Medical One scandal raises questions about oversight of vaccine suppliers

When a San Francisco-based healthcare company came under fire this month for saying it failed to properly screen the people it vaccinated to make sure they were eligible, it triggered a violent reaction and a question: After the vaccines are distributed, does anyone make sure that the medical providers follow the rules?

Surprisingly, however, it also calls for caution on the part of some health experts who fear that cracking down too hard on bad actors could slow the rollout as new variants of the deadly disease gain momentum.

“It’s a balance,” said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group.

Debate over vaccine vendor oversight intensified this week after NPR released a report, based on leaked internal communications, alleging that One Medical, a high-end healthcare provider popular with tech companies , allowed people who were not eligible to make appointments for a coronavirus vaccine and get the coveted photo. Some of these people are said to have worked in 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 vaccinations.

One Medical has taken issue with the idea of ​​knowingly ignoring the eligibility criteria and the company says it has improved its verification process.

The state has appealed to Blue Shield to decide how the vaccines are allocated, but it is unclear how the government monitors who gets vaccinated after the vaccines are distributed. State health officials did not immediately respond to whether they are conducting audits, unannounced inspections or taking other steps to prevent health care providers from misusing the vaccine. Santa Clara County requires vaccine suppliers to sign distribution agreements ensuring that only candidates eligible for California Department of Public Health guidelines are vaccinated. San Mateo says it has “permanent communications” with suppliers to ensure the vaccine is properly distributed. But it appears that most policing activity takes place after questions arise.

The governor’s office said on Wednesday it would rework the way it gets the vaccine for vulnerable communities after news surfaced that appointment access codes were widely shared with people who were not. not eligible, allowing them to schedule 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 that they had stopped providing vaccines to the company. San Francisco has asked the company to return approximately 1,620 doses of Pfizer vaccine. Santa Clara County said it had provided One Medical with around 300 doses for healthcare workers on company staff, but had no plans to allocate more vaccines at One Medical.

The growing stories of people skipping the line for vaccines have angered residents, especially those from eligible populations who are still struggling to find an appointment. One Medical is not the only one. San Jose’s Good Samaritan Hospital came under fire recently when reports revealed it vaccinated teachers in Los Gatos before they were eligible.

But healthcare experts and ethicists warn that policing or opposing bad actors could have unintended consequences.

Santa Clara County, for example, denied Good Samaritan the vaccine, and the hospital eventually shut down its vaccination clinic, sending some residents to scramble for vaccines elsewhere.

“It is clearly not fair that healthy and young people who have the means to jump the line and get it above the rest,” said Monica Gandhi, an infectious disease expert at UCSF. “On the other hand, my whole thinking about immunization and the logistical challenges is that the fewer barriers we have, the fewer levels we have, the less restrictions we have, we’re actually just going to attract people faster, and we’re all gonna get there anyway.

Herd immunity, she noted, is the end goal, and people are better protected from the deadly disease when those around them are vaccinated.

Gandhi also referred to voting rights as a warning about what could happen if vaccine distribution was too restrictive.

“I can’t stop thinking about the vote and what happened with all those election laws that ended up creating the suppression of voters,” she said, noting that efforts to increase the rate of voting. turnout and facilitating voting during the Georgia pandemic paid off with a record turnout.

Charles Binkley, director of bioethics at the University of Santa Clara’s Markkula Center for Applied Ethics, said there should be a system of checks and balances, but “I’m worried about that old saying about you. cut your nose to annoy you.

Rather than pulling the vaccine supply from One Medical, he said, he’d rather see health departments work with it and give the company time to improve.