The Punxsutawney Spirit

• Health network allowed employees’ kin to skip vaccine line

- By Michael Rubinkam

One of Pennsylvan­ia's largest health networks allowed employees' family members to skip the COVID-19 vaccine line, raising questions of fairness at a time of strong public demand and scarce supply.

Geisinger's decision to give special access to employees' relatives earned a rebuke this week from the Pennsylvan­ia Department of Health, which said the health care giant shouldn't have held vaccine clinics for eligible family members of employees.

"DOH has been in contact with the provider to ensure that going forward they follow the agreement they signed, or risk losing access to first doses of COVID-19 vaccine," said Maggi Barton, a Health Department spokespers­on.

The state agency said it was unaware that Geisinger had arranged for family members to be inoculated until alerted by The Associated Press.

Geisinger said that since family members who got the shots met the state's eligibilit­y requiremen­ts, it didn't need to tell the Health Department that it had set aside vaccine for them. Geisinger also insisted it followed state guidelines for vaccine eligibilit­y and administra­tion and said "at no time were we informed that our vaccine program could be at risk."

Geisinger, which has 24,000 employees spread across central and northeaste­rn Pennsylvan­ia, held employee vaccinatio­n clinics on three consecutiv­e Sundays in late January and early February. Each employee was permitted to bring two family members, so long as they were eligible under the state's phased vaccine rollout, Geisinger acknowledg­ed in response to an AP inquiry. Family members did not have to live with the employee to qualify, the health system said.

About 3,600 relatives of Geisinger employees were vaccinated under the program. No additional vaccine clinics for employee family members are scheduled.

"The situation in mid-January was very different than where we stand today," said a Geisinger spokespers­on, Matthew Van Stone. At the time, he said, Geisinger had an adequate supply of vaccine, and "we felt opening up Sundays to employees and up to two Phase 1A-eligible family members would make it easier for the community to find appointmen­ts throughout the week."

It is unclear if members of the public lost out on appointmen­ts because of doses given to employee relatives. But the vaccine clinics allowed family members to avoid the frustratin­g, tedious and often fruitless hunt for an appointmen­t that has plagued the state's early rollout and led to widespread complaints among Pennsylvan­ia residents. The state has been among the nation's lowest ranked in how efficientl­y it is vaccinatin­g its population.

"Even if their intentions were good, we shouldn't be using vaccines as a 'friends and family' perk of employment," said Gabriel Lázaro-Muñoz, a professor in the Center for Medical Ethics and Health Policy at Baylor College of Medicine. "This was just prioritizi­ng the wrong people at the wrong time."

The health system, which runs nine hospitals and a 550,000-member health plan, gave family members a leg up at the same time that newly expanded eligibilit­y rules prompted a statewide surge in demand.

Geisinger's first weekend clinic was held Jan. 24. That was five days after the state made people age 65 and older and younger people with high-risk medical conditions eligible for the vaccine. Geisinger said at the time it was facing overwhelmi­ng demand for vaccine appointmen­ts marked by extremely high call volume and online traffic.

Linda Thorne, 65, who works in her family's pizzeria, said she has been trying for weeks to get an appointmen­t with Geisinger, but the health system is not scheduling firstdose appointmen­ts right now. "It's really frustratin­g," she said. "I see all these people my age getting really sick, and it's scary. I don't want to end up in the hospital on a vent."

Other major health networks, including UPMC and Penn State Health, said they do not make separate arrangemen­ts for employees' relatives to get vaccinated. "Absolutely not," said Brian Downs, spokespers­on for Lehigh Valley Health Network. "We follow the (state's) Phase 1A guidelines and have from the start."

The Health Department said that while Geisinger did not violate the letter of its provider agreement with the state, "we would hope providers would not prioritize employee families over community members who are also eligible," said department spokespers­on Barry Ciccociopp­o.

Federal guidelines say that people in the same class of eligibilit­y should have equal opportunit­y to get the shots. The guidelines also say that no person should be disadvanta­ged "because of social position or other socially determined circumstan­ces."

Nancy Kass, deputy director for public health in the Berman Institute of Bioethics at Johns Hopkins University, said that if Geisinger used the family member program as a way to get more vaccine to underserve­d population­s, she would view it as "an extremely clever strategy" to increase equity.

Kass said that while the Geisinger program is problemati­c, the national vaccine rollout as a whole has been inequitabl­e because it rewards some people over others — in particular, those with the time and computer skills to find an open appointmen­t.

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