Bill Lang didn’t get much of a break over Thanksgiving. Almost every day last week, the medical director at a high-end concierge medical practice, WorldClinic, heard from clients asking when a Covid-19 vaccine would be available.

Two patients even texted on Thanksgiving day. “Since then, I’ve had at least three texts or calls every day just asking, ‘When do you think I can get a vaccine?’” said Lang, who is based in Washington, but also speaks with patients across the U.S. and internationally.

Athletes, politicians, and other wealthy or well-connected people have managed to get special treatment throughout the pandemic, including preferential access to testing and unapproved therapies. Early access to coronavirus vaccines is likely to be no different, medical experts and ethicists told STAT. It could happen in any number of ways, they said: fudging the definition of “essential workers” or “high-risk” conditions, lobbying by influential industries, physicians caving to pressure to keep their patients happy, and even through outright bribery or theft.

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