After the first round of COVID-19 vaccines is administered to those at the top of the priority list, it will likely be possible for people to jump the line under an honor system, according to a report.

The Food and Drug Administration has informed Pfizer that it intends to give the green light for its shot, which could go into people’s arms as early as Monday, Health and Human Services Secretary Alex Azar said Monday.

It will be quite easy to make sure health-care workers and nursing home residents are at the front of the vaccination line because hospitals and long-term care facilities can just scan their staff and resident lists to figure out who should be inoculated, Axios reported.

“Right now we’re very much focused on getting it to the hospitals and the nursing homes, and they’ll be what we call a closed point of distribution,” Bryan Mroz, acting assistant secretary of the Maryland Department of Health, told the outlet.

But after that, things will get murky and enforcement will be trickier, according to Axios.

Experts have said the next round of jabs should go to people who are most at risk to catch or spread the deadly bug, or for serious illness, including service workers and people with underlying medical issues.

“Eventually you’ll get to the point where there’s a lot of providers and distribution points involved in this plan, and it’s going to be harder and harder to ensure you adhere strictly to these priority groups,” Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, told the news outlet.

“I’m sure there will be a point where we see line jumping,” he said. “As far as enforcement, states will try to direct vaccines as best as they can to reach the populations they want to, but once they’re at those distribution points, it’s hard to control this process.”

Health care providers providing the jabs must enroll in a federal program and sign a provider agreement written by the Centers for Disease Control and Prevention, according to the report.

They are required to administer the vaccines in adherance to guidance by the Advisory Committee on Immunization Practices, the federal panel recommending how to distribute the doses, Axios reported.

But the providers will likely have to take people’s word that they’re members of particular priority groups.

“I doubt they’re going to require a lot of documentation. If you say you have diabetes, they’re not going to want to see your blood sugar,” Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security, told Axios.

“I think we do have to depend to a significant extent on people’s honesty, and to some extent, it’s an honor system. You can check age … but the rest of it you really can’t,” he added.

A nurse holds a vial of the Pfizer-BioNTech COVID-19 vaccine.Frank Augstein/Pool via AP

But given the level of skepticism about the vaccines in the general population, some experts aren’t too worried about line-jumping.

“Of all the things that are keeping me awake at night, this is not one of them. If the order in which some people get vaccinated is different than the ideal, at least some people are getting vaccinated,” Toner said.

“I’d rather have people so eager to get a vaccine that they find a way to game the system than people not wanting to get vaccinated,” he said.

Mroz added: “That’s a problem I kind of want to have — people lined up to get” a shot.



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