Coming to a black market near you: the Covid-19 vaccine

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The Covid-19 vaccine could end up on the black market, experts warn.

The much-criticized deployment by the Trump administration laid the groundwork for a scenario in which the wealthy and politically connected use their money and power to cut their tails and get vaccinated before anyone else, they said.

New York Governor Andrew Cuomo has previously threatened to impose fines of up to $ 1 million and revoke the licenses of doctors, nurses and others who fail to meet state and government vaccine distribution guidelines federal government, which currently prioritize inoculation of primary health care caregivers and nursing home residents.

There have been reports in Miami of large hospital donors who received the first vaccine and in New York of tycoons transporting their friends to Florida to be vaccinated with doses reserved at a nursing home.

And in Colorado, some teachers are crying out loud after nurses and educators in wealthier public school districts and private schools got vaccinated first.

“It’s a bit frustrating that districts that don’t already have the same wealth accumulated around them are lower on the totem pole,” said a ninth grade teacher from Aurora Public Schools, one of the most poor people from the Denver area, who asked not to be identified by name. “Districts that were already receiving a lot of support got it before districts that need more support.”

Arthur Caplan of the Grossman School of Medicine at New York University and one of the nation’s top bioethicists said the complaint would likely be heard a lot louder as the rift between vaccine holders and non-vaccine holders widened. vaccinated.

“We hear of some politicians, some administrators of large hospitals and others getting vaccinated before healthcare workers and the elderly,” Caplan said. “I also hear that some [drug manufacturing and distribution] companies say as soon as government contracts are executed, they will make getting vaccines a priority. “

The result will be higher prices for everyone, Caplan said.

“Anything that is seen as potentially saving lives, saving lives and is in short supply creates black markets,” Caplan said, echoing remarks he made in an interview last month.

Scarcity helped turn toilet paper and face masks into gold at the start of the pandemic, and it is likely that it will do the same for vaccines, making them especially attractive to thieves and foreign copiers, have other experts said.

“The danger is that there is already a market for unregulated drugs,” said Michael Einhorn, president of medical supplier Dealmed. “And the problem is that the products will be imported from foreign countries that may not have as strict regulations as the United States – where the products can be diverted, sold alongside and imported into the United States. “

Jonathan Cushing of Transparency International, an anti-corruption watchdog, issued a similar warning in November.

“The vaccine is likely to have a high ‘market value’, making government supplies an attractive target for theft and diversion unless adequate safeguards are built into supply chains,” Cushing wrote.

Cushing said in an email that so far he has not seen “any black market issues in the United States”, but the potential is there.

“There have been reports of substandard or falsified vaccines already made in India, as well as falsified hand sanitizers in the United States appearing throughout the pandemic,” he said. “We’ve also seen people use connections to access drugs that are supposed to be therapeutic, like hydroxychloroquine.

“I would say that much of the planning for distribution in the United States was done too late in the day, and the lack of clear guidelines and eligibility criteria for receiving vaccines is probably the root cause of many problems encountered. in the United States at the moment, ”he added. And then that lack of planning gives individuals the ability to skip the line and exploit their position to put vaccines ahead of others. ”

Dr Sadiya Khan, epidemiologist at Northwestern University’s Feinberg School of Medicine, agreed and added that the lack of a cohesive vaccine distribution plan is clear evidence that the federal government has not learned lessons. of its failure to step up testing to slow the spread of the virus.

“The lack of any federal infrastructure in the counties and states is leading to total disaster in addition to inefficient distribution,” Khan said. “The distribution of vaccines is groundhog day of what the Covid-19 test was at the start of the pandemic. These significant delays are likely to lead to more hospitalizations and preventable deaths. “

President-elect Joe Biden, who has joined the chorus of critics criticizing President Donald Trump’s Operation Warp Speed ​​for failing to meet his target of deploying 20 million vaccines by the end of 2020, has committed to “moving heaven and earth” to accelerate the pace of distribution.

Biden also pledged to invoke the Defense Production Act, which allows a president to force private companies to prioritize the manufacture of certain items for national security.

In Colorado, teachers were thrown into a loop this week after the State Department of Public Health and Environment surprised educators by suddenly announcing Wednesday that it was prioritizing first responders and people. elderly. The announcement came just a week after Governor Jared Polis put teachers on the state’s priority vaccine list.

By that time, school nurses and health workers in affluent public school districts like the Cherry Creek School District in suburban Denver had already been vaccinated, as had several teachers in private schools like the UK Primary School. Stanley in Denver, NBC News has learned.

Asked two private school teachers who posted pictures online of themselves holding immunization cards after being vaccinated last week at a local pharmacy, Sumant Bhat, headmaster of the UK Stanley Primary School , said in an email that he had not arranged any vaccinations for his staff.

“While teachers are now in Category 1B, we have communicated internally that they are currently below the line in that category and therefore ‘NOT’ for the vaccine at this time,” Bhat wrote. “We are in frequent contact with our network of independent schools and our public health partners to determine when we will be able to deploy a thoughtful plan to make vaccines available to our teachers and staff.

With the federal government leaving it to local authorities to distribute the vaccine, Caplan said the likelihood that a low-priority person will be offered a vaccine is increased.

Caplan’s advice for resolving this ethical dilemma?

“We believe the employee should accept the vaccine,” wrote Caplan and fellow ethicist Kyle Ferguson. “What objectives would be favored by the refusal? Those who feel the force of the dilemma assume that their refusal would release a scarce resource, that the released dose would end up in the arm of someone who needs it most. But it is debatable. It is likely that the vaccine will not leave the facility. “

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