At Elite Medical Centers, even non-qualifying employees are vaccinated

© Michael A. McCoy for The New York Times
Frontline workers waited in line last month to receive the Covid-19 vaccine at a hospital in Arlington, Va. At a handful of large medical centers, employees not involved in patient care were shot.

© Hannah Yoon for The New York Times
Stickers were received by recipients at a Philadelphia hospital last month.

A 20-person working on computers. A young researcher studying cancer. Technicians in basic research laboratories.

These are among the thousands of people vaccinated against the coronavirus in hospitals affiliated with Columbia University, New York University, Harvard and Vanderbilt, even as millions of front-line workers and older Americans await their turn.

The Centers for Disease Control and Prevention has issued recommendations aimed at ensuring that the country’s vaccines first reach those most at risk: health workers dealing with Covid-19 patients, and residents and staff at nursing homes, followed by people 75 years and older and certain essential workers.

Each state has drawn up its own version of the guidelines, but with the deployment at an icy pace, the pressure has increased for a more flexible approach. Officials at the CDC and the Food and Drug Administration recently suggested that it might be wise to simply loosen the criteria and distribute the vaccine as widely as possible.

However, officials did not anticipate that the vaccines would be given to healthy people in their twenties and thirties in front of older people, essential workers or others at high risk. States must still prioritize groups that are “meaningful,” Dr. FDA commissioner Stephen Hahn told reporters on Friday.

But a handful of the country’s most prestigious academic hospitals have taken the idea much further. Workers who have nothing to do with patient care and who are not 75 years or older were offered the shots. Some of the institutions were among the first recipients of the limited stock in the United States.

© Kevin Hagen / Associated Press
The NYU Langone Medical Center in Manhattan, which begins vaccinating staff members who are not with patients before giving the vaccine to patients.

“Chronism and compounds have no place in the development of this vaccine,” said Ruth Faden, a bioethicist at Johns Hopkins University in Baltimore. “If we do not do it right, the consequences can be quite disastrous, so it is very important that people here are sensitive to the rules of the game.”

The CDC never intended to include workers who were not with patients, such as administrators and graduate students, in the first level of preferential vaccinations, says Dr. Stanley Perlman, an immunologist at the University of Iowa and a member of the issuing committee. the recommendations.

“It all got so confusing,” he said. “In retrospect, I think it probably should have been a little more precise about what we were thinking, because we never thought of hospital administrators.”

In Nashville, Vanderbilt University Medical Center asked all staff members, whether they were treating patients or not, to register for vaccination. Vaccinations began in December when the Tennessee Hospital Association approved vaccinations for all hospital workers, regardless of their roles.

On January 6, the medical center planned to start vaccinating its high-risk patients, but only after “administering the initial vaccine dose to more than 15,000 people working at the medical center,” according to an email it sent to the patients. .

“We continue to follow the guidance 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 care staff,” said John Howser, communications center for the medical center, in a statement said.

© Yuki Iwamura / Reuters
A pharmacist was waiting this week to administer the Covid vaccine at a nursing home in Brooklyn.

But the Tennessee Department of Health sees it differently. “Hospitals have been encouraged since the start of the process to use any remaining vaccine to vaccinate high-priority populations,” said Bill Christian, a spokesman for the department.

“Some hospitals have interpreted their ‘staff’ broadly,” he added.

The Tennessee Department, he said, “continues to praise hospitals that have prioritized only their top high-risk vaccination staff and made any remaining vaccination available to help meet community needs by vaccinating” high-priority groups.

“I wish our elderly family members had received the vaccine before me,” said a young employee at Vanderbilt who had no contact with patients and asked not to be identified for fear of retaliation.

In Boston, Brigham and Women’s Hospital and Massachusetts General Hospital, both affiliated with Harvard University, vaccinated more than 34,000 employees, including those involved in patient care, researchers who may come into contact with coronavirus samples, and those involved in clinical trials, according to Rich Copp, a spokeswoman for the hospitals.

