Vaccine shortages have led to theft, smuggling and a free-for-all to get doses.
Will it happen again with COVID- 19?
“I’m concerned about people fraudulently selling vaccine and people being defrauded by (phony promises).”
—Dr. Georges Benjamin, executive director of the American Public Health Association
CHICAGO — Sixteen years ago, in the middle of a wretched Chicago Bears season, a scandal erupted at Halas Hall that had nothing to do with inept quarterbacking or sketchy play calling — but like the Bears’ misery, it remains relevant today. ¶ An acute shortage of influenza vaccine gripped the country in the fall of 2004, forcing the elderly to wait in hourslong lines for a dose, often without success. The scarcity became such a hot political issue that both President George W. Bush and his election challenger, John Kerry, forswore flu shots until the crisis eased. ¶ But even as Illinois flu clinics closed for want of the vaccine, the Bears obtained shots through their prescribing physician and offered them to players — young men in superb physical condition who fell far outside the rationing guidelines established by federal health officials.
“Everyone should be stepping up … and giving (the vaccine) to those who need it,” Dale Galassie, then the executive director of the Lake County Health Department, said when the news broke. “I’d like to know why an athlete in top shape is being given a flu shot.”
The uproar in Lake Forest was just one small part of a national ruckus over the vaccine that lasted for months. Along with cries of unfairness came reports of more sinister matters such as theft, smuggling and price gouging.
As America prepares to distribute another scarce vaccine, some are wary that history could repeat. Interpol is warning that criminals are scheming to intercept COVID-19 vaccines, and federal officials have raised concerns about counterfeit doses — the scenario that most worries Dr. Georges Benjamin, executive director of the American Public Health Association.
“My biggest fear is not so much that too many celebrities will get it first,” he said. “Tragically, that’s going to happen. I just hope there’s not a lot of it. My biggest fear is the black market and the false market. I’m concerned about people fraudulently selling vaccine and people being defrauded by (phony promises).”
Vaccine distribution is typically handled by private entities. In the case of flu vaccines, federal health officials tell manufacturers what to make, and health clinics, hospitals and physicians place their orders.
But the system went haywire in 2004 when a bacterial contamination spoiled 50 million doses bound for the U.S., creating a massive shortage. While the U.S. Centers for Disease Control and Prevention announced a rationing plan to save doses for infants, the elderly and other highrisk people, it was voluntary.
That created a free-for-all in which some health care providers got the vaccine and others didn’t. Seniors crowded pharmacies and doctors’ offices in search of shots, and in some cases traveled all the way to Canada for a dose (a “flu cruise” that ran out of Seattle charged $105 for a scenic boat ride and a shot).
Some were out of luck no matter where they looked.
“If I don’t get the flu shot it will do me in,” a 68-year-old man with an oxygen tank told the Chicago Tribune while waiting more than seven hours for the vaccine at a Mundelein grocery store.
The Bears, meanwhile, secured the vaccine through their prescribing physician weeks before the shortage was announced. But they didn’t give the shots until the scarcity was front-page news, prompting a flood of angry phone calls to the team switchboard once word leaked out.
Though the Bears offered shots to the entire organization, a spokesman said only two players with asthma ended up getting them, along with an undisclosed number of staffers. Some, such as defensive end Michael Haynes, said they declined on moral grounds.
“It’s offered to everybody, but some guys are like, ‘You know what, other people deserve to get it more than we do,’” he said.
The Bears said they returned the unused doses to their doctor, who gave them to high-risk patients.
The crisis also brought price gougers, smugglers and thieves out of the woodwork. A California pharmacist said a vendor offered a vial of 10 shots for $700, a tenfold markup over the usual price. A New Jersey convenience store owner illegally imported hundreds of doses from Saudi Arabia and tried to sell them to a hospital, only to be caught in a sting.
And at a health clinic in Colorado, someone slipped into a backroom and made off with 620 doses intended for children.
“I just can’t believe anybody would do this,” a doctor said. “It means it probably is on the black market somewhere.”
Could something similar happen with the COVID-19 vaccines? Some signs are ominous.
The vaccines will travel through global supply chains, and Interpol, the international law enforcement agency, has warned that “high demand combined with a limited supply will make COVID-19 vaccines the equivalent of liquid gold to organized crime networks as soon as one is available.”
U.S. Customs and Immigration Enforcement officials say they anticipate that criminals will also try to sell counterfeit vaccines to the unwary, possibly via social media ads, illicit websites or robocalls.
Hackers are looking for a piece of the action too: IBM cybersecurity experts say someone, likely operating on behalf of a nation-state, tried to penetrate the computer systems of companies involved in keeping the vaccines cold. The intent behind the attempted breach wasn’t clear, they said.
Some experts, though, said they are confident the initial batches of vaccine, intended for health care workers and nursing home residents, will be secure, at least as they travel to local hospitals and health clinics.
“(Foul play) is probably not going to happen in the big shipments because they’re GPS trackable,” said Northwestern University logistics expert Hani Mahmassani, who has run a workshop on COVID-19 vaccine distribution.
“The opportunity to steal it, unless you have a major criminal operation, is very restricted. Once it’s available locally and is administered (in settings) like we’re doing with COVID tests, there will be much less control.”
But Jeff Thiel, assistant vice president for pharmacy services at NorthShore University HealthSystem, said the organization’s hospitals will treat the vaccine like a controlled substance once it arrives.
“We’ll have it on inventory, locked up, not accessible to everyone,” he said. “We’ll treat it very carefully and make sure we have tight controls.”
The COVID-19 vaccine differs from flu shots because doctors, hospitals and health clinics won’t be dealing with manufacturers. The federal government is the only U.S. customer for the vaccines, and will distribute the doses through state and local health departments.
Emory University’s Dr. Walter Orenstein, former director of the U.S. Immunization Program, said that should reduce the opportunities for chicanery.
“I think the likelihood is slim given the tremendous (government) control,” he said. “If, at some point, it becomes a complete private sector market, then these things might happen.”
Mahmassani noted that other countries are producing their own vaccines, and those could be smuggled into the U.S. if demand is high. But Dr. Amesh Adalja of the Johns Hopkins Center for Health Security said he was hopeful intense government oversight will blunt that threat, too.
As for low-risk but well-connected people jumping the line, immunologist Barry Bloom, former dean of the Harvard T.H. Chan School of Public Health, said it probably won’t happen much at first, but could become a problem once the distribution list broadens to include essential workers.
Some states, he noted, have already given that designation to professional wrestlers and financiers.
Illinois Gov. J.B. Pritzker, asked how the state will prevent wealthy or influential people from getting the vaccine out of turn, didn’t answer directly, but said local health departments must have their distribution plans approved by the state.
Dr. Candice Robinson, medical director for the Chicago Department of Public Health, said her agency will adhere to the priorities established by the federal government. Thiel said those rules should discourage surreptitious vaccine seekers.
“We have pretty specific guidance on who should receive this product,” he said. “We have something to show to individuals (about) where they fit into the schedule.”