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Stanford Medicine apologized on Twitter Friday after protesters overturned their vaccination distribution plan, excluding nearly all residents and fellows, many of whom are treating COVID-19 patients. But some say the error shows the residents need better representation and advocacy.
While only seven of Stanford’s more than 1,300 residents were initially selected to receive the vaccine, many workers who did not have direct contact with sick patients, according to The New York Times ,
A Stanford resident was shown in one San Francisco Chronicle videoand said that although the protest was organized by the residents, they and others are also fighting back for the fellows and nurses who were left out of the list.
“It’s not all about the residents. The people you see here are all residents because we’re close by and it was easy for us to collect all of our programs,” but he said some in other groups, including some pediatric nurses and therapists, were also overlooked.
“Inhabitants can die too”
Protesters carried signs saying “Lack of Priority,” “Help Me Help My Patients,” “Frontline and Forgetting,” and “Residents Can Die,”
According to NPR, a board of key residents sent a letter to Stanford leaders on Thursday evening expressing anger at the allocation plan.
On Friday, Stanford deans and executives sent an email apology to staff: “We are writing to acknowledge the deep concerns raised by our community regarding the development and implementation of our vaccine distribution plan. take full responsibility and apologize to all of you. Recognize that we should have acted faster to address the mistakes that resulted in an outcome we did not expect, ”they wrote.
“We are working quickly to address the shortcomings in our plan and develop a revised version.”
Stanford did not respond to publication time Medscape Medical News’ questions about what the revised plan would look like.
The apology noted that more people would be able to access the vaccine with the next batch of vials, which they expected to arrive this week.
Carrie Rassbach, MD, director of the Pediatrics Residency Program at Stanford, said others are stepping up in the meantime.
“The Dept of Peds Chair, Division Chiefs, Associate Chairs, education leaders and others who are not at high risk have offered to wait until all clinically oriented domestic workers are offered vaccination,” she says wrote on Twitter.
Need better representation
The New York Times, who received a copy of the memo on the selection process, reported that the flawed plan was designed by researchers and ethicists and that the goal was to assign a risk score with a hospital staff algorithm that would calculate the greatest risk of getting the virus and seriously ill, using factors such as age, job description, and number of COVID-19 cases detected in the person’s ward.
Residents, who are typically younger and work in many departments, moved the list down.
The Times reported that hospital administrators should review the list the algorithm generated, but the memo revealed that this did not happen due to the rapid generation of the list and frenetic communication between overwhelmed administrators.
Janis Orlowski, MD, chief health care officer for the Association of American Medical Colleges Medscape Medical News the Stanford outage wasn’t something they’d expected when the AAMC sent advice to medical institutions a week before the Pfizer vaccine came out.
She said she thought medical students would be the group the organization should advocate for getting the early vaccines, not the residents. She and others expected residents to be definitely recognized as vital frontline workers and given priority over the vaccine.
“We sent a note saying that medical students, such as residents and physicians – if they were on a clinical rotation – should be considered essential workers and vaccinated like other individuals in their cohort,” said Orlowski.
She said she had not heard of similar problems with the introduction of vaccines at other institutions and that the Stanford problem appeared to be an “unfortunate” event – “good people trying to do the right thing and it was a failure” .
Maximilian Cruz, MD, a fourth-year resident in Ohio, told me Medscape Medical News that while he did not think the omission of residents from Stanford’s first phase of vaccination was deliberate, he said it reflects a larger problem: “the lack of resident representation.”
He said, ‘It’s the same reason residents across the country have mediocre benefits at best – 401K matching is a dream for most – sad maternity leave and mostly nonexistent paternity leave, wages largely stagnant since the’ 60s when corrected for inflation, etc.. “
“I believe the protests from Stanford residents – in a way that ensured continued safe patient care – were justified and helped bring about the prompt response from the leadership,” said Cruz, who is the current president of the United States. National Med-Peds Residents’ Association; he stressed that his opinion on the matter is his.
Cruz pointed out the countless health care inequalities that the pandemic has highlighted.
“The lack of representation and power residents have in workplace decisions that directly affect them can be added to that list,” he said.
Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News and Nurse.com and has edited the Chicago Sun-Times, the Cincinnati Enquirer and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick