A ‘restricted’ free-for-all

Russia’s coronavirus vaccine is rolling out in Moscow to risk groups, but hospitals are actually inoculating anyone who wants it, due to low demand driven by safety concerns

Last week, Vladimir Putin ordered health officials to begin rolling out Russia’s coronavirus vaccine, Sputnik V, on a mass scale to people in certain risk groups — namely, doctors, teachers, and others most likely to come into contact with infected persons. Despite these restrictions, officials in and around Moscow (where the vaccine has been made available first) have been administering the shots to virtually anyone who wants one, learned Meduza special correspondents Svetlana Reiter and Liliya Yapparova, who also discovered a special chat group on Telegram that contains instructions explaining how to get Sputnik V, even if you’re not in a risk group.

Russia’s Health Ministry and city officials in Moscow have been clear about who, technically speaking, can get Sputnik V, the country’s first vaccine against the coronavirus. The eligible risk groups include health workers, teachers, “workers in the fields of public transportation, trade, and food,” law enforcement, and social workers, as well as salon workers, dry cleaners, bank tellers, and security guards. Also, students and military conscripts.

According to instructions from Mayor Sergey Sobyanin’s office, Muscovites hoping to get inoculated against COVID-19 need to bring their passport, health insurance policy number, and documentation proving their employment in one of the identified fields.

Spokespeople for Russia’s Health Ministry told Meduza that they plan to move doctors and teachers to the front of the vaccine line. An official in the federal government with knowledge of Sputnik V’s rollout also told Meduza that each region across the country will receive roughly 17,500 doses of the vaccine to begin mass inoculations.

Sputnik V’s chief developer, Denis Logunov, told Meduza that the vaccine still hasn’t completed its Phase III trial, meaning that it cannot yet be made available to the general public. The drug currently has only “limited” approval, which allows health officials to vaccinate only people in certain risk groups, Logunov explained.

So far, the only published data from Sputnik V’s completed clinical trials come from the vaccine’s combined Phase I-II trial and its 20 participants. “We have no [detailed, published] data on how this vaccine will affect the body, shall we say, in the long run,” says Svetlana Zavidova, the executive director of the nonprofit Association of Clinical Trials Organizations. “And we still have no data about the drug’s effectiveness. We can’t even assess the risk of widescale use,” she warns.

Though the concrete data is still lacking, the Russian authorities appear to be confident in the vaccine. Sources in the Health Ministry and at the Gamaleya Research Institute (which developed Sputnik V) told Meduza that researchers plan to publish their provisional results before the year’s end in an authoritative international medical journal.

Not everyone, however, is leaping at the opportunity to get vaccinated before the clinical trials are done. Dmitry Belyakov, the head of an independent union for first responders, told Meduza that his supervisors offered him first access to Sputnik V, but he declined. “Some people signed up and others didn’t want it. It’s a personal thing and management didn’t pressure anyone,” Belyakov says.

In and around Moscow, mass vaccinations against COVID-19 are already underway. Doctors, teachers, and others in risk groups, however, aren’t being prioritized — the shots are going to anyone who wants them.

Telegram and the vaccine

On December 2, just hours after President Putin’s announcement that Russia would begin mass vaccinations against the coronavirus, a chat group on the instant messaging platform Telegram appeared called “Civil Vaccination” — later renamed “Civil (Mass) Vaccination Sputnik V (GamCovidWak)” — where one of the first messages contained surprisingly detailed instructions explaining how Muscovites could get inoculated immediately, regardless of their profession. For example, one message told people to visit a hospital in the town of Khimki and ask for “Head Nurse Olga Pavlovna,” who is allegedly responsible for doling out the facility’s Sputnik V. Civil Vaccination lists another six hospitals in and around Moscow where the coronavirus shot is available.

According to the Telegram channel, doctors are eager to vaccinate groups of five people at once because Sputnik V is shipped in five-dose ampoules. The chat group’s members quickly started organizing themselves into groups of five to make it easier for hospitals to vaccinate them all at once. “As soon as you get five [people] together, the vaccine is thawed in 20 minutes and they give it to you,” says the channel in its instructions.

In hospitals outside the city — in Nakhabino, Krasnogorsk, Khimki, and Reutov — health workers are saying openly that Sputnik V is available to anyone, regardless of profession, despite the fact that the region’s Health Department insists that the vaccine is restricted to people in risk groups until December 15.

Before Meduza published this story, roughly 400 people had joined the Civil Vaccination channel. (The chat group was closed after this story was released.) Members compared the lines for vaccination at different hospitals, shared photos of vials containing Sputnik V, and discussed its side effects. The channel’s community also debated rumors about mass vaccinations “of everyone, including civilians,” at Defense Ministry facilities. Here and there, someone posted messages trying to buy the vaccine from others. “Money doesn’t help if you don’t know where to pay. If you know where, please send me a message. Seriously,” wrote a chat-room administrator.

Meduza was unable to corroborate reports that Russia’s coronavirus vaccine is for sale illegally, but a source with ties to Sputnik V’s developer says there is a black market for the drug. “The doctors who don’t want to get the shot are selling their doses for 100,000 rubles [$1,350]. Maybe you don’t believe in the vaccine, and you could give your dose to a nurse, but no,” says Meduza’s source.

“It’s not a problem”

Six individuals who are not in any of the designated risk groups told Meduza that they managed to get the coronavirus vaccine at hospitals in and around Moscow between December 5 and 7. These people say they were asked only for their identification and medical insurance cards. One man says he even informed the hospital openly that he isn’t in a risk group. “They said there weren’t many people yet, so it wasn’t a problem,” the hospital told him.

