Santa Clara County considers penalties for inequitable COVID-19 vaccine distribution
Clinical nurse Jesse Rideout sticks a syringe into the first dose of the COVID-19 vaccine before administering it at O'Connor Hospital in San Jose, Calif. (San José Spotlight / Vicente Vera, Pool)

    Santa Clara County officials are publicly worrying whether area health care providers will stick to the guidelines when it comes to distributing COVID-19 vaccines, and deliberating what the county could and should do if they don’t.

    Already, in at least two cases so far, private health care providers in California — including one in the South Bay — have distributed coronavirus vaccines in questionable ways, skipping over at-risk people who are eligible or offering doses to groups that would otherwise be ineligible.

    Unhappy with how private providers have administered coronavirus testing, county leaders worried about whether the vaccines will go to those who need them most.

    “I know that the hope and expectation is that that responsibility will be undertaken by folks in the health care arena who are in the private and nonprofit sector outside the governmental sphere,” said County Supervisor Joe Simitian during the county’s health and hospital committee meeting in December. “But we had that hope and expectation with testing only to be disappointed, frankly.”

    The first doses of the Pfizer and Moderna coronavirus vaccines made their way to area health care providers at the end of last month. The vaccines are seen as essential to ending the COVID-19 pandemic. But because the initial number of doses are severely limited, government officials have created priority lists for who should receive them. California’s public health department has mandated that health care workers at risk of exposure to COVID-19 need to be first in line for the vaccine.

    That’s not what happened at Stanford Medicine, though.

    The organization, which runs Stanford’s School of Medicine and Stanford Health Care, allocated doses of the vaccine to just seven of its 5,000 medical residents, according to ProPublica. The organization excluded from receiving the vaccine residents who work closely with COVID-19 patients, while putting on the initial vaccination list higher-ranking doctors who were less at risk, according to the report. Stanford blamed a flawed algorithm that determined the distribution of the initial vaccines and promised to vaccinate all at-risk workers when it received more doses.

    Meanwhile, in San Diego, Sharp HealthCare ended up having a surplus of vaccine doses and gave them to police officers and firefighters, according to according to KGTV. Police officers are not in the California’s first group of people who are supposed receive the vaccines. The provider was worried the doses would expire if they weren’t used right away, but failed to contact county health officials to get direction on what to do with the surplus, KGTV reported.

    hree vials containing the COVID-19 vaccines being administered at O’Connor Hospital in San Jose, Calif. (San José Spotlight / Vicente Vera, Pool)

    But county officials are worried private health care providers may hold back vaccines. Adding to their concern is the track record of area health care providers in administering COVID-19 tests.

    For months, the county criticized private health care providers that were limiting the number of COVID-19 tests they were offering.

    It eventually approved the imposition of financial penalties of up to $5,000 on providers that weren’t offering sufficient numbers of tests. By early December, county officials had issued $40,000 worth of fines to local hospitals for failing to comply with its coronavirus testing order.

    County health officials don’t yet have a system in place to fine or otherwise punish health care providers that don’t follow the rules and dispense vaccines to their most at-risk workers first. But the county could approve put in place a new order that would give officials that authority and require private hospitals to follow guidelines in distributing vaccines, County Executive Jeff Smith said.

    “If, for example, we felt like a particular health system was hoarding or not complying with the state and federal regulations or in some other way sabotaging the need in the community,” Smith said said during the December meeting. “There certainly is the possibility of a local health order to straighten that out.”

    Providers that violate the guidelines already face possible state sanctions. Gov. Gavin Newsom last month warned that health care providers who vaccinate people outside of priority groups could lose their licenses.

    “If you skip the line or you intend to skip the line, you will be sanctioned, you will lose your license,” Newsom said. “You will not only lose your license, we will be very aggressive in terms of highlighting the reputational impacts as well.”

    However, Newsom said the state would not issue penalties against health care providers trying to use a vaccine before it expires.

    “The key is to make sure while we are enforcing against the rules of the road, we’re not necessarily enforcing against common sense and the energy of someone who says I don’t want to waste this dose,” Newsom said. “We’re just looking for gross negligence, people who are skipping the line that know they shouldn’t be skipping the line, people taking care of people of means and influence and not the rest of us.”

    As of Jan. 3, 454,306 COVID-19 vaccines have been administered in California.

    Have a question about COVID-19 vaccines? Email [email protected] and we’ll get the answer.

    Contact Mauricio La Plante at [email protected] or follow @mslaplantenews on Twitter.

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