Relief over the arrival of COVID-19 vaccines in the U.S. quickly curdled into frustration over supply shortages, delivery problems, and unequal distribution.
But one group has gotten a head start in receiving the coveted shots: people who’ve donated money to hospitals distributing the vaccine.
Hospitals from coast to coast have offered their wealthy contributors early access to vaccines, prompting at least one investigation by state health authorities.
In Topeka, Kansas, members of Stormont Vail Health’s board of directors and a separate fundraising board got vaccine shots during the first phase of the state’s rollout when vaccinations were supposed to go to nursing home residents and health-care workers, local media outlet KCUR reported.
The first round of shots was meant for people in health-care jobs who can’t work from home and may be directly or indirectly exposed to patients or infectious materials because of their jobs. Hospital board members were not on this list.
A hospital spokesman “defended giving early access to the fundraising and hospital boards,” KCUR reported, saying that board members’ decisions help “make sure that everything’s running day to day.” (Board members also typically donate to the nonprofits they help lead.)
As soon as vaccines were approved for use in the U.S., there were concerns that people with more resources would maneuver for early doses.
The Association for Healthcare Philanthropy even posted a script for hospital officials to use when turning down donors who requested early vaccine access.
However, in several instances, it’s not the donors who are asking for the shots, it’s the hospitals that are inviting the donors to get vaccinated. Those hospitals are “outliers,” said Alice Ayres, president and CEO of the Association for Healthcare Philanthropy.
VIP treatment for, well, VIPs
In Seattle, Wash. Overlake Medical Center posted a public apology after its chief development officer emailed donors who had given $10,000 or more, offering “major donors” invite-only access to vaccine appointments, the Seattle Times reported.
The hospital said the donors were among some 4,000 people, including patients, employees and volunteers, who were contacted about vaccine appointments after the hospital’s scheduling system failed, according to the Seattle Times.
“We’re under pressure to vaccinate people who are eligible and increase capacity,” the medical center’s chief executive officer told the newspaper. “In hindsight, we could certainly look back and say this wasn’t the best way to do it.”
In New Jersey, donors and relatives of executives at Hunterdon Medical Center received vaccine shots “weeks before” the general public, when the shots were supposed to be reserved for frontline medical workers and people in long-term care facilities, New Jersey 101.5 FM reported.
A hospital spokesman said the facility followed all state guidelines, and only offered others the shots “if doses were likely to go to waste.”
Some of the first people to get shots, on Dec. 18, a day after the first vaccine shipment arrived at the hospital, were a couple who have been longtime donors to the hospital’s foundation and gave at least $10,000 in 2018, according to a vaccine registry obtained by New Jersey 101.5 FM.
‘Unethical, inequitable and antithetical to the values of philanthropy’
“This is unthinkable,” said Jay Frost, a fundraising consultant, speaking generally about the issue of hospitals appearing to give favorable treatment to donors. “It’s appalling. Donors should not receive preferential treatment, especially when it comes to healthcare. It’s hard for me to imagine a scenario in which someone who needed, let’s say, a kidney, would be first in line because they’d made a larger donation than someone else.”
The Association of Fundraising Professionals recently condemned the practice, describing it as “unethical, inequitable and antithetical to the values of philanthropy and ethical fundraising.” In New York state, facilities that give shots to people who aren’t on the state’s priority list can be fined up to $1 million, Gov. Andrew Cuomo announced in late December.
One more assault on fragile public trust
The implications of this preferential treatment reach far beyond the institutions themselves, one expert told MarketWatch.
When people hear about wealthier elites getting vaccine doses ahead of the general public, it’s one more assault on an already-frayed public trust at a time when people’s faith in health-care institutions is crucial to ending the pandemic, said Joseph Carrese, a medical doctor and professor of medicine at Johns Hopkins University’s Berman Institute of Bioethics.
“The public in general is pretty fragile right now,” Carrese said. “It’s been hard for the last several months.” Older people, who are more likely to be isolated, have been told to wear masks and refrain from visiting their loved ones, he noted.
“They’re trying desperately to get the vaccine and they look in the paper and read that someone who is well-connected jumped the line. I can only imagine how frustrated, demoralized and angry about it they would be. What then happens to credibility and public trust? Do they then start to think, ‘Why bother, why should I do what they say?’ If we lose our credibility and, in turn, their trust in us, I think there’s potentially all sorts of negative consequences.”
People’s willingness to follow social distancing orders, wear masks and get vaccinated depends on their belief that health officials are acting with their best interests in mind, Carrese added. If they don’t believe that to be the case, they could stop following health officials’ advice. And that has implications for everyone.
“ “The public trust is not some sort of abstract meaningless thing. If we’re asking people to do the hard things, like wear your mask and don’t visit your family, if they don’t trust that we have their best interest in mind, maybe they won’t do it.” ”
Hospitals could lose their vaccination license
There’s a lot at stake if hospitals don’t follow state rules for vaccine distribution. In addition to fines in states such as New York, hospitals can lose their license to administer vaccines, which could make the vaccine rollout slower for everyone, Ayres said.
State health officials and the CDC track every vial of vaccine, as well as personal information about the recipient of each shot, Ayres said. There are checks and balances to make sure hospitals follow guidelines, and a paper trail to ensure compliance.
She couldn’t comment specifically on the hospitals in Topeka, Seattle and New Jersey where donors had gotten early access to vaccines, but said that in some instances, it’s possible hospitals are contacting donors because they have leftover doses and need to use them.
“You could have a debate as to whether or not that is perfectly ethical,” Ayres said. “I think at the moment at least it’s significantly worse, or even criminal, to let vaccine go unused.”
Potentially ‘catastrophic’ consequences for hospitals
The good news: “The couple of stories that are out there are really the minority by a vast amount,” Ayres told MarketWatch. She said “99.999 percent” of hospitals administering vaccines say they’ve been following guidelines and not letting people jump lines for any reason, not only because it would be unethical, but because “if we are found in any way not to be following guidelines, that would be catastrophic.”
It’s also true that many hospital donors happen to be in the high-priority age groups, Ayres added. Some of those donors may be contacting hospitals, not because they’re expecting special treatment, but because they’re genuinely unsure of when and how to get a shot, and they’re turning to whoever they know in the medical field, she said.
Trying to assist donors appears to be one aspect of what happened in New Jersey, where “the day before the state opened vaccine appointments to senior citizens and any adult with high-risk conditions,” a hospital’s foundation sent donors a letter inviting them to call the foundation’s director of major gifts “to ‘help you schedule an appointment’ as soon as they became eligible,” New Jersey 101.5 reported.
The letter stated that donors would not get early access to shots, but “rather that we will assist you in navigating a process that is rapidly changing and can sometimes be complex.”
A spokesman for the hospital, Hunterdon Healthcare, said 99.6% of doses the hospital had administered had gone to people on the high-priority list, and that in “the remaining few instances” the hospital vaccinated volunteers who were easily contacted and available immediately, including some donors and board members.
“We believed, and still believe, that it was better to vaccinate someone immediately available to us than to allow any vaccine to go to waste,” said Jason VanDiver, chief marketing and communications officer.
“In no case did we prioritize a donor, board member, or executive over an eligible clinician, senior, or at-risk individual who was available to receive a vaccination,” he added.