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Two Maryland hospital systems, GBMC and AAMC, offered COVID-19 vaccines to their board members

Two Maryland hospital systems have offered COVID-19 vaccines to all of their board members, officials confirmed, a move that heightens concerns about the well-connected receiving inequitable access amid a global shortage.

Anne Arundel Medical Center in Annapolis offered vaccines to its 21 board members and those of its parent company, Luminis Health, in early January, after making them available to all employees, “because they are integral to our ability to fulfill our mission,” said Arminta Plater, a Luminis Health spokeswoman.

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Greater Baltimore Medical Center in Towson offered vaccines to members of its three boards in mid-January — after clinical workers, but before the state health department expanded the criteria to include people 75 and over, said Dr. Harold Tucker, the hospital system’s chief medical officer.

The shortage of vaccines has created intense demand across the country. While Maryland awaits more supply from the federal government, less than 10% of state residents have received their first dose of vaccine and less than 4% have received their second as of Thursday, according to the state.

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Gov. Larry Hogan reiterated Maryland’s lack of adequate vaccine supply from the federal government Thursday and said hospitals offering vaccines to board members who are not part of an eligible group “would be absolutely wrong, and we’d like to know the specifics of that.”

“If somebody’s not qualified, they’re not qualified,” the Republican governor said at a news conference in Annapolis Thursday afternoon. “If they’re not eligible, they should never receive a vaccine.”

Hospital board members may receive COVID-19 vaccines if they are eligible under the state’s vaccination plan, state health department spokesman Charlie Gischlar said in a statement.

“Hospitals have also indicated to us that having their senior leaders take the vaccine helps to improve vaccine confidence and uptake among employees,” he said.

The hospitals say they did not violate Maryland’s guidelines on vaccine distribution.

Gischlar did not respond to a follow-up question about whether offering vaccines to all board members, regardless of age or other factors, violated any guidelines.

Despite the state and federal guidance, hospitals have latitude over whom they vaccinate, and in what order, said Dr. Nilesh Kalyanaraman, Anne Arundel County’s chief health officer.

“The hospitals were given vaccines to vaccinate people at the hospital,” he said. “They have to decide how that works.”

Spokespeople for the University of Maryland Medical System, Johns Hopkins Medicine, LifeBridge Health and MedStar Health, the four major hospital systems in the Baltimore region, said they have not offered vaccines to board members who did not already qualify due to their age, occupation or other factors.

“Board members are not considered health care workers,” Hopkins spokeswoman Kim Hoppe said in a statement. “The only Johns Hopkins Medicine board members who have received vaccines from JHM are those who met the criteria in the jurisdiction where our hospitals are located. They have the same access to vaccine appointments as all other eligible individuals.”

LifeBridge Health has 100,000 people on its waiting list for vaccines, and no one who does not meet the eligibility criteria has been allowed to be vaccinated at Sinai Hospital or the system’s other hospitals, LifeBridge spokeswoman Sharon Boston said.

“All vaccination request registrations, including those from board members, are reviewed by a panel to ensure that individuals are eligible before anyone can be scheduled for a vaccination,” Boston said in a statement.

“From the outset, LifeBridge Health has had a medical ethicist as part of the vaccination planning team to offer insights and guidance on the rollout process, particularly as it pertains to limited supply,” she added.

Harald Schmidt, an assistant professor in the department of medical ethics and health policy at the University of Pennsylvania, said giving board members vaccines during an ongoing shortage is unethical and diminishes the work being done by others to ensure that the most vulnerable groups receive the doses they need.

”This is not the time to jump the line, whether you have connections with means or otherwise are able to do that,” Schmidt said. “That just creates chaos, and what we need is a structured approach.

”The focus really has to be on risk-vulnerability and equity, and not connections.”

The news of board members being offered vaccines follows reports of workers at elite medical institutions around the country being prioritized, in some cases against the Centers for Disease Control and Prevention’s and states’ recommendations.

Those currently eligible in Maryland include health care workers, front-line hospital staff, nursing home residents and staff, first responders and public safety workers, teachers, people with disabilities, people in assisted living and group homes, veterinarians, clergy, grocery store workers, mass transit workers, people over age 65 and those with some preexisting health conditions.

