Rich people pulling strings, offering cash to try to get early access to the COVID vaccine, of course

There’s no evidence in this LA Times piece that any of them have succeeded but why would there be? No one has an incentive to admit to it. The Times interviewed doctors, who obviously won’t cop to letting VIPs cut the line. And black-market activity, even of the high-end variety in which some bigwig dials up a pal at Pfizer or some hospital to gain access, necessarily happens under the radar.

The silver lining on stories like this, per John McCormack, is that they’ll operate as a de facto PR campaign for the vaccine. If celebrities are angling to get first crack, that’s a major selling point in a celebrity-obsessed culture.

But public awareness that line-cutting is being attempted is also an opportunity for the likes of Gavin Newsom and San Francisco Mayor London Breed, both of whom are in political trouble after bending their own social-distancing rules to socialize with friends last month. If Newsom wants to slow down the recall effort against him and win back some fans among voters, he should find some rich bastard who bought his way into getting the vaccine early and make an example of him. If there’s no law yet prohibiting vaccine line-cutting and no disciplinary sanction for doctors who facilitate it, that can be remedied easily enough. A country that sent Aunt Becky from “Full House” to prison for a few months for trying to bribe her dumb kids’ way into USC can find some jail time for someone who bribed their way past senior citizens to get immunized before he was supposed to. Aunt Becky didn’t put anyone at risk of dying, after all.

There are legal and less legal ways of making sure you’re at the front of the line. The less legal way is through simple string-pulling, the favored M.O. of the rich and important since the beginning of the time. The more legal way, the Times notes, is to join a medical concierge practice, which doesn’t — or shouldn’t — mean you get the vaccine before medical workers and senior citizens but ensures that you’ll get it basically the moment you become eligible. There’s no crime in that, although you’re left to wonder whether someone who can afford $25,000 a year for concierge privileges wouldn’t also happily offer another $25,000 under the table for a shot of the good stuff from Pfizer ASAP. “People are willing to pay tens of thousands of dollars” for the vaccine, said one doctor to the paper.

[G]etting earlier access to the shot may not even require much backroom deal-making. Some wealthy patients may get the shots sooner than the average person because they’re members of exclusive healthcare groups that offer the kind of high-quality, primary care most Americans can’t afford…

Doctors in boutique practices say they’ll adhere to public health guidelines in determining who gets priority. But being on a waiting list at a practice that has special freezers and other high-quality resources means you’re already near the front of the line once the supply opens up…

Taryn Vian, a health sector anti-corruption expert who teaches at the University of San Francisco, said powerful people could gain early access to the vaccine not by using bribery or coercion, but through more subtle means, like making requests to similarly powerful friends.

A friend of the leader of a pharmaceutical company, medical distributor, hospital or nursing home could ask if there are any extra doses available, and the leader could ask their assistant to see if they could help. The assistant might then interpret the request as a demand to misappropriate a dose, Vian explained.

One doctor claims that a patient offered to “donate” $25,000 to the hospital he’s attached to in return for the vaccine, which does sound an awful lot like what Lori Loughlin did.

A bribe dressed up as a “donation” presumably might create criminal jeopardy, but fortunately for line-cutters there’s a safer way to gain dubious early access. California has designated “essential workers” and people with underlying health conditions for early vaccination once medical workers and nursing-home residents are done, but the definitions of those terms are conveniently vague. There are tens of millions of “essential workers” across the U.S., with two-thirds of California’s work force qualifying as “essential” per the Times. And a gigantic number of Americans have some sort of underlying health condition. If you’ve got the bread, it’d be easy enough to lawyer your way into arguing that you too are “essential” or have a meaningful health problem, thereby ensuring vaccine access before poorer, less healthy people. That’s another thing that Newsom and California’s legislature could do right now to ensure more equitable distribution of the vaccine — tighten the definitions of the terms to make sure that VIPs can’t sneak through.

The surest way to weaken the black market for the vaccine, of course, is to make sure that the legal supply keeps rolling out to states in a timely way. The less anxious Americans are about scarcity, the more willing they may be to wait their turn in the expectation that they won’t need to wait long. Which is just one reason why this story is bad news:

Officials in multiple states said they were alerted late Wednesday that their second shipments of Pfizer-BioNTech’s vaccine had been drastically cut for next week, sparking widespread confusion and conflicting statements from Pfizer and federal officials about who was at fault…

“We have millions more doses sitting in our warehouse but, as of now, we have not received any shipment instructions for additional doses,” [Pfizer’s] statement read…

Another person involved in the planning, who spoke on the condition of anonymity because they were not authorized to discuss the situation, said Pfizer executives were baffled that the administration was not immediately distributing all of its vaccine, instead leaving much of it on the shelves.

A source in the administration told WaPo that the smaller shipments are due to some sort of timing snafu in which states were placing orders earlier in the week, at a moment when Pfizer’s stockpile was smaller than it was later in the week. But as you’ve just seen, the company itself disputes that. This smells like good ol’ government bureaucratic inefficiency at work, with the feds’ distribution planning a step behind state demand and Pfizer’s supply.

One possibility unmentioned in the article is that they’re worried that states simply don’t have the capacity to manage the glut of vaccine doses they’re expecting next week. Remember that Moderna’s vaccine is set to be approved any day now (possibly today), with millions of doses to be shipped next week along with the new shipment from Pfizer. Given the logistics of storing the two vaccines, conceivably the feds are worried about overwhelming state governments with a supply that’s too large to administer in full over the course of a week and which may therefore end up going partly to waste because the remainder can’t be warehoused properly. Not a great sign, if true.

That’s what Scott Gottlieb, a Pfizer board member, seems to think is happening. I’ll leave you with this.