Since the first covid-19 vaccines began rolling out, there have been examples and anecdotal evidence that some people are skipping the line—spotlighting health inequities and ethical concerns.
According to NPR, “A national health care provider has administered COVID-19 vaccinations to people deemed ineligible for the scarce vaccine by local health departments, including people with connections to company leaders and customers of its concierge medical service, according to internal communications leaked to NPR.
San Francisco-based One Medical has been allocated thousands of vaccine doses by local health departments in some of the areas they provide medical services. Ineligible individuals with connections to company leadership were set up with vaccine appointments, and patients who were disqualified from receiving the vaccine were nonetheless permitted to skip the line ahead of other high-risk patients.
The problems have occurred in numerous company locations across several states. The Washington State Department of Health, citing a complaint it received this month, told NPR it had halted COVID-19 vaccine distribution to the company. Other regulators have also received complaints or stopped providing the vaccine.
One Medical has branded itself as a high-end health care provider serving a relatively affluent clientele, with each customer paying a $199 fee annually to receive easy online access to appointment scheduling, telemedicine and a streamlined, tech-focused medical experience. The company went public with an initial public offering in January 2020, with a valuation in the billions of dollars.
One Medical’s shortcomings take place amid broader anecdotal evidence that suggests patients throughout the U.S. are skipping the line due in part to loose enforcement. The situation highlights a serious ethical issue: determining who is entitled to a vaccine at a time of scarce availability and who is responsible for enforcing eligibility rules.
Experts say an appropriate system for vaccine distribution focuses on first targeting those most at risk for serious consequences from COVID-19. ‘We’re trying to focus on those individuals who are most likely to develop severe illness or death and to most likely be exposed to the virus,’ said Gabriel Lázaro-Muñoz, who teaches medical ethics and health policy at the Baylor College of Medicine. ‘The overall goal is to save as many lives as possible, and with that we are not valuing any life over another.’”
In response to this news, 69% of global Sermo physicians said they have been aware that some patients and providers are using personal connections to facilitate vaccine line skipping. And 47% of doctors have personally had patients ask if they can skip the vaccine line.
When asked if they feel there is a bigger issue here involving health inequity and medical ethics—in which people of affluence can pay for better/faster medical care—81% answered yes. Overall, 60% of physicians feel there has been an issue with the organization of the covid-19 vaccine rollout program in their area. And 44% believe that some of the issues occurring could be attributed to “the fog of war,” which is what the chief medical officer of One Medical said was behind the line skipping of ineligible patients.
Below, Sermo physicians from around the world share their professional insights, perspectives, and opinions on this important topic—in their own words:
Unfortunately, these instances are NOT unique to this organization. I have no problem with the odd vaccination to technically ineligible folks to avoid waisting vaccine (e.g. at the end of a long day when eligible folks did not show up as scheduled). Wasting precious vaccine should be avoided at all costs. OTOH-Deliberately dosing folks of privilege (e.g. economic or by non-patient-contact employment by a certain health system) should be prosecuted.
Anesthesiology
Health care to high bidder is one of the malignant aspects of our healthy (sic) system. Easy to see that there are ethical issues with some of the more entrepreneurial delivery models. So this behavior is far from surprising.
Family Medicine / Practice (FP)
Approaching the population in my country was very imposing in the sense of instilling panic both by the press and by the state government agencies and by the spoken and written press. Despite the efforts of frontline vaccination staff, planning has been difficult and many people have not vaccinated yet!
Plastic & Reconstructive Surgery
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