States holding key vaccine discussions in closed meetings
IOWA CITY, Iowa — As the nation's COVID- 19 vaccination campaign accelerates, governors, public health directors and committees advising them are holding key discussions behind closed doors, including debates about who should be eligible for the shots and how best to distribute them.
Are view by The Associated Press finds that advisory committees created to help determine how to prioritize limited doses have held closed meetings in at least 13 states that are home to more than 70 million people.
In at least 15 other states, the meetings have been open to the public, the AP found. But even in those states, governor sand health departments can modify or override committee recommendations with little or no public explanation. In several others, governors and their staffs make decisions without formal advisory bodies to guide them.
The lack of transparency raises the risk that some decisions will be grounded in politics rather than public health and that well-connected industries could receive special treatment while the concerns of marginalized groups are ignored.
“You don't want to have `God squads' making these decisions about life and death without any kind of public oversight or public accountability ,” said Oregon State University professor Courtney Campbell, an expert in bioethics.
In Iowa, the governor moved legislators and other Capitol employees ahead of inmates and correctional officers on the vaccine priority list, despite at least 19 coronavirus deaths among state prisoners and staff. In Oregon, the governor prioritized teachers for shots before the elderly without seeking a recommendation from an advisory committee that has debated other sensitive topics publicly.
Campbell praised the Oregon panel's transparency and commitment to equity but criticized the lack of public deliberation that went into the decision on teachers. “You want to know what groups are prioritized but also what evidence is used scientifically to determine which should go first and their reasoning process,” he said.
The federal Advisory Committee on Immunization Practices has recommended t hat states “promote transparency” as one of four ethical principles in vaccine allocation programs. The committee advised in November that decisions and plans “must be evidence- based, cl ear, understandable and publicly available,” and that public participation in their creation and review should occur to the extent possible.
Public distrust of government has been a major problem throughout the pandemic, and “you want to take those kinds of factors that contribute to public suspicion out of the equation,” Campbell said.
When Texas' vaccine panel met last month, the subject of equity surfaced. One member said that obtaining racial and ethnic data on vaccinations would be critical to assessing whether the state's efforts were succeeding.
But the identity of that member — and where that discussion wound up — is unknown. That the topic was mentioned at all is known only because of meeting notes that state health officials provide through open records requests but do not post publicly.
The notes also mentioned worries about elderly residents who are unable to stand in line and concern over dry-ice freezers used to store vaccines. But the three-hour panel meetings that occur most Mondays are not open to the public, leaving the state's 30 million residents in the dark about how decisions are made.
Across the country, officials say they closed the meetings so that health experts, industry representatives and other panel members can have freewheeling discussions on sensitive topics.