It looks like money can put a country at the front of the line when it comes to getting the COVID-19 vaccine, and some wealthy individuals are taking the same approach.
With both Pfizer-BioNTech and Moderna COVID-19 vaccines approved by the United States and other countries for emergency use, the vaccines are being spoken for, with the wealthiest Western countries snatching up most of the initial doses.
The US has already secured the first 100 million doses of Pfizer-BioNTech vaccine and another 100 million doses from Moderna. Both vaccines require two doses per person treated.
The US, which has the option to buy an additional 300 million doses from Moderna and 100 million to 500 million doses from Pfizer, has a population of 331 million.
The US also has the most coronavirus cases, more than 18 million, and the most deaths, over 322,800, as of Wednesday, according to the Johns Hopkins University Coronavirus Resource Center.
Globally, there are more than 78 million reported cases and over 1.71 million COVID-19 deaths.
According to Oxfam, a confederation of 20 independent charitable organizations focusing on alleviating global poverty, wealthier nations have bought enough doses to vaccinate their entire populations nearly three times over by the end of 2021. Canada tops the list with enough doses to vaccinate each citizen five times.
In total, rich nations representing 14 percent of the world's population have bought 53 percent of all the most promising vaccines so far. Oxfam estimated that only 10 percent of the populations in 70 poor countries will get vaccinated in 2021.
COVAX, or the COVID-19 Vaccines Global Access Facility, aims to accelerate the development and production of vaccines through global cooperation and ensure that all countries can obtain them. The initial goal of COVAX is to distribute 2 billion doses of the vaccines by the end of 2021. China joined COVAX in October as a self-financing country, which helps the facility aid poorer countries.
Trying to pay for priorities
While the wealthier countries have moved to the front of the line for the vaccines, well-off individuals in the US also are trying to do the same, with some reportedly offering to pay as much as five figures in US dollars to bypass government-mandated priorities.
With the vaccines initially in short supply, priorities are to first vaccinate healthcare workers and nursing home residents. A panel advising the US Centers for Disease Control and Prevention recommended on Sunday that the next in line should be people age 75 and over plus frontline essential workers such as emergency responders, teachers and grocery store employees. So far, more than a half million people in the US have gotten their first shot, which needs to be followed by a second shot a few weeks later.
Some people, however, don't want to wait.
According to the Los Angeles Times, doctors offering concierge medical care to wealthy individuals are getting hundreds of inquiries a day to see if they can jump the line to get the COVID-19 vaccines.
Hollywood celebrities and Silicon Valley executives accustomed to getting preferred treatment with their money are instructing their assistants to find out how they can get better treatment, the newspaper reported.
"Their people are calling me literally every day," the Times quoted one doctor, who requested anonymity. "They don't want to wait. They want to know how they can get it more quickly."
Dr Jeff Toll, at Cedars-Sinai Medical Center in Los Angeles, one of the first hospitals to receive the vaccine, said a patient asked him: "If I donate $25,000 to Cedars, would that help me get in line?" Toll said he replied no.
California Governor Gavin Newsom has warned that California will be "very aggressive in making sure that those with means, those with influence, are not crowding out those that are most deserving of the vaccines".
"Those that think they can get ahead of the line and those that think because they have resources or they have relationships that will allow them to do it… we also will be monitoring that very, very closely," Newsom said.
STAT News, which covers biotech and pharmaceutical news, reported that athletes, politicians and well-connected or wealthy people have managed to get special treatment during the pandemic, "including preferential access to testing and unapproved therapies. Early access to coronavirus vaccines is likely to be no different".
STAT said it could happen in different ways: fudging the definition of "essential workers" or "high-risk" conditions, physicians caving to pressure to keep their patients happy, and even through outright bribery or theft.
"When we talk about the concept of individuals being able to get to the front of the line, that's not difficult, because our system is designed to advantage those people with means like that," Glenn Ellis, a visiting scholar at the National Center for Bioethics in Research and Health Care at Tuskegee University and a bioethics fellow at Harvard Medical School, told STAT.
"They don't have to really do anything sinister. All they have to do is access the system that they are a part of."
The Times reported that doctors are receiving offers of "tens of thousands of dollars in cash", in addition to "making their personal assistants pester doctors every day and asking whether a five-figure donation to a hospital would help them jump the line".