When a San Francisco-based healthcare company was criticized this month for allegations that it did not properly screen the people it was vaccinating to make sure they were eligible, it generated a reaction and a question: since vaccines are distributed, is anyone watching to make sure that health professionals are following the rules?
Surprisingly, however, it is also generating caution on the part of some health experts, who fear that suppressing evildoers too firmly might delay the launch as new variants of the deadly disease are gaining momentum.
“It’s a balance,” said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group.
The debate over monitoring vaccine suppliers accelerated this week after NPR published a report, based on leaked internal communications, claiming that One Medical, a leading healthcare provider popular with technology companies, allowed people who were not eligible to schedule coronavirus vaccine appointments and get the coveted shot. Some of these people allegedly worked at the company or were friends or relatives of employees. Patients were allowed to sign up for a free trial to reserve a vaccine, and the company reportedly did not verify eligibility when people arrived for the vaccines.
One Medical contested the idea that it consciously disregarded the eligibility requirements, and the company says it has improved its verification process.
The state chose Blue Shield to decide how vaccines are distributed, but it is not clear how the government supervises who gets the vaccines after the vaccines are distributed. State health officials did not immediately respond to a question about whether to carry out audits, unannounced inspections or whether to take any other measures to prevent health professionals from misusing the vaccine. Santa Clara County requires vaccine providers to sign distribution agreements that ensure that only those qualified under California Department of Public Health guidelines are vaccinated. San Mateo says it has “ongoing communications” with suppliers to ensure that the vaccine is properly distributed. But it appears that most policing occurs after questions arise.
The governor’s office said on Wednesday that it will overhaul the way it takes the vaccine to vulnerable communities after news emerged that access codes to consultations were widely shared with people who were not eligible, allowing them to make appointments. at mass vaccination sites, including the Oakland Coliseum.
In response to the One Medical controversy, several Bay Area counties, including Alameda, San Mateo and San Francisco, said this week they had stopped supplying the company with the vaccine. San Francisco asked the company to return about 1,620 doses of the Pfizer vaccine. Santa Clara County said it had provided One Medical with about 300 doses for healthcare professionals on the company’s staff, but has no future plans to assign more vaccines to One Medical.
More and more stories about people who abuse vaccines have caused anger among residents, especially those in eligible populations who are still struggling to find an appointment. One Medical is not alone. The Bom Samaritano Hospital in San Jose was attacked recently when news leaked that teachers in Los Gatos had been vaccinated before they were eligible.
But health experts and ethics experts warn that policing or being too harsh on bad actors can have unintended consequences.
Santa Clara County, for example, withheld the Good Samaritan vaccine and the hospital ended up closing its vaccine clinic, sending some residents to get vaccines elsewhere.
“It is evident that it is not fair for healthy, young and resourceful people to skip the line and position themselves above the rest,” said Monica Gandhi, specialist in infectious diseases at UCSF. “On the other hand, all my thinking about vaccination and logistical challenges is that the less barriers we have, the less layers we have, the less restrictions we have. In fact, we’re just going to make people get there faster, and we’re all going to get there anyway. “
Herd immunity, she noted, is the ultimate goal, and people are better protected from deadly disease when people around them are vaccinated.
Gandhi also pointed to voting rights as a cautionary tale about what could happen if the vaccine’s distribution were too restrictive.
“I’m just thinking about voting and what happened to all those electoral statutes that ended up creating suppression of voters,” she said, pointing out that efforts to increase participation and make voting easier during the Georgia pandemic paid off with participation. record.
Charles Binkley, director of bioethics at the Markkula Center for Applied Ethics at the University of Santa Clara, said there should be a system of checks and balances, but “I worry about that old saying of cutting your nose to offend your face.”
Rather than counties withdrawing vaccine supplies from One Medical, he said, he preferred to see health departments work and give the company time to improve.
“I prefer to have a system where we let some bad players in, rather than restricting it to the point of rejecting people, especially the vulnerable,” said Binkley.
Consumer advocate Wright hopes that with a new Johnson & Johnson coronavirus vaccine expected to be approved and available soon, the supply of the vaccine will increase to the point where he finds out who to prioritize is no longer an issue.
“Hopefully, in a few weeks, we will be in a world of surplus rather than scarcity,” he said. “And then the question is not about prioritization, but about extension.”