Some think Moderna VIPS may cut the line to get scarce Covid-19 vaccine

When biotech company Moderna announced Tuesday that it planned to offer its workforce a chance to get vaccinated with its recently authorized Covid-19 vaccine, their decision raised some eyebrows. In addition to employees, the company said it would offer shots to its board members and the “adult household members of our team.” Moderna’s decision calls into question whether there are loopholes that will allow some people to cut the proverbial line to get their shot.

“What it appears to be is, privilege and power gaining priority access to the vaccine,” said Dr. William Moss, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.

Nancy Berlinger, a research scholar at The Hastings Center, a nonprofit think tank, agreed. “It’s a rather problematic example that [the vaccine] is going to go to the VIPs first rather than to rank and file. You can imagine people are watching this pretty closely,” she said.

Vaccines against Covid-19 are largely seen as a way out of a pandemic that has wreaked havoc across the globe over the last year, but at the moment they are in very scarce supply. In the United States, two — one developed by Moderna and the other by pharmaceutical giant Pfizer in partnership with BioNTech — were given Emergency Use Authorization earlier in December by the US Food and Drug Administration, and several more vaccines are in the pipeline.

According to the US Centers for Disease Control and Prevention, more than 12 million doses of the two vaccines have been distributed to states so far, and nearly 2.6 million doses have actually been administered, mostly to health care workers and residents of long-term care facilities — the two groups in the CDC’s recommended-first tier for vaccine prioritization.

In a company-issued statement, Moderna explained that it is making the shot available to its workers in the United States through a voluntary and confidential program “to provide an additional layer of COVID-19 protection” because Moderna workers are conducting essential services in developing, manufacturing and delivering the vaccine.

As for the adult household members of people on the team, the rationale is “to reduce the risk of absenteeism and disruption due to a COVID-19 infection in an adult household member.”

In an email to CNN, a spokesperson for Moderna said, “We have committed specific volumes to the US Government, and we expect to meet those commitments. So these are doses beyond those commitments and sales.” He noted Moderna has approximately 1,200 employees.

This is in contrast to Pfizer, a global behemoth with almost 90,000 employees. According to a statement sent to CNN Monday, “Pfizer plans to vaccinate its employees as groups of them become eligible per the CDC guidelines. The first group is expected to be the company’s essential workers, especially in manufacturing, who are critical to the vaccine effort and the continued supply of all Pfizer medicines. There are no plans to prioritize the vaccination of our executives or board members ahead of other high-risk groups.”

In an interview from mid-December, Pfizer CEO Albert Bourla told CNBC that while he is very excited to get vaccinated when it’s his turn, he doesn’t want to be seen as “cutting the line.” However, he said one circumstance that would lead him to get vaccinated early would be to help increase public confidence in its safety.

But that would not apply to other Pfizer employees. “We have made the decision that if we have to do that, we will not do it with our executives. So, none of the executives or board members will cut the line, they will take it as their age and occupation type is,” said Bourla.

While none of the experts CNN spoke with for this story thought the number of vaccines that might go to Moderna employees would at all affect the vaccine supply available for general distribution, they said it was a matter of fairness and perception.

“Moderna is trying to reward the board and the company for getting the job done about creating vaccines. I’m going to say it’s prioritization based on gratitude. I get it; I understand the desire to do that,” bioethicist Arthur Caplan said.

But Caplan, director of the Division of Medical Ethics at the NYU Grossman School of Medicine and a CNN analyst, still doesn’t think it passes the sniff test.

“In general, my view is, you try to stick with the high-risk folks and get agreement on who they are and get them done: nursing home folks, healthcare workers. I think that’s the right way to role model by the manufacturers of vaccines. I’m not even happy that so many politicians are getting vaccinated,” he said.

Caplan is an unpaid adviser to Moderna (as well as to Janssen, maker of another vaccine candidate) but did not advise Moderna on this issue.

The company can argue that those involved in the vaccine manufacturing should be considered essential workers.

“I do have concerns about prioritizing the board members [but] not the employees who are on the frontline manufacturing the vaccine,” said Moss.

Board members, Moss said, tend to have the type of job “where it’s very easy to work remotely and protect yourself. In certain other types of jobs that are essential, it’s impossible to [work remotely], and that includes frontline health care workers but also the bus drivers, the teachers, people who work in grocery stores.”

“Vaccine, manufacturing is obviously an essential industry during a pandemic that is only going to be ended by the development, manufacturing, distribution of that vaccine — that’s pretty clear,” Berlinger said.

“However, we’re in a time of limited supply, and we have to prioritize … across a very large country. [It’s] important to keep in mind that we shouldn’t conflate an essential industry with being in a high-risk environment. That is, not everybody who’s involved in the manufacturing or the distribution of a vaccine is actually at high risk of either getting Covid or getting severe Covid,” she said.

Berlinger, who is lead author of The Hastings Center’s Ethical Framework for Health Care Institutions Responding to Covid-19, said the Moderna situation presents an “ethical test” for people who have access and can jump the queue. “Should you take advantage of your access? Should you jump the queue if you have a chance?”

“If you can protect yourself, you should wait your turn, because this is one of those situations where the more people who use their access to go to the head of the queue, it actually starts slowing things down for other people,” she said.

Caplan also comes down on the side of waiting one’s turn.

“If I were them, I’d say ‘No Thanks, I’ll wait until my turn comes.’ It’s an offer that doesn’t have to be accepted,” said Caplan. “If you’re going to take the offer, you want to be ready to stand in front of a nursing home resident or a high-risk healthcare worker and say, ‘This is why I felt justified in saying yes.'”