When Stanford Health Care and Stanford Children's Health administered the first doses of the COVID-19 vaccine on Friday, Dec. 18, most of its resident physicians, many of whom are on the frontlines of caring for patients with the deadly virus, weren't among those being inoculated, according to a letter to hospital leadership.
In response, a large group of resident physicians staged a protest in front of Stanford Hospital on Friday morning to raise concerns over the allocations.
Of the 5,000 doses of the vaccine in the hospital's planned rollout to hospital employees, only seven residents and fellows were included, the Chief Resident Council said in the Dec. 17 letter sent to the medical center's leadership.
"There is still no articulated plan to vaccinate the remaining 1,300+ residents and fellows, including those on the front line directly treating COVID-19 patients," the letter said. The residents felt "a deep sense of distrust towards the hospital administration given the sacrifices we have been making and the promises made to us," the letter said.
"Stanford's decision to de-prioritize residents and fellows is defenseless on the basis of science, reason, ethics, and equality. Many of us know senior faculty who have worked from home since the pandemic began in March 2020, with no in-person patient responsibilities, who were selected for vaccination. Meanwhile, we fellows strap on N95 masks for the tenth month of this pandemic without a transparent and clear plan for our protection in place."
In a Dec. 17 email obtained by this news organization, a member for the Graduate Medical Education community, of which the residents are a part of, said: "This is of course hurtful and frustrating as many of us have been on the frontline for weeks and we are actively being recruited onto the COVID ICU Surge unit."
The hospital's vaccine task force allegedly did not alter the list when they were contacted by the residents. The residents said they were not included due to an algorithm the hospital followed because they don't have a "location," such as being assigned to a specific nursing unit or nursing emergency department unit, and thus received zero points in the algorithm. Age was also a factor, and the residents received fewer points because they are younger, according to the email.
"Even many of our ICU fellows are not included in the vaccine pool for tomorrow (Dec. 19)," a resident who requested anonymity told this news organization.
Dr. Niraj L. Sehgal, chief medical officer for Stanford Health Care, apologized for the way the vaccine allocations rolled out in a letter on Thursday to the graduate medical education community.
"I wish we had been able to focus on the excitement of tomorrow and the start of our vaccination efforts. Despite our best intentions to thoughtfully map out a principled vaccine plan to include our residents, fellows, and faculty, it's clear there were several unintended missteps. Please know the perceived lack of priority for residents and fellows was not the intent at all. We've spent the day understanding the issues so we can quickly move forward together. It won't make up for how you felt today. I personally couldn't feel worse about it."
The hospital anticipates receiving additional doses of vaccine from Moderna Inc., which received authorization by the Food and Drug Administration on Friday to distribute its inoculant. Sehgal said the hospital is "increasingly confident" it would have enough vaccine doses "for everyone," including the residents and fellows, he said.
The Chief Resident Council found that explanation inadequate, however. When the error was discovered on Tuesday, the hospital still did not make any changes to equitably distribute the vaccine to the residents and fellows, it noted.
"Negligence to act on the error once it was found is astounding, and to us is reflective of the lack of resident representation in decision-making and oversight at Stanford Medicine," the council wrote.
Stanford Medicine, which oversees Stanford Health Care and Stanford Children's Health, also acknowledged the error in a statement on Friday.
"We take complete responsibility for the errors in the execution of our vaccine distribution plan. Our intent was to develop an ethical and equitable process for distribution of the vaccine. We apologize to our entire community, including our residents, fellows, and other frontline care providers, who have performed heroically during our pandemic response. We are immediately revising our plan to better sequence the distribution of the vaccine," the statement said.
Stanford Health Care spokesperson Lisa Kim said the revised allocations would be coming out of the first 3,900 doses the hospital received from Pfizer-BioNTech.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.