D.C.’s Vaccine Jackpots Are Getting Out of Management – Thebritishjournal

It was anarchy at the deli counter. On Sunday afternoon in Washington, D.C.’s Shaw neighborhood, a couple dozen masked people had crowded into a corner of a Giant supermarket, where they swiveled their heads warily. As I approached them, a slightly haggard man in an orange down jacket stopped me. “Here for the extra vaccine doses?” asked the man, who was part of the group, not a Giant employee. He handed me a scrap of paper with the number 24 scrawled on it.

For more than a week, lines have quietly been forming at certain D.C. supermarket pharmacies, which have started giving away leftover vaccine doses each day just before closing time, usually to between one and three people. Vaccine lines for eligible recipients have already become a common sight in some places, but these shots are available to anyone—not just the health-care and frontline emergency workers who qualified weeks ago in most states, or even those 65 and older, who became eligible in D.C. on Monday. And the lucky few who get a shot also get scheduled for a second dose. At the Giant in Shaw, the crowd by the deli included people who looked old enough to meet the age cutoff and people who looked young enough to be students—all hoping to strike the vaccine jackpot. The most hard-core among them had been up since 4:30 in the morning.

Grocery stores’ decision to skirt the established order of distribution is a last-ditch effort to save a precious resource at risk of going to waste. Both the Pfizer/BioNTech and Moderna vaccines must be stored in extreme cold and administered soon after thawing, and both spoil quickly and cannot be refrozen. Already, reports have emerged across the U.S. of doses going bad. The federal government has delivered more than 27 million doses to distributors so far, but only 9 million people have received at least one. In D.C., the health department’s mandate is to not let any vaccine perish. At least several grocery-store pharmacies are doing what they can to get shots into as many arms as possible—but the lines and crowds that have ensued offer a particularly vivid illustration of how even good intentions can lead to trouble in the absence of a fully fleshed-out national vaccination plan.

This week, I visited four of D.C.’s five Giant pharmacies to see the lines for myself. In Brentwood, people started queuing not long before noon. On H Street, the line started at 4 o’clock one morning, in the freezing cold, two hours before the store unlocked its doors; the next day, it snaked out the door by early afternoon. Shaw was by far the most chaotic. The whole scene had serious Lord of the Flies energy—the extreme fatigue, the undercurrents of cutthroat competition, the physical danger of infection looming over it all. The group had even begun to hash out the basics of self-governance. “Yesterday was a little bit of a disaster,” a young woman who’d been waiting for nine and a half hours on Sunday told me. “So that’s why we started doing the informal deli-number system—to try to create some order.” (I explained to the man in the orange jacket that I was not there to get vaccinated and returned my paper scrap, which he promptly handed to another newcomer.)

Giant and the D.C. Department of Health both declined to answer specific questions about lines at pharmacies, including how widespread the phenomenon might be within the city. A Giant spokesperson acknowledged only that lines had formed in at least one of the company’s D.C. branches on Sunday, and said that stores “are not accepting wait lists for extra vaccines, nor do we want people lining up to receive extra vaccines.” The health department reiterated its nothing-goes-to-waste approach: “Pharmacists should follow our guidance, if doses will expire due to missed appointments, they should administer the vaccine to anyone who wants to take it,” a spokesperson told me over email.

(The health department did not say whether lines were forming at any other pharmacies. I reached out to Safeway, another major D.C. grocer that reportedly has given out end-of-day vaccines to lucky shoppers, to inquire about lines, and a spokesperson simply told me that the company’s pharmacies follow local guidelines when administering vaccines. I also reached out to CVS, whose spokesperson said it is not currently offering vaccines at its pharmacies. Walgreens did not return a request for comment.)

The line trouble seems to have begun with a TikTok. On New Year’s Day, a law student named David MacMillan posted a video in which he recounted how, as he and a friend were shopping at a D.C. Giant, a pharmacist had flagged them down and offered to vaccinate them. Since then, reports have circulated about these and other winners of random last-minute vaccine giveaways at the city’s supermarkets. Two middle-aged architects lucked out at a Safeway. So did a shopper looking for Hot Pockets.

These surprise doses exist for two reasons. The vaccines are currently shipped in multidose vials, rather than prefilled syringes or single-dose vials, so each batch comes with a little extra. And sometimes eligible people fail to show up for their vaccination appointments. As word got around that anyone could get a leftover vaccine if they happened to be in the right place at the right time, people started trying to engineer being in the right place at the right time. Some succeeded, and soon more and more people were loitering around supermarket pharmacies near closing time in the hope of getting lucky. Lines formed at a number of supermarkets around the city. They got longer and longer and longer.

At the Shaw Giant, the woman who had been waiting for nine and a half hours told me that she’d heard about the extra doses two Sundays ago, when a pharmacist at D.C.’s L Street Safeway unexpectedly offered to vaccinate two of her best friends. The next day, she and her partner showed up at the H Street Giant at 3 p.m., the time her friends said they’d been vaccinated. By then, though, a line had already formed. (The woman, who identified herself as a restaurant server, requested anonymity to protect her and her partner’s privacy.)

