As a frenzy of newly eligible older adults seek COVID-19 vaccinations, hospitals in the Puget Sound region are quietly giving people of influence — including hospital foundation board members and donors — special access to vaccines.

Providence Regional Medical Center in Everett offered on Jan. 25 an invite-only clinic for donors, board members and fundraising campaign volunteers, according to an email addressed to donors obtained by The Seattle Times. At the same time, the hospital was not providing vaccine access to the general public, according to a spokesman.

And in a soft launch of its vaccine rollout to seniors, EvergreenHealth in Kirkland performed a “test” of its scheduling tool by sharing a link to vaccine appointments with certain foundation board members and volunteers, in addition to people who serve older adults.

Special-access vaccine appointments first drew a rebuke from Gov. Jay Inslee Tuesday, when he chastised Overlake Medical Center for launching a program directing donors, board members, retirees and volunteers to reserved appointments.

As many seniors, especially those in marginalized communities, struggle to navigate a disorganized landscape of sign-ups and hotlines for shots, these exclusive opportunities illustrate concerns about unequal access to a taxpayer-funded vaccine that offers potentially lifesaving protection. 

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Washington state’s vaccine rollout depends heavily on hospitals to rapidly move people through high-traffic vaccination clinics. Fair access to vaccine doses relies on an honor system among those seeking vaccines, leaving vaccine providers — public, private, nonprofit and otherwise — with a weighty responsibility. 

Special access clinics raise questions about whether the state can achieve its goal of equitably distributing vaccine and reach people of all races, ethnicities and socioeconomic backgrounds — a crucial task as communities of color suffer disproportionately from COVID-19 infections and deaths. 

Hospitals officials have said they were trying to fill vaccine appointments quickly or test software as efficiently as possible using familiar contacts, but at least two organizations acknowledged they erred by creating an appearance of favoritism toward connected individuals.

Teresita Batayola, the CEO of International Community Health Services, which serves immigrant communities, said learning about special access to vaccines was like a “gut punch.”

“Privilege has given access to some groups of people,” Batayola said, while others from some communities hard-hit by the disease “have virtually no access” to vaccines.

‘Valued friends’

“As a courtesy to you, we are offering a special clinic for our valued Friends of Providence, Board Members and Campaign Volunteers,” wrote Lori Kloes, the chief philanthropy officer of the Providence General Foundation, in a Jan. 19 email noting vaccine eligibility had expanded to those 65 and over.

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Hospital foundations, along with universities, are one of the most high-profile avenues for philanthropists in a given community. The wealthiest get new wings named after them.

Often, the foundations help donors navigate hospitals’ bureaucracy, ensuring they secure appointments, recovery rooms with a view or a quickly returned phone call.

“The rich got advantages in the health care system long before COVID, but when we’re in a plague you expect everybody to follow the rules,” said Arthur Caplan, director of the Division of Medical Ethics at the New York University Grossman School of Medicine.

Membership to the Friends of Providence Donor Society begins with a minimum of $10,000 in cumulative gifts to the foundation. The group includes owners of auto dealerships and prominent Everett-area philanthropists.

The “special invitation only” clinic was scheduled Monday from 7:30 a.m. to noon, Kloes wrote. “We sincerely appreciate your support and service to Providence …” 

The Seattle Times obtained the email from a donor who was offered access to the clinic. When she read the email, the donor, who asked that her name not be used because she didn’t want attention from the public or from Providence board members, said she “was horrified.”

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She asked Providence to remove her from the list, though age qualifies her for vaccination. She has not received a dose. 

“Put their name on the plaque, send them a thank-you note, give them tickets to a Mariners game — that’s fine,” the woman said of donors. “But don’t move them to the front of the line in a life-or-death situation.”

In a statement, Providence said it reached out to “members of the community we had contact information for, which included our hospital volunteers, volunteer board members, and members of the community who have donated to our charitable foundation in the past,” adding that the organization administered vaccine only to those “who attested they qualify.”  

Providence supplied the link to 148 volunteers, including fundraisers and people who help with tasks around the hospital like cleaning, 21 board members and 249 “Friends of Providence,” spokesman Casey Calamusa wrote. In all, 245 were vaccinated in the reserved access system.

At the time of the special-access clinic, Providence expected to provide vaccination for the general public this week, but ultimately did not receive enough supply, Calamusa wrote.

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“In retrospect we understand that in our haste to vaccinate people quickly — including certain members of our hospital community — we created the impression that some people are able to use their access to unfairly get a vaccination appointment,” the statement read, adding that Providence’s overall vaccination campaign includes reaching out to vulnerable populations.

Providence said it was “evaluating our processes and engaging ethics and compliance leaders” to ensure it follows state guidance. 

Calamusa said Providence leaders proactively reported the clinic to Gov. Jay Inslee’s office on Wednesday, after the governor’s rebuke of Overlake, and assured it the practice would not continue or happen again.

Three days before Providence’s email, on Jan. 16, EvergreenHealth sent out a notice for a “soft launch” of its next phase of vaccinations. Hospital officials said they wanted to test a new scheduling system before it was opened to the general public, with roughly 500 doses available that day.

Eight of the 24 foundation board members received the invitation, along with 58 volunteers, and people from local organizations that serve seniors. Donors were not sent an invitation, although foundation board members are typically large contributors. 

EvergreenHealth Foundation vice chair Jeff Cashman, 66, was vaccinated on the 16th. The CEO of the Redmond financial advisory firm Cashman Consulting, Cashman and his company have given at least $67,000 to the hospital foundation since 2013, according to the foundation’s annual reports.

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“EvergreenHealth has been at the forefront of this pandemic and to suggest anything else is clearly wrong and inappropriate,” Cashman said in an email.

The bulk of the Evergreen volunteer invitations went to a group of area residents who serve on internal hospital task forces and committees and advise the hospital’s administration and its board of commissioners.

To give early access doses to board members “made me nauseated,” an EvergreenHealth physician told The Seattle Times, arguing it was not ethical. “There have to be options other than giving it to the privileged members of the board.” 

While EvergreenHealth was vaccinating board members, volunteers and others, many older adults without connections were attempting to navigate Washington state’s confusing system, which lacks enough vaccine supply to reach everyone who qualifies.

Stephanie Wilson, a 71-year-old EvergreenHealth patient on immune-suppressing drugs for her acute rheumatoid arthritis, said Thursday that she’d spent the last two to three weeks at her computer, trying to find an available vaccine slot — without success. 

The process has made her question how other people have been able to be vaccinated. 

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“Where are all these appointments going?” she asked. “Somebody’s getting them.”

Evergreen spokesperson Kay Taylor emphasized that the invitations went out to community groups that served seniors — including Northshore Senior Center and Peter Kirk Community Center, as well as to board members and volunteers — who qualified under the current guidelines, she said. And the soft launch proved useful: “We provided vaccine to our community and learned that the scheduling tool was not ready for prime time,” Taylor said.

The Seattle Times on Tuesday revealed that Overlake Medical Center had reached out with special opportunities to donors and board members, among other groups. The medical system said it offered short-notice vaccination appointments not available to the general public in order to keep scaling up vaccination, despite technical issues with its scheduling services. It later apologized publicly. 

Five other regional health systems — UW Medicine, Swedish, MultiCare, Kaiser Permanente Washington and Virginia Mason Franciscan — said they had not held special clinics or offered reserved appointments to donors or board members.

Tiffany Moss, a Swedish spokeswoman, wrote that some board members had volunteered at a mass vaccination clinic it held with Seattle University and were vaccinated along with other volunteers. Swedish said it considers any of its volunteers to be health care workers and “would not be able to run the clinic without” them. 

‘A very bad equity issue’

Offers of special access to donors or board members, along with the chaotic distribution of limited vaccine, raise concerns that the vaccine isn’t being dispensed equitably, which the state Department of Health (DOH) promised would be at the core of its vaccination efforts. 

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Low-income seniors who lack access to computers or transportation have struggled to find doses.

William Harmon, a 70-year-old resident of a low-income senior housing program above a homeless service center in Seattle, said he’s been unable to find an appointment. Operation Nightwatch, which houses the program, has experienced an outbreak in the building and two deaths.

“I tried and every place I called they didn’t have it,” said Harmon, who has a history of heart problems. “So I figured I’d wait until it gets a little easier.”

Community health clinics and social workers who care for low-income seniors have expressed concern that vaccines made available to large hospital systems aren’t making their way to some of the most vulnerable to the disease. They say seniors with language barriers are also finding trouble navigating the online system.

Batayola, of International Community Health Services, said last week there were no vaccines left for the organization’s roughly 7,000 elderly patients, many of whom are from the immigrant communities hardest hit by COVID-19, until she lobbied the state, county and mayor’s office and got 500 additional doses. 

Racial equity data is not yet available on the state’s vaccination dashboard, but the state plans to add that information soon, according to Danielle Koenig, a DOH spokeswoman. 

Just 17 states were reporting such data as of Jan. 19, according to the Kaiser Family Foundation. In 13 of 16 states examined, the share of vaccinations among white people was larger than that demographic’s proportion of coronavirus cases, according to the foundation

“I feel very strongly that we have a very bad equity issue here,” said Batayola.