US vaccine roll-out’s next challenge: Verifying who is ‘essential’

As industries in the United States push for their workers to receive early access to COVID-19 vaccines, local health departments and pharmacies are facing the challenge of verifying the identity of essential workers to ensure no one cuts the line.

The vaccination campaign under way is now focused on hospital staff and nursing homes – tightly controlled environments where verification is relatively simple. But beginning in January or February, Americans employed in a range of industries will be eligible for inoculation, provided they are essential front-line workers.

The absence of a plan to verify vaccine candidates’ jobs and confusion over who qualifies as essential raise the risks of fraud and disorganisation.

Who decides which worker is essential?

The criteria to qualify as an essential, front-line worker varies from state to state. The US Centers for Disease Control and Prevention (CDC) estimated roughly 30 million essential workers will be next in line for a shot. An additional 57 million essential workers will be vaccinated later.

The lack of clear guidelines will significantly complicate the verification process as those workers seek shots.

The United States has two authorised COVID-19 vaccines, one from Pfizer and BioNTech and another from Moderna. The vaccines are rolling out as hospitals reach peak capacity and deaths have exceeded 317,000.

The US Department of Homeland Security in March published a list of essential US workers during the pandemic.

The list covers nearly 70 percent of the US labour force and has provided little clarity to health officials trying to distribute initially limited doses of vaccines.

Many states over the summer began developing their own priority lists, at times deferring to the importance of local industries. States generally have broad discretion when it comes to vaccine distribution.

This has resulted in a patchwork of guidelines across the country, with companies complaining their workers are considered essential in one state, but not in another.

A panel of experts that advises the CDC on Sunday recommended that people 75 and older and workers including first responders, teachers, food and agriculture, manufacturing, US Postal Service, public transit and grocery store workers should have the next priority for the vaccines.

Some US states have signalled they will nevertheless continue with the distribution plans they originally drafted.

Florida Governor Ron DeSantis said he intends to prioritise people over the age of 65 in his state, rather than essential workers.

“As we get into the general community the vaccines are going to be targeted where the risk is greatest and that is in our elderly population,” he said during a news conference on Tuesday, “we are not going to put young, healthy workers ahead of our elderly, vulnerable population.”

FL is prioritizing our elderly population for vaccination against COVID-19. We are seeing progress made regarding residents of LTC facilities and will not be putting young & healthy “essential” employees ahead of our general 65+ population when it comes to vaccine distribution. pic.twitter.com/adbqIHjUiK

— Ron DeSantis (@GovRonDeSantis) December 23, 2020

Michael Einhorn, the president of New York medical supply distributor Dealmed, criticised health officials’ decisions to prioritise essential workers for the next phase of the vaccine, rather than distributing it along age lines.

“There will be people trying to cut the line and commit fraud to get a vaccine,” said Einhorn, whose company has been involved in flu shot distribution.

How will eligibility be confirmed?

It is not clear yet how health departments and pharmacies will verify the identity of a significantly larger and more diverse group of people eligible for the next round of vaccines.

Pharmacy operators CVS, Walgreens and Kroger each referred to state and local guidelines when asked how they would verify essential workers.

“If the jurisdiction requests support from Walgreens, Walgreens will distribute a voucher or authorisation form that the individual can use to schedule an appointment for a vaccination,” a Walgreens spokeswoman said in a statement.

CVS said it would share more information once it got closer to the next phase of vaccine distribution in the first quarter of 2021.

Kroger in a statement said it would require customers to make an online appointment and use a screening tool to manage the verification process.

“In some instances, the state will identify and verify the individuals before they are referred to us for vaccination,” a Kroger spokeswoman said.

States have not outlined how they will verify workers’ identities. Companies pushing to have their workers vaccinated are exploring different options.

The Consumer Brands Association, which represents food, beverage, personal care and household product companies, and the Food Industry Association, representing food retailers, said they were developing template letters for employees to verify their essential worker status.

“We understand states may have different designation standards, but (we are) working to provide our members with a resource to help reduce confusion,” a spokeswoman for the Food Industry Association said in a statement.