A8 EZ RE THE WASHINGTON POST.SATURDAY, OCTOBER 23 , 2021
particular, piled up after regula-
tors probed the shots’ safety and
Americans opted for mRNA vac-
cines from Pfizer-BioNTech and
Moderna instead.
“Everybody was looking at that
thinking, boy, we’ve got all this
perfectly good vaccine that’s go-
ing to expire, and in India they
can’t even get an y,” said Marcus
Plescia, chief medical officer at
the Association of State and Terri-
torial Health Officials.
Plescia said “that conversation
sorted itself out” after the federal
government clarified the reasons
it’s impractical to share expiring
doses. Pfizer doses, for example,
need to be kept in cold storage,
and there’s no standard to ensure
that health providers can safely
gather and transport expiring
doses.
The frustration in California
notwithstanding, Plescia said
state health officials generally
support the federal govern ment’s
caution.
“At least right now, there’s not
any kind of system or mechanism
to provide any quality assurance
to this,” he said.
As of Oct. 11, approximately
4.6 percent of more than 486 mil-
lion coronavirus vaccine doses
have been wasted, according to
federal data.
“This rate remains low, which
is evidence of the strong partner-
ship among the federal govern-
ment, jurisdictions and vaccine
providers to get as many people
vaccinated as possible while re-
ducing vaccine wastage across the
system,” said Kirsten Allen, a
spokeswoman for the Depart-
ment of Health and Human Ser-
vices.
The federal government is ex-
ploring ways to reabsorb unused
vaccines that it could then send
internationally, but it has run into
logistical problems. Because vac-
cines are dispersed so widely, offi-
cials said, going from site to site to
gather them would consume sig-
nificant resources.
The Centers for Disease Con-
trol and Prevention has stressed
publicly that it retains control
over the vaccines, including the
possibility of export. On its web-
site, the CDC writes, the doses
remain “U.S. government proper-
ty until administered to the vacci-
nation recipient.”
[email protected]
[email protected]cuss export restrictions publicly.
“We have examined those, and
continue to work with states,
CDC , FDA and CAG as we explore
all options, but that process is
being led at the federal level and
states have been advised they
should not be sending any doses
internationally, due to these com-
plex factors.”
During the spring and summer,
the gap between the U.S. and
Mexican vaccination programs
was wide.
“The contrast was huge,” said
Carlos González Gutiérrez, the
Mexican consul in San Diego. “My
23-year-old daughter was able to
get fully vaccinated in California,
while in Mexico family and
friends over 65 were still not able
to get their first dose.”
The difference has narrowed,
but Mexico still does not have
enough doses to open its vaccina-
tion program to most minors.
“The responsibility of vaccinat-
ing people lies with the Mexican
government and I think we’ve
done a good job of it,” González
said. “But we won’t reach our full
potential unless we continue to
receive support from our friends
in California.”
The United States has donated
10.9 million vaccine doses to Mex-ico, making it among the top
recipients. Nearly 40 percent of
Mexicans have been fully vacci-
nated. But health officials on the
border say they are frustrated that
a bureaucratic hurdle is impeding
an easy way to further expand
vaccine availability in Mexico.
“It’s hard to believe that it’s
ever be tter to let doses expire and
throw them away rather than put
them to use,” said Jess Mandel,
chief of pulmonary and critical
care medicine at the University of
California at San Diego School of
Medicine.
In May, the university helped
spearhead a drive to vaccinate
26,000 Mexican workers from 40
maquilas , factories that produce
goods for export to the United
States. Vaccine export restrictions
meant the drive had to be held
between Mexican and U.S. cus-
toms checkpoints.
Public health officials say they
understand liability concerns, but
they shouldn’t preclude state and
local donation efforts, particular-
ly if recipient countries are will-
ing to sign waivers.
“Not only do we have a moral
imperative to help our neigh-
bors,” Mandel said, “but the better
we can ensure that covid is con-
trolled a few miles away on theMexican side of the border, the
more it will protect the health of
people here in San Diego.”
The U.S.-M exico border has
been closed to nonessential travel
since March 2020. But tens of
thousands of people still cross the
border each day, many of them
U.S. citizens or permanent resi-
dents who choose to live in Mexi-
co