Meduza’s own correspondent managed to register for Sputnik V at a clinic in Khimki with just a name and age. The nurse never asked for proof of residency or profession. During registration, the clinic later confirmed that the vaccine was being offered without restrictions. Meduza also verified that the vaccine was available to the general public at a hospital in Krasnogorsk that was recommended by the Civil Vaccination chat group, but another facility listed by the group in Zvenigorod said its supply of Sputnik V was meant only for doctors and teachers.

Even the hospitals that do ask vaccine patients to list their professions apparently don’t require documentation. According to reports in the Telegram group and based on the experience of a Novaya Gazeta correspondent, it’s enough simply to tell the nurses that you’re a teacher or even that you occasionally volunteer with children.

A vaccination against research

Moscow’s uncontrolled, mass COVID-19 immunization campaign threatens to damage the clinical trials of coronavirus vaccines in Russia, a source with ties to Sputnik V’s developers told Meduza, explaining that control subjects who received a placebo might get vaccinated independently, outside the trial study, thereby corrupting the clinical results. Meanwhile, test subjects who receive a coronavirus vaccine but then proceed with another immunization (just to be sure) are potentially endangering themselves.

According to reports on Civil Vaccination, participants in coronavirus vaccine trial studies have found it impossible to get the immunizations now offered to the public because their names appear blacklisted in Russia’s State Unified Medical Information and Analytical System. Individuals who have formally exited clinical trials, however, are entitled to receive Sputnik V, if they belong to one of the designated risk groups.

Local clinics in Moscow, however, don’t have access to these lists of vaccine-study participants, and some of these patients have managed to get shots outside the trial to ensure that they’ve been immunized against COVID-19. Meduza learned about three such cases. On Telegram, some acknowledged that they joined Sputnik V’s clinical trials not to help the drug’s development, but to get first access and return to some semblance of their lives before the pandemic. With the vaccine now available publicly, they want it again, just in case they received a placebo in the Phase III trial.

When asked for a comment about the coronavirus vaccine’s rollout in Moscow, the Russian Direct Investment Fund (the sovereign wealth fund sponsoring Sputnik V’s development) referred Meduza to Russia’s Health Ministry, which has not responded. A source with ties to the vaccine’s developers stressed to Meduza that Sputnik V’s creators have no control over Russia’s immunization process; rules prohibit researchers from contacting the doctors now administering the vaccine.

After this article was published, Moscow’s Municipal Health Department told Meduza that participants in clinical trials are barred from the city’s new immunization program: “There are personalized records for all volunteers, and the system does not allow these people to be vaccinated.” Health officials also argued that volunteers cannot receive Sputnik V even if they’ve formally exited their clinical trial.

Doctors and Sputnik V

Despite Sputnik V’s apparently wide availability around Moscow, not all the local medical workers say they’ve been offered the vaccine. One paramedic told Meduza that she and her colleagues haven’t heard about access to the drug. “Maybe they’re [only] vaccinating doctors from the ‘red’ zones,” she guessed, alluding to the areas throughout the capital where COVID-19 infections have spiked. Even if she’s offered Sputnik V, however, she says she’ll decline, having soured on Russian-made vaccines after a bad experience with a domestic flu shot: “There are good guys at the Gamaleya [Research Institute], but they were under pressure — they were rushed. Faster, faster, they said.”

Oncologist Mikhail Laskov told Meduza that he’s waiting to read the published clinical data on Sputnik V’s effectiveness before he agrees to be vaccinated. “Everything I know [about the drug] is from press releases, and that’s not enough for me to make a decision,” Laskov says.

A source in Mayor Sobyanin’s office confirmed to Meduza that many of the city’s doctors and teachers have been hesitant to sign up for Sputnik V. At the same time, a source close to the management at a hospital in Lapino now treating coronavirus patients says most of the staff members have already been vaccinated.

“Nobody wants to wait forever”

Elena Romanova, the spokeswoman for Moscow’s Regional Health Department, assured Meduza repeatedly that the vaccine’s rollout prioritizes teachers, health workers, public service workers, and housing and utility professionals. She could not, however, explain why several vaccination centers around the capital have offered Sputnik V to individuals outside these risk groups and sometimes to people registered in other regions. Romanova also declined to say if hospitals are verifying that patients aren’t also participants in clinical trials before administering Sputnik V.

Romanova’s department has reported that there are now roughly 30,000 medical workers in the Moscow region tending to patients infected with COVID-19, but she declined to say how many of these people have been vaccinated against the disease. Romanova also declined to say how many doses of Sputnik V are available locally. On December 7, Governor Andrey Vorobyov said the region had already inoculated 5,000 people.

Moscow’s Municipal Health Department did not respond to Meduza’s inquiries.

The fact that Sputnik V ampoules come bundled in five doses, a federal official familiar with Russia’s vaccination program confirmed to Meduza, incentivizes health workers to distribute the drug widely. “What happens is you get one doctor or teacher and nobody wants to wait, so they open it up and give it to anyone who wants it, so nothing is wasted. They don’t pour it down the drain, thank God,” says Meduza’s source.

“The main thing for us is to make a plan,” a nurse distributing the coronavirus vaccine at one of Moscow’s clinics told Meduza. “They’ve delivered it, so we administer it. Nobody wants to wait forever for people in the risk groups [to show up], and we’ve got to file our reports.”

Story by Liliya Yapparova and Svetlana Reiter, edited by Pavel Merzlikin

Abridged translation by Kevin Rothrock