health crisis in 2020. In First in Line Lindsay lays out her triumphs and setbacks as a single mother and working student who overcomes barriers with the love of her family and the support of mentors and leaders. Her beginnings as a four-dollar-an-hour grocery store fortified her with the resilience to persevere over decades to become an executive at a globally recognized nationally known healthcare system. Lindsay recounts working through the darkest months of the COVID-19 crisis in 2020 and leading the critical care units at Long Island Jewish Medical Center. The suffering and losses she witnessed ignited Lindsay’s passion for seeing an end to inequities in healthcare. First in Line tackles a variety of issues: bias and inequity in healthcare; chronic disease in marginalized communities; maternal, infant, and Black and Brown women’s health; and mental health. While Lindsay continues to beat the drum for vaccination as COVID-19 continues to impact our lives, she advocates for a holistic approach for improved, equitable healthcare for all people who live on the margins.