20-something that works on computers. A young researcher studying cancer. Technicians in basic research laboratories.
These are some of the thousands of people who have been immunized against coronavirus in hospitals affiliated with Columbia University, New York University, Harvard and Vanderbilt, even as millions of front-line workers and senior Americans wait their turn.
The Centers for Disease Control and Prevention has issued recommendations aimed at ensuring that vaccines in the country first reach those with the highest risk: health workers who interact with patients with Covid-1
Each country has created its own version of the guidelines, but with the proliferation at an icy pace, the pressure is growing for a more flexible approach. Officials at the CDC and the Food and Drug Administration recently suggested that it might be wiser to simply loosen the criteria and spread the vaccine as widely as possible.
However, these officials did not provide for vaccines to be given to healthy people 20-30 years old before the elderly, emergency workers or other high-risk individuals. States still have to prioritize groups that “make sense,” FDA Commissioner Stephen Hahn told reporters on Friday.
But a handful of the country’s most prestigious academic hospitals have already developed the idea much further. Shots are offered to workers who have nothing to do with patient care and who are not 75 or older. Some of the institutions were among the first recipients of limited supplies in the United States.
“The link and connections have no place in the spread of this vaccine,” said Ruth Faden, a bioethicist at Johns Hopkins University in Baltimore. “If we don’t do the right thing, the consequences can be quite catastrophic, so it’s really important for people to be hypersensitive to the rules of the game here.”
The CDC never intended to include non-patient workers, such as administrators and graduate students, in the first level of priority vaccinations, said Dr. Stanley Perlman, an immunologist at the University of Iowa and a member of the commission that issued the recommendations.
“It’s all been so confusing,” he said. “In retrospect, I think we probably should have been a little more specific about what we were thinking, because we never thought about hospital administrators.”
In Nashville, Vanderbilt University Medical Center asked all staff, whether treating patients or not, to register for vaccination. The inoculations began in December, when the Tennessee Hospital Association sanctioned vaccinations for all hospital employees, regardless of their roles.
On January 6, the medical center announced plans to vaccinate its high-risk patients, but only after “introducing the initial dose of vaccine to more than 15,000 people working at the medical center,” an email sent to patients said.
“We continue to follow the instructions we receive from the Tennessee Department of Health as we vaccinate the Vanderbilt Health workforce and other priority groups of patients, staff and community health personnel,” said John Hauser, chief medical officer of the medical center. .
But the Tennessee Department of Health sees it differently. “Hospitals are encouraged from the start of the on-board process to use any other vaccines to vaccinate high-priority populations,” said Bill Christian, a spokesman for the department.
“Some hospitals have interpreted their ‘staff’ widely,” he added.
The Tennessee department, he said, “continues to applaud hospitals that have prioritized only their first-rate, high-risk vaccination staff and provided all other vaccinations to help meet the community’s vaccination needs” with high-priority groups.
“I would like our elderly relatives to have received the vaccine before me,” said a young Vanderbilt official who has no contact with patients and asked not to be identified for fear of reprisals.
In Boston, Brigham and Women’s Hospital and Massachusetts General Hospital, both affiliated with Harvard University, have immunized more than 34,000 staff, including those caring for patients, researchers who may come into contact with samples. from coronavirus and engaged in clinical trials, according to Rich Kopp, a hospital spokesman.
The reason? Some laboratory scientists in hospitals may be needed as the coronavirus revives. “Our first-wave experience has shown that some members of the research community may need to be redeployed to support the work of caring for patients with Covid,” said Mr Kopp.
Still, medical centers announced plans to immunize other employees Monday.
In New York State, only a small portion of approximately 2.1 million front-line workers are immunized. Gov. Andrew Cuomo has threatened to impose fines of up to $ 100,000 on hospitals that do not vaccinate quickly enough to use their doses.
At Columbia University, the rumor spread quickly in research laboratories, away from patient care: If you show up at Milstein Hospital, the university’s main medical center, you can get vaccinated – whether or not your job has anything to do with patients.
Graduate students, doctoral students and researchers soon lined up in the hospital auditorium, according to several university officials. Almost everyone in a hospital-related cancer research center received the vaccine.
Hospital officials said they eventually learned of emails directing people to the audience, but that anyone who did not need the vaccine was rejected.
“So far, we have worked to vaccinate tens of thousands of staff, starting with patient-oriented staff, and are constantly working to improve the vaccination process,” said Kate Spatziani, the hospital’s vice president of communications.
She added: “We will continue to do so until everyone is vaccinated. We follow all the guidelines of the State Department of Health in New York on the priority of the vaccine. “
But some recipients were upset to find that they did not meet state requirements.
“Now I understand that it’s not our turn and I feel terrible when I get out of the turn,” said a young researcher whose work has nothing to do with Covid-19. “Frankly, I’m a little angry at the hospital and the university for not controlling it properly.”
At Langone Medical Center in New York, the range of staff who have no contact with patients was more conscious.
“Currently, we only offer the Covid-19 vaccine to first-line employees,” the center’s website said. “We will send a message to our patients as soon as we have the vaccine for patients.”
But in an email to staff members on December 28, Andrew Rubin, senior vice president at the medical center, said the center had completed vaccinating its 15,000 patients who interact with patients and would begin vaccinating all other staff members. No mention is made of the elderly or other priority groups identified by the State of New York.
On Tuesday, an email to New York Medical Center staff who had not yet signed up for vaccination said: “As a health care worker, you have the opportunity to get the vaccine that millions across the country want – and you can have, right now.”
In a tacit acknowledgment that these staff would not otherwise qualify for the vaccine so soon, the email warned that once the state expanded the eligibility criteria, “you may have to wait weeks, if not months, to receive it based on demand and availability. ”
Government officials were concerned that both New York and Colombia had opened vaccinations for low-risk employees to millions of state residents who needed the shots.
On Friday, New York expanded its vaccination guidelines to include key workers and those over 75.
However, the guidelines “do not provide carte blanche for vaccination to all hospital employees, regardless of their function,” said Gary Holmes, a spokesman for the state Department of Health. “Although we do not know all the facts here, as far as there is a violation, DOH will investigate.”
In particular, some government officials were furious. Instead, the institutions had to ask the state what to do as soon as they finished immunizing frontline employees, said an official who spoke on condition of anonymity because he was not authorized to discuss the issue.
“The only reason they have as many vaccines as they are is because they were the keepers of the vaccine – because they have cold stores,” the official said. “It was not the New York vaccine to be used for New York”
The problem is not limited to academic medical centers. Some hospitals have so few inspections that many people have been able to get around the line with false claims about vaccines.
For example, in Maricopa County, Arizona, an online form recommends that applicants use a personal email address, not a hospital-related one, and does not require employee identification numbers.
“Yes, we want people to be vaccinated, but we need to give high-risk groups access,” said Saskia Popescu, a hospital epidemiologist at the University of Arizona. If the process is so disorganized, it “undermines the credibility of the public health process and I think it’s really heartbreaking.”
Several university staff, including several who unknowingly took the vaccine out of action, were also discouraged by what they saw as an unfair and unfair process.
“It’s such a naked demonstration of privilege, you know?” said one Colombian teacher who did not receive the vaccine and asked not to be identified for fear of retaliation by administrators. “That’s because we’re in elite universities and medical centers.”