The Ethics of Hunting Leftover Vaccines
Sites like Dr. B have encouraged people, eager for their vaccine, but not yet eligible, to be on the lookout for a leftover dose. But while some sites will dole out leftover vaccines to ineligible people at the end of the day, other vaccination sites — especially those operated by the Federal Emergency Management Agency — have strict regulations for where leftover vaccines can go.
For example, the RingCentral Coliseum in Oakland is a FEMA-operated site. According to officials from the California Governor's Office of Emergency Services, site operators will call the Alameda Office of Education, the Sheriff's Office and the Transportation Commission to give leftover vaccines to vulnerable individuals in high-risk jobs.
Other sites, like San Francisco's Moscone Center, operated through Kaiser Permanente, have different guidelines that allow them to be more loose with their leftover vaccines.
"Standard practice is that appointments are required at the Moscone vaccination hub," a spokesperson from San Francisco's COVID Command Center said — but "occasionally, when small amounts of unused vaccines are left over at the end of the day, vaccines may be made available to a limited number of people who do not have appointments."
But Binkley is skeptical of this standby-line model for vaccine distribution.
"Is 'first-come, first-served' really a great ethical model? Well, no," he said. "Typically the 'first-comers' are not the most vulnerable, or who need it the most."
Binkley worries that when people wait in line for a leftover vaccine, the people who might need a vaccine, but can't wait in line, aren't able to get that shot. And he worries that sites like Dr. B perpetuate this problem.
If Dr. B prioritized people not by who signed up first, but instead based prioritization on a person's personal information and health circumstances, they could "prioritize you according to the phases and the tiers that have been decided on," Binkley said.
"So, if you have a line forming for leftover doses at the end of the day and you have a healthy 22-year-old at the front of the line and a 89-year-old with diabetes at the end of the line, you would prioritize the 89-year-old over the 22-year-old, just based on phases," he said.
In Binkley's ideal ethical world, Dr. B would morph into a structure of volunteers who would get the vaccine — but who would also bring along people who don't have access to transportation, or who are from more vulnerable populations, to get the vaccine with them.
"What I would love to see is people saying, 'OK, I'm going to get my vaccine, I'm going to reach out to people I know who don't have transportation and see if they want to go with me," Binkley said. "So that we not only think about ourselves, and we think about our neighbor."