Next challenge for vaccine implementation in the USA: See who is ‘essential’

(Reuters) – As US industries push for workers to have early access to COVID-19 vaccines, local health departments and pharmacies face the challenge of verifying the identity of essential workers to ensure that no one cuts the queue.

ARCHIVE PHOTO: A healthcare professional receives a dose of the modern coronavirus vaccine (COVID-19) at Rady Children’s Hospital in San Diego, California, USA, December 22, 2020. REUTERS / Bing Guan

The ongoing vaccination campaign now focuses on staff in hospitals and nursing homes, tightly controlled environments where verification is relatively simple. But beginning in January or February, Americans employed in a variety of industries will be eligible for vaccination, provided they are essential frontline workers.

The absence of a plan to verify the jobs of vaccine candidates and the confusion over who qualifies as essential increases the risks of fraud and disorganization.


The criteria for qualifying as an essential frontline worker vary from state to state. The United States Centers for Disease Control and Prevention estimates that some 30 million essential workers will be next in line for an injection. Another 57 million essential workers will be vaccinated later.

The lack of clear guidelines will significantly complicate the verification process as these workers search for the photos.

The United States has two authorized COVID-19 vaccines, one from Pfizer Inc and BioNTech SE and the other from Moderna Inc. Vaccines are being launched as hospitals reach peak capacity and deaths exceed 317,000.

The United States Department of Homeland Security published in March a list of essential American workers during the pandemic.

The list covers nearly 70% of the United States’ workforce and offers little clarity to health officials trying to distribute initially limited doses of vaccines.

Many states during the summer began to develop their own lists of priorities, sometimes paying attention to the importance of local industries. States generally have ample freedom of choice when it comes to the distribution of vaccines.

This has resulted in a patchwork of guidelines across the country, with companies complaining that their workers are considered essential in one state, but not in another.

A panel of experts advising the CDC on Sunday recommended that people aged 75 and over and workers, including first responders, teachers, food and agriculture, manufacturing, the US postal service, public transportation and grocery workers, should have the next priority for the vaccines.

Some US states have signaled that they will continue with the distribution plans they originally drafted.

Michael Einhorn, the chairman of Dealmed, a medical supplies distributor in New York, criticized health authorities’ decisions to prioritize workers essential to the next phase of the vaccine, rather than distributing it according to age.

“There will be people trying to cut the line and commit fraud to get a vaccine,” said Einhorn, whose company was involved in distributing the flu vaccine.


It is not yet clear how health departments and pharmacies will verify the identity of a significantly larger and more diverse group of people eligible for the next round of vaccines.

Pharmacy operators CVS, Walgreens and Kroger Co referred to state and local guidelines when asked how they would verify essential workers.

“If the jurisdiction requests support from Walgreens, Walgreens will distribute a voucher or authorization form that the individual can use to schedule a vaccination appointment,” a Walgreens spokeswoman said in a statement.

CVS said it would share more information as it approaches the next phase of distribution of the vaccine in the first quarter of 2021.

In a statement, Kroger said it would require customers to make an appointment online and use a screening tool to manage the verification process.

“In some cases, the state will identify and verify individuals before they are referred to us for vaccination,” said a Kroger spokeswoman.

States have not outlined how they will verify workers’ identities.

A North Carolina health department spokeswoman said on Thursday that the state would rely on self-certification and “hope that people will respect that prioritization is in place.”

Companies that are pushing for their employees to be vaccinated are exploring different options.

The Consumer Brands Association, which represents food, beverage, personal care and household products companies, and the Food Industry Association, which represents food retailers, said they were developing model letters for employees to verify their essential worker status.

“We understand that states may have different designation standards, but (we are) working to provide our members with a resource to help reduce confusion,” said a spokeswoman for the Food Industry Association in a statement.

Reporting by Tina Bellon and Melissa Fares in New York; Editing by Cynthia Osterman