So began the arms race. The next day they arrived at 2 p.m., and again they found a line. The day after, noon—and another line. When I spoke with the couple on Sunday, they’d tried every day for the past week, without success. That morning, they’d decided to go all in, showing up at the H Street location at 4:50 a.m.—only to find that they were third and fourth in line. The first person had arrived at 4 o’clock. Rather than stick around, they rushed to another Giant. They arrived at the Shaw store at 5:08 a.m., they told me, 52 minutes before its doors opened, and nearly five hours before the pharmacy did. This time, they were first in line. And by a mile, too—no one else showed up until close to noon.

Getting vaccinated wouldn’t change her behavior, the young woman told me as she waited; she knows that the evidence remains unclear as to whether she could still transmit the virus to friends who have not been vaccinated, so she will continue to practice social distancing. But the vaccine would make her feel safer at the restaurant where she works. If she didn’t wait in line at Giant, she’d have to wait much, much longer for the third stage of the vaccination campaign, after health-care personnel, residents of long-term-care facilities, frontline essential workers, and people 65 and older have all been vaccinated.  

In theory, random extra-dose lotteries give anyone a chance at early vaccination. In practice, though, they privilege those who have the time to wait all day and the wherewithal to know that’s even an option. The lines are not organized by vulnerability or social good; they’re organized by who wakes up earliest. At the H Street location, Angelean Redman seemed to be in prime position on Sunday morning. She arrived at about 4:30 a.m., early enough to snag the second spot in line. Redman, a retiree who told me she’d worked for more than 40 years at the Pentagon, falls within two of the pandemic’s most vulnerable demographics: She is Black and older than 65. (On Sunday, the city had not yet opened its vaccination campaign to people older than 65.)

In line, Redman slept in a chair, did crossword puzzles, and made a pact with the young man ahead of her to save each other’s place when one of them went to the bathroom. At the end of the day, the pharmacist announced that only one extra dose remained, and it went to someone less vulnerable. Redman had waited 10 hours around other people for nothing, at considerable risk of exposure to the virus.

To some extent, this whole mess was inevitable. “The fact that there’s some doses left at the end of the day is the nature of the beast,” Saad Omer, a vaccinologist and the director of the Yale Institute for Global Health, told me. Pharmacies have no choice but to decide what to do with the leftovers, and anything is better than letting precious doses go to waste. “It’s obviously not ideal to have that kind of a situation, where you have high-risk groups and they’re not receiving it,” Omer said. “One thing I hope people realize is that the staff there are trying to do their best.”

Still, he stressed, the problem is that no clear, widespread plan exists for what to do with the extra vaccines, and the root of that problem is the lack of guidance from the federal government. Because the Trump administration did not issue a comprehensive national vaccination plan, states have no recommendations to refer to when faced with a tricky situation like this one. And because states could not begin developing their own vaccination plans in earnest until late December, when Congress finally allocated nearly $9 billion for vaccine distribution, they had virtually no time to run the simulations and tabletop exercises that could have foreseen these sorts of problems. At a moment when the pandemic is infecting 250,000 people and killing more than 3,000 every day, these delays matter.

As far behind as the U.S. is, there’s still time to solve these problems before the vaccination campaign’s next phases, the logistical challenges of which will be far greater. One solution, Omer said, would be for states or companies to institute a system to notify unvaccinated people in the highest-priority groups when an extra dose was available nearby. Within each group, recipients could be chosen by lottery, and if a candidate didn’t respond quickly enough, the system could select a new one. No one would have to wait for hours in dangerously crowded conditions for an extra dose that, on any given day, might or might not exist.

For now, though, individual pharmacies have no choice but to work out solutions for themselves. At the Shaw Giant on Sunday afternoon, the crowd was growing far too large for effective social distancing. Samir Balile, who is in charge of clinical programs at all 153 Giant pharmacies in the Mid-Atlantic and happens to live right down the street from the Shaw store, was called in to help manage the situation. He stood in front of the crowd and announced that the pharmacy would be prioritizing store employees and people 65 or older that day. Everyone else had to leave.

For a moment, no one moved. Some had been standing there for hours. One woman refused to go. A man asked if he should return at closing time. “Please don’t even come back,” Balile said. “It’s too dangerous.” After a few minutes, the waitress and her partner gave up. That, they said, was their last try.

Redman, the retiree, for her part, was back at it the next day. On Monday, she arrived at the H Street Giant just after 6 a.m. with some fruit and her crossword puzzles. When I met her there, she was second in line again, this time behind a government worker who spent most of the day rereading the sixth Harry Potter book. “If I don’t do it today, Jesus, I’ll be No. 1 tomorrow,” she told me.

As the line stretched out the door and the tension built, Redman befriended the government worker, who asked to be identified by her middle name, Elizabeth, to protect her privacy. The two women were told that the pharmacy had about 20 doses to administer that day, so they counted down as people came in with appointments. At the end of the day, the pharmacist announced that three doses were left. Redman and Elizabeth did celebratory elbow bumps and took a group photograph with the man who was third in line. In a few weeks, when they return for their second dose, Elizabeth is going to drive Redman to the pharmacy.

D.C.’s Vaccine Jackpots Are Getting Out of Control The British Journal Editors and Wire Services/ The Atlantic.

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