A federal manufacturing contract to increase COVID-19 vaccine production has an unusual clause that could move a company's employees and their families to the front of the vaccination line.

Transcript

LULU GARCIA-NAVARRO, HOST:

Families banding together in shifts to try and get appointments, clogged phone lines and glitchy Web portals - the vaccine rollout in America has been a mess so far. All that as we're seeing a staggering rise in infections and after almost 400,000 Americans have died of COVID-19. And now we're learning that a federal deal to increase vaccine manufacturing has an unusual clause that could allow certain people to cut the line. NPR pharmaceuticals correspondent Sydney Lupkin is here to tell us about it. Good morning.

SYDNEY LUPKIN, BYLINE: Good morning.

GARCIA-NAVARRO: So tell us about this stipulation. What is it, and who does it apply to?

LUPKIN: It's a clause in one of the Operation Warp Speed contracts between the federal government and a company called Emergent BioSolutions. It makes drugs and vaccines on behalf of other companies. Emergent signed a deal in the spring to increase manufacturing capacity for COVID-19 vaccines and treatments, but the deal says that Emergent is allowed to hang on to vaccine doses in order to immunize its employees and their families.

GARCIA-NAVARRO: So have you seen that in any other Operation Warp Speed contracts?

LUPKIN: No. It seems to be unique to this contract with Emergent, and it raises some ethical questions.

GARCIA-NAVARRO: I can imagine. I mean, it goes against, I think, public health guidance for who should get the vaccine first.

LUPKIN: Right. Remember that the Centers for Disease Control and Prevention and its advisers worked on plans for vaccine prioritization throughout 2020. They wanted to determine who gets the vaccine and when and how to do that in the most fair and effective way possible. The CDC made recommendations, and then states were able to take those and make their own plans. It's why, for example, we've been seeing front-line health care workers and residents of long-term care facilities getting the vaccine first. They're at the highest risk of catching the virus and getting really sick from it. And now people 65 and older are getting prioritized. But the Emergent plan could allow for its employees and their families to get the vaccine before it's their turn. Now, both the company and the government say that won't happen, but I sent the clause to Ameet Sarpatwari, assistant director of Harvard Medical School's Program on Regulation, Therapeutics and Law.

AMEET SARPATWARI: The only reason that clause is in there is that they considered the possibility of jumping the queue, and it allows them the option of doing so. And so when they say that they aren't intending to, that doesn't mean much.

LUPKIN: He thinks the federal government made a mistake by allowing Emergent to include this in its contract.

GARCIA-NAVARRO: So, I mean, is Emergent the only company doing that?

LUPKIN: Vaccine maker Moderna has another plan for protecting workers, one that's not part of its contract. The company announced that it would vaccinate its employees, board members and their adult family members. Moderna will be using doses that are separate from what it promised to the federal government, so technically, these people aren't jumping the line. They're more making their own line with a small number of doses not available to the general public.

GARCIA-NAVARRO: I mean, I guess you could argue that vaccine manufacturers are a type of essential worker - very essential right now.

LUPKIN: You could. And they're included in a phase of vaccine allocation, just not the highest priority one. I spoke to Ruth Faden, the founding director of the Berman Institute for Bioethics at Johns Hopkins University. She told me the fact that companies are planning to vaccinate employees' families ahead of schedule is especially problematic.

RUTH FADEN: Have you ever heard any discussion that immediate family members of even frontline health workers should get vaccine.

LUPKIN: I told her I hadn't.

FADEN: I haven't, either. And that's because it doesn't pass an ethics smell test.

LUPKIN: There are people at greater risk, she told me.

GARCIA-NAVARRO: That's NPR pharmaceuticals correspondent Sydney Lupkin. Thank you very much.

LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.