The reason? Some laboratory scientists may be needed in hospitals if the coronavirus goes up again. “Our first-wave experience has shown that some members of the research community need to be redeployed to support work in patients with Covid,” he said. Copp said.

The medical centers nevertheless announced plans to immunize the rest of their employees from Monday.

In the state of New York, only a fraction of the estimated 2.1 million frontline workers have been vaccinated. Government Andrew Cuomo has threatened to impose fines of up to $ 100,000 on hospitals that do not vaccinate fast enough to use their doses.

At Columbia University, the message quickly spread through research laboratories that were far removed from patient care: if you show up at Milstein Hospital, the university’s primary medical center, you can get vaccinated – no matter if you work with patients.

According to several university workers, postgraduate students, postdoctoral fellows and researchers were soon queuing up in the hospital auditorium. Almost everyone at one cancer research center attached to the hospital received the vaccine.

Hospital officials said they eventually became aware of emails sending people to the auditorium, but that someone who did not need the vaccine was turned down.

“We have worked so far to vaccinate tens of thousands of employees, starting with staff experiencing patients, and we are constantly improving our vaccination process,” said Kate Spaziani, vice president of communications for the hospital.

She added: ‘We will continue to do this until everyone gets a vaccine. We follow all guidelines for government departments in New York regarding vaccine priority. ”

But some recipients were upset to learn that they did not qualify under state guidelines.

“I now understand that it was not our turn, and I feel terrible to go out of turn,” said a young researcher whose work has no bearing on Covid-19. “I’m honestly a little angry with the hospital and the university because I did not control it properly.”

At NYU’s Langone Medical Center, the focus was more on staff members who have no contact with patients.

“We are currently offering the Covid-19 vaccine to frontline employees only,” reads the center’s website. “We will notify our patients as soon as we have the vaccine available to patients.”

But in an email to staff members on Dec. 28, Andrew Rubin, a senior vice president at the medical center, said the center had already vaccinated its 15,000 employees who deal with patients and would begin vaccinating all other staff members. There was no mention of older adults or other priority groups specified by the state of New York.

An email to NYU Medical Center staff who have not yet registered for vaccination states: ‘As an employee of a healthcare institution, you have the opportunity to receive a vaccine that millions of people across the country want – and you can now. “

In a tacit acknowledgment that those employees would not otherwise qualify for the vaccine as soon as possible, the email warned that once the state has expanded the criteria for admission, ‘you may have to wait weeks, if not months, to get it. received based on demand and availability. ”

Government officials were upset that both NYU and Columbia opened low-risk vaccinations for staff members in front of millions of state residents who needed the shots.

On Friday, New York expanded its lead on vaccinations to include essential workers and people over 75.

The guidelines “do not provide carte blanche to vaccinate all employees of a hospital business, regardless of their function,” said Gary Holmes, a spokesman for the health department. “Although we do not know all the facts here, DOH will, to the extent that there is an offense, investigate it.”

Privately, some government officials were furious. Rather, the institutions should have asked the state to do the following as soon as they vaccinated the frontline staff, one official said on condition of anonymity because he was not authorized to discuss the matter.

“The only reason they had as much vaccine as they had was because they were supervisors of the vaccine – because they had cold rooms,” the official said. “It was not the NYU’s vaccine to use for NYU”

The problem is not limited to academic medical centers. Some hospitals have conducted so few investigations that many people have been able to pull the trigger with false claims on the vaccines.

In Maricopa County, Ariz., For example, an online form recommends that applicants use a personal e-mail address, rather than one associated with a hospital, and not require worker identification numbers.

“Yes, we want people to be vaccinated, but we need to make sure the high-risk groups have access,” said Saskia Popescu, a hospital epidemiologist at the University of Arizona. If the process is so disorganized, it’s a damage to confidence in the public health process, and I think it’s just heartbreaking. ‘

Several university employees, including some who unknowingly accept the vaccine, are also dissatisfied with what they see as an unfair and unfair process.

“It’s such a naked display of privilege, you know?” said a member of the Columbia faculty who did not receive the vaccine and asked not to be identified for fear of retaliation from administrators. “It’s because we’re at elite universities and medical centers.”