WASHINGTON - U.S. diplomats serving in countries with poor medical infrastructure and high coronavirus infection rates are venting frustrations about the way top officials in Washington are distributing the vaccines for the virus, according to meeting notes, interviews and documents obtained by The Washington Post.
The limited supply of the vaccines has forced State Department leaders to make difficult and unenviable decisions, and has created humbling experiences for U.S. diplomats representing the world's wealthiest country.
Managing the shortage is an early challenge for Secretary of State Antony Blinken, who has pledged to restore "morale and trust" in his department.
At least 13 foreign governments offered to inoculate U.S. officials serving abroad with their own supplies of U.S.-made Moderna and Pfizer vaccines - a gesture the State Department has accepted, said senior U.S. officials. The department is evaluating offers from at least eight other countries that are willing to do the same.
In Russia, some State Department personnel appealed to Moscow for doses of its Russian-made Sputnik V vaccine after Washington could not promise the delivery of U.S.-made vaccine in the near future, officials said. The Sputnik vaccine has not been approved by the World Health Organization or the U.S. Centers for Disease Control and Prevention. The State Department is not recommending that its employees take it but is permitting them to make their own health decisions.
The pandemic has killed more than 2.4 million people worldwide.
"It's embarrassing for the world's richest country to require the charity of other nations when it comes to vaccines," said one U.S. diplomat posted to the Middle East, "especially when you consider that the best vaccines were made in the U.S."
That's not the only indignity.
In China, some U.S. personnel have complained about being subjected to an anal swab test by Chinese authorities, said U.S. officials. The invasive technique has been heralded by Chinese doctors as more effective in detecting the coronavirus than a nasal swab despite the unpleasant nature of the procedure. In response to questions about the anal swab testing of U.S. officials, a State Department spokesperson said the department was "evaluating all reasonable options" to address the issue with the aim of preserving the "dignity" of U.S. officials "consistent with the Vienna Convention on Diplomatic Relations."
The State Department, like other U.S. agencies, is at the mercy of the Department of Health and Human Services for how much vaccine it receives. The State Department requested 315,000 doses of vaccine to cover the entirety of its workforce and has received 23% of that in three separate tranches, said officials, who like others spoke on the condition of anonymity to discuss internal operations.
The State Department's acting undersecretary for management, Carol Perez, acknowledged in a memo to employees this month that "there has been some confusion surrounding the Department's distribution of COVID-19 vaccines as we work to quickly provide the vaccines to our workforce."
Perez and other senior officials told The Washington Post that they were working to address concerns of diplomats in the field about the vaccines.
"The health and safety of our people is a top priority for the department and we are committed to providing our workforce timely, accurate information about vaccine distribution," Perez said. "This is a very fluid situation, and we understand employees are eager for information."
In his first address to the staff in January, Blinken noted that the pandemic had claimed the lives of five American State Department employees and 42 locally employed staffers around the world. "Many more have gotten sick," he said. "The president is committed to getting us through it as quickly as possible."
Some diplomats expressed sympathy for State Department leaders during an unprecedented crisis.
"The department has done a decent job of administering vaccines under very difficult circumstances," said a representative of the American Foreign Service Association (AFSA), the union that represents U.S. diplomats. "That said, the department could do a better job at communicating."
To address the communication concerns, Perez and the department's chief medical officer, Larry Padget, held a conference call Feb. 2 in which 900 U.S. officials phoned in from around the world.
A lingering complaint among some U.S. diplomats is their belief that the vaccine distribution disproportionately favors U.S. personnel in Washington and New York at the expense of diplomats in Brazil, Oman, Russia, Bahrain and dozens of other at-risk countries. They say non-mission-critical officials in the United States have been able to obtain the vaccine simply by coming into the office once a week, while diplomats abroad are left stranded with no assurances of inoculation in the near future.
"Washington is prioritizing domestic workers, with no real plan for the rest of us, when they all have access to U.S. health care," said one senior U.S. diplomat. "And the reason they give - continuity of work - makes no sense. What about continuity of working in the field?"
State Department leaders say they have implemented tougher vetting of which U.S.-based employees receive the vaccine and deny that they have disproportionately benefited the Washington area.
While the first tranche of vaccines the department received in December did primarily go to U.S. officials on the East Coast - in particular front-line medical personnel, the department's 24/7 watch centers and personnel in the New York passport office - the allotment also went to U.S. personnel in the capitals of Afghanistan, Iraq and Somalia.
The second allotment went to a mix of workers in regional passport offices in New Orleans; Portsmouth, N.H.; and Hot Springs, Ark., as well as foreign-based workers in West Africa, Mexico and Turkmenistan, officials said.
They said the bulk of the third allotment will go overseas to posts in eastern and southern Africa. They acknowledged that this plan leaves out many countries hosting U.S. personnel but said they are doing their best with a limited supply.
U.S. diplomats stationed abroad say the perception of being deprioritized also stems from an order that Washington sent to overseas posts, including those with travel restrictions in place and rising case loads, to send their most senior health unit staffers to Washington to assist with vaccinating employees in the Washington area.
"Our health units have been hollowed out to support vaccinations in D.C.," said one diplomat posted abroad.
A State Department spokesman said the department "authorized staff rotations" to "learn at a very high and expert level how to do contact-tracing and patient management." The official said the department will maintain "sufficient staffing to support our operations abroad."
The Biden administration has been more transparent about vaccine distribution than the Trump administration, diplomats noted, but there is room for improvement. "State needs to send out updated information on a regular basis," said the AFSA official.
Some U.S. diplomats look enviously at how the U.S. military is managing vaccine distribution, though the comparison is complicated by the Pentagon's larger size and the logistical challenges of reaching smaller far-flung embassies and consulates around the world.
The State Department, which has about 75,000 employees, has received about 73,000 doses and declined to say how many people it has vaccinated. Officials from other agencies, including the Treasury Department and USAID, also receive the shots supplied to U.S. embassies.
The Pentagon has administered more than 800,000 first doses of the vaccine, with 210,000 of those service members receiving second doses, the department said last week. There are about 1.4 million troops on active duty and about 2.9 million people employed by the Defense Department.
Lawrence Gostin, a professor of global health law at Georgetown University, said vaccine supply issues and a lack of information about inventory have clouded public health officials' ability to predict the pace of mass vaccinations.
"The lack of data has plagued our vaccine rollout in every sector," he said. "Making these vaccines is also time-consuming."
But that does not diminish the responsibility the department has to diplomats serving abroad, he said. "We're asking them to go to dangerous places. We have an ethical obligation to vaccinate our people overseas," he's said. "And it's hard not to bristle at the idea that we would farm out the protection of our diplomatic corps to a foreign government."
- - -
The Washington Post's Dan Lamothe and Julie Tate contributed to this report.