A Faulty Algorithm Screwed Residents Out of Stanford’s Vaccine Distribution Plan

Medical residents flooded Stanford Hospital on Friday in protest after executives there reportedly used a faulty algorithm to triage its first wave of vaccinations and overwhelmingly left out caregivers working on the front lines of the covid-19 pandemic.

Of Stanford Medicine’s roughly 1,300 residents, just seven were chosen to be among the first 5,000 employees in line to receive the new Pfizer/BioNTech vaccine, ProPublica reports. A letter to hospital executives that was signed by residents and reviewed by Ars Technica claimed that high-ranking doctors and senior faculty who have worked remotely since March made the list while just 0.5% of residents were selected for vaccination. And just to add insult to injury, this decision came the same week that residents were asked to volunteer for shifts in the Intensive Care Unit—where they’d likely work in close contact with covid-19 patients—as the hospital braces for an anticipated spike in cases, ostensibly because of the holiday season.

In a ProPublica interview, Sarah Johnson, an OB-GYN resident who has delivered babies from covid-19 patients, called this “the final straw” for hospital staff already feeling worn out and overlooked after routinely risking exposure during an international health crisis.

“Residents are patient-facing, we’re the ones who have been asked to intubate, yet some attendings who have been face-timing us from home are being vaccinated before us,” she told the outlet. “This is the final straw to say, ‘We don’t actually care about you.’”

Residents called for Stanford executives to “vaccinate the frontline” as protests erupted both inside and outside the hospital on Friday. Dozens brandished signs with messages like “First in the room. Back of the line” and “#Healthcare hero. Support is zero.”

Stanford came up with an algorithm to “ethically” chose who among its staff would be first to get vaccinated, but design flaws apparently put residents at a disadvantage from the get-go. Medical school grads are typically required to complete some sort of residency program before they can obtain their medical license where they work under the supervision of other physicians. Because the position is temporary, residents don’t have an assigned “location” to “plug into the calculation” that determines who would be first in line for the vaccine, a chief resident explained in an email to his peers. And they tend to be younger, he added, which also made them less likely to make the cut, presumably because older people have a higher risk to develop severe complications from the virus.

Stanford Medicine executives have since admitted they screwed up:

“We take complete responsibility for the errors in the execution of our vaccine distribution plan,” reads a press statement emailed to Gizmodo. “Our intent was to roll out an ethical and equitable plan for the entire organization, and there were flaws in that plan that we are actively trying to repair,”

In an email to staff reviewed by NPR, Stanford executives and deans apologized and said they’d discovered “significant gaps” in their development of a vaccine distribution plan. They went on to say that they’re working on correcting the plan, and anticipate being able to vaccinate “a substantial segment of our community” hopefully as soon as next week once a larger shipment of vaccines arrives.

Residents are also calling for nurses, therapists, janitors, food service workers, and other essential staff that the algorithm may have overlooked to be included among those considered for the first round of vaccinations, NBC reports. And, ideally, they’d like a seat at the table as the hospital revises its plan.

I can’t even begin to imagine the frustration these residents must feel, risking their health and safety every day just to be brushed over when relief is finally in sight. And not to detract from their struggle, but the fact that their ages put them at a disadvantage for receiving the vaccine hit way too close to home for me as someone who has been immunocompromised basically their entire adult life. Hopefully, Stanford can make this right soon, because this pandemic has been going on for almost a year now and workers on the front lines have more than earned the right to skip the queue.

Update: 12/18/2020, 9:16 p.m. ET: Added statement from Stanford Medicine.