About half of Iowa vaccine providers can deny access to noncustomers, nonpatients
A medical worker holds a vial of COVID-19 vaccine. (Photo courtesy of Truman Medical Centers/University Health)
Roughly one-half of Iowa’s 1,700 providers of the COVID-19 vaccine are free to deny the vaccine to noncustomers, according to state health officials.
With many Iowa clinics and hospitals refusing the vaccine to anyone who is not already doing business with them as a patient, some Iowans must go to pharmacies that may not be local, or that lack the same level of staffing and experience in giving vaccines.
Earlier this week, Kurt Ullrich, a 69-year-old writer in rural Jackson County, called Medical Associates of Maquoketa near his home since he knew the clinic would be receiving a supply of the vaccine. He asked about getting his name placed on the list for receiving the vaccine.
“After doing that, I got a call back, asking if I was a patient there,” Ullrich says. “When I told them I was not, they told me I couldn’t get a vaccine. I then spoke with someone identified as the office manager who was very annoyed with my questions about fairness.”
Ullrich contacted the Iowa Department of Public Health, sending them an email that asked, “Is this ethical or, more importantly, legal? It concerns when these places choose who shall live and who shall die. I assumed that when the state sends out the vaccine it is a democratic process, not one in which one the well-connected get first shot at the vaccine.”
In response, the department sent back a one-sentence, unsigned message that said, “The Iowa Department of Public Health does not dictate how individual organizations vaccinate, other than establishing the phase and priority groups for vaccination.”
A different Maquoketa clinic told an Iowa Capital Dispatch reporter the same thing Ullrich says he was told by Medical Associates: One has to be a patient of the clinic to get on its list for a vaccine.
The Capital Dispatch then asked IDPH whether the system in Iowa allows pharmacies, as well as clinics and hospitals, to refuse vaccines based on an individual’s status as a nonpatient or a noncustomer, and whether the vaccine providers can “prioritize who gets a vaccine from them based on whether the individuals do business with them.”
In response, department spokeswoman Sarah Ekstrand said, “Iowa has 1,700 enrolled vaccine providers. Approximately half of Iowa’s enrolled vaccine providers will offer vaccine to anyone who qualifies, such as a pharmacy or a local public health agency.”
Craig Cooper, senior communications specialist at eastern Iowa’s Genesis Health System, says Genesis, like many health care providers, has a policy of limiting coronavirus vaccine distribution to its own patients. He noted that nonpatients still have access to the vaccine from other providers in the area and through community clinics Genesis itself is helping to staff. He said Genesis refers nonpatients to those other providers.
As for why Genesis isn’t making its share of the vaccine directly available to all who inquire, he said, “One of the reasons we do that is because of recordkeeping. You know, we can get it into the record when they have a vaccination.”
As in all other states, the coronavirus vaccine is being made available in Iowa to groups of individuals on a prioritized basis. Currently, Iowans who are part of the so-called “Phase 1B” — state lawmakers, school employees, processing plant workers, etc. — are eligible, although there are five prioritized tiers of eligibility within that phase.
Nola Aigner Davis, communications officer for the Polk County Health Department, said that as things stand now, Iowa pharmacies, clinics and hospitals that get the vaccine can refuse access to noncustomers even when those individuals are within the appropriate phase and tier.
“The Polk County Health Department strategy is to work with several different partners so that there is wide distribution among the pharmacies, health department, Drake University and clinics,” she said. “Therefore, if you don’t have a ‘clinic home,’ or a ‘pharmacy home,’ you can schedule an appointment with the health department or Drake University.”
She said that as more vaccine becomes available, providers are expected to make their share of the vaccine available to the broader community once their own patients and customers are vaccinated.
“Although,” she added, “between Public Health and Drake, we will absorb the majority. Once we allocate vaccine to any of our partners, it is their choice how they want to administer their vaccine — as long as they stay within the phase and the tiers the state and county have put forth and are currently in.”
As for Ullrich, he now plans to get his vaccine from Osterhaus Pharmacy in Maquoketa, but doesn’t understand why the state allows any of its providers to deny vaccines on the basis of patient or customer status.
“I’m thrilled that more of my friends and neighbors were able receive the vaccine, but the systemic discrimination by the medical community is galling,” he said.
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