An Augusta-based health provider offered a small number of early doses of the coronavirus vaccine to donors and retired medical staff last month, starting that process more than a week before widely registering people 70 and older for appointments on Friday.
The effort by MaineGeneral Health, which operates the large hospital near Interstate 95 in Augusta, is unlike any other in Maine so far. Employees of the philanthropy office called people who have donated to the hospital to help schedule them for early appointments. While the scope looks relatively small, it is reminiscent of situations across the country that have drawn negative attention recently as limited vaccines begin to roll out widely to an anxious public.
“As we see numerous reports of line jumping and favoritism, any situation that could lead to distrust in the fairness of the vaccine allocation process needs to be proactively managed,” said Holly Fernandez Lynch, an ethics professor at the University of Pennsylvania’s medical school. “Redeploying staff to help with vaccination is reasonable, but care should have been taken to avoid fundraising staff connecting with prior donors on this.”
MaineGeneral billed the effort as part of a clinic to come on Monday to test its processes before appointments for the general public begin on Wednesday, saying everyone in a test group of 40 people scheduled for Monday vaccines is age 70 or older, meeting recently expanded state guidelines for vaccination. It opened vaccine registration to the public on Friday, prompting 400,000 calls on that one day alone, according to the Kennebec Journal.
Less than a third of those 40 people are donors with most having given because they are retired physicians, staff or volunteers, spokesperson Joy McKenna said. Philanthropy staff have been engaged as the hospital marshals resources to make phone calls and coordinate clinics, she said.
The hospital found a glitch with registration software as a result of the test and 20 more patients who called for appointments on Friday were given slots on Monday, she said. MaineGeneral will offer 90 vaccine appointments on Wednesday, 120 or Thursday and 210 on Saturday.
“This was never done as a way to give someone a special privilege,” McKenna said. “We certainly made sure we weren’t using personal family or friends to do this.”
But Maine’s two largest health providers, MaineHealth and Northern Light Health, said they did no similar tests before making shots available to the general public. Some MaineHealth hospitals offered vaccines to patients ages 70 and up before phone registration for the public was available, but donors were not involved, a spokesperson said.
One past MaineGeneral donor provided the Bangor Daily News with a Jan. 21 voicemail from the hospital’s philanthropy director in which she expressed a desire to discuss upcoming vaccinations. When the person called back, they said the director told them the hospital was offering that slot because of the person’s status as a supporter.
The past donor, who spoke with the BDN on condition of anonymity, took the call as a direct reference to a donation. When asked about that, McKenna said many who were contacted “have multiple touchpoints” with the health provider, “meaning they are supporters of us in one way or another.”
The Maine Center for Disease Control and Prevention received a complaint about the MaineGeneral effort, spokesperson Robert Long said. The agency reached out to the hospital to remind it that equity was a guiding principle of the state’s vaccine effort and was assured that there was only a limited number of early appointments, he said.
The episode comes at a sensitive time of the national vaccine rollout, which was limited mostly to health care workers and residents and employees of long-term care facilities since it began in December. After a federal policy change, states moved last month to expand vaccinations to older and vulnerable members of the general public, but demand has well exceeded supply.
At the same time, there have been complaints of favoritism. Rhode Island’s attorney general is investigating reports of two hospitals offering shots to board members. Washington Gov. Jay Inslee rebuked a Seattle-area hospital system for opening appointments to board members over age 70. Hospitals in Kansas, Florida, New Jersey and Virginia also have faced questions about distributing vaccines, including to donors, trustees and relatives of executives.
Medical ethicists said there were many good reasons for MaineGeneral and other hospitals to test processes before opening wider clinics, but even well-intended efforts involving philanthropy staff and donors can be seen negatively.
It is an example of the many nuanced judgment calls being made by states and medical systems across the country, said Johanna Crane, a medical anthropologist at Albany Medical College in New York. As they rush to both vaccinate many people and use available doses as quickly as possible, any effort to ensure equity will always be “imperfect,” she said.
“If you are in a position of privilege to have connections to people who have access to appointments, then that helps,” Crane said.
BDN writer Jessica Piper and The Associated Press contributed to this report.