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Residents of Stanford Medicine who work in close contact with COVID-19 patients have been excluded from the first wave of staff for Pfizer’s new vaccine. In their place were senior doctors who carried a lower risk of patient transmission, according to interviews with six residents and two other staff and email communications obtained by ProPublica.
“The residents are facing the patients, we are the ones who have been asked to intubate, but some of the people who have faced us at home are vaccinated before us,” said Sarah Johnson, third year OB-GYN resident. who delivered COVID-positive patients during the pandemic. “It’s the last straw to say, ‘We don’t really care about you.'”
Another resident, who asked not to be named, said a nurse who works in an operating room for elective surgeries was told she would receive the vaccine in the first wave. “We test people for COVID before elective surgeries, so by definition we will know if these patients have COVID,” he said, so to him it didn’t make sense that this nurse was a priority .
An algorithm chose who would be the first 5,000 in line. Residents said they were told they were at a disadvantage because they did not have an assigned ‘location’ to log into the math and because they were young, according to an email from a chief resident to his peers. Residents are the lowest ranked physicians in a hospital. Stanford Medicine has about 1,300 in all disciplines.
Only seven of them were on the priority vaccination list, despite the fact that this week residents were asked to volunteer for intensive care coverage in anticipation of an increase in COVID-19 cases.
Stanford Medicine did not respond to a request for comment on how the vaccines were allocated and whether there was a flaw in the algorithm. The uproar reflects the challenges of ethically allocating a limited vaccine supply and balancing competing factors, such as age, risk of disease and co-morbidities. The angst that arises when such decisions are made without all stakeholders being involved only adds to the challenge.
In a letter to Stanford management on Thursday, the Chief Residents’ Council wrote: “As management points to an error in an algorithm intended to ensure fairness and justice, we understand that this error was identified on Tuesday and that a decision was made not to revise the vaccine allocation schedule until it is released today. The council asked for a schedule for the vaccination of residents and transparency regarding the algorithm.
Stanford administrators began to apologize. Chief Medical Officer Dr Niraj Sehgal emailed residents saying, “Please be aware that the perceived lack of priority for residents and fellows was not the intention at all.” He added that with the early approval of Moderna’s vaccine, “we are increasingly confident that we are getting everyone, including all of you, vaccinated. He signed with “a sincere apology”. Some departments seem to be trying to solve the problem on their own. Dr. Mary Hawn, director of the surgical department, confessed to being “disturbed and perplexed” by
the immunization list which “included many medical staff who are not our frontline physicians.” She emailed her department asking those nominated for the first wave to “bring a resident who is facing a patient to get the vaccine for you” and ask the program director for her “buddy” assignment. .
She added, “Let’s get it right.”
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