The dozens of members of the GBMC HealthCare board, the Gilchrist Hospice Care board and the GBMC Philanthropy Committee, some of whom serve on multiple boards, were among about 600 hospital “volunteers” offered vaccines in the third and fourth tiers of GBMC’s vaccination plan, once doses had been offered to all clinical staff, Tucker said.

“At no time did we set up a separate session where [board members] would come in and get it done,” Tucker said. “We followed standard protocols of having a very structured, tiered approach.”

Only about half of GBMC’s front-line clinical workers had received a vaccine from the hospital system when board members were invited to make appointments in mid-January, he said. But because of a two-week delay in vaccine delivery, Tucker cautioned, “there may be many more who did it elsewhere.”

As of Thursday, close to 60% of the hospital’s clinical workers had been vaccinated.

“Some of those front-line staff work at other institutions,” Tucker said. “We didn’t require them to get it done through GBMC.”

The hospital is not requiring its employees to be vaccinated at all, he said. While the vaccines were offered to all board members, he could not confirm how many got the shots, and, he said, some got vaccines elsewhere.

GBMC began doling out its first 1,000 doses of the Moderna vaccine to physicians, nurses and other clinical staff in the “highest risk areas,” such as emergency rooms, intensive-care units and operating rooms, during the week of Dec. 28, Tucker said.

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In the first week of January, GBMC administered an additional 1,500 vaccine doses — these from Pfizer — to more clinical staff, as well as doctors, nurses and staff at the Gilchrist Centers, the Ambulatory Testing Center and the hospital network’s other affiliated practices, Tucker said.

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Board members and other volunteers were offered appointments the week of Jan. 11, as the numbers of front-line staff signing up for the latest batch of 1,000 vaccines “were dwindling,” Tucker said. The hospital system notified eligible patients when Hogan expanded the criteria to include them, and it has offered vaccines to nonaffiliated community members over age 75, Tucker said.

“We’ve tried to be very thoughtful, systematic and ethical about it,” he said. “We followed our approach, which was ethically based, and the governor’s guidelines. … I don’t think we were unfair to any group that wanted to get the vaccine. I think we handled it quite appropriately.”

While GBMC confronted delayed vaccine shipments, the Anne Arundel Medical Center got them quicker than expected, allowing officials “to open up vaccination more broadly than we anticipated,” said Plater, the Luminis Health spokeswoman.

The Annapolis hospital will be offering vaccine appointments “to all of our volunteers and the broader community as we confirm and secure vaccine supply from the state,” Plater said.

“We will continue to open vaccine registration as we move through this process — prioritizing vulnerable populations in accordance with CDC and state guidance,” she said in a statement.

While all board members were offered appointments, it’s not clear how many got shots, because Anne Arundel Medical Center does not track their vaccinations separately from the rest of the population.

Bob Atlas, president and CEO of the Maryland Hospital Association, said the hospitals who offered board members vaccines were acting “in good faith” and “interpreted the initial guidance” from the state in a manner that led them to believe they were eligible.

The Maryland Department of Health has since updated its eligibility criteria, and state hospitals have administered 350,000 vaccine shots in the past two months, Atlas said, vaccinating all willing frontline staff members and now prioritizing patients with compromised immune systems.

“They are also working with MDH and local health departments to bring vaccines to those most vulnerable in their communities,” he said in a statement. “They are in the pandemic fight for the long haul.”

Although doses given to board members detract from an already scarce supply of vaccines, Schmidt, the medical ethicist, said the greater concern might be the perception it creates among the general population waiting to be vaccinated.

”A really important aspect here is trust in the system, and the damage there could be immense,” Schmidt said. “This is only a small number of people, but people just think, ‘Well, the system is biased in favor of the rich and connected.’ That is certainly not what we need now.

“If there’s one thing that 2020 and our dealing with COVID has told us, is that it has had a hugely disparate impact on people who have the most to lose as it is, so these kinds of initiatives will only exacerbate these disparities and don’t help with turning the corner that we need to turn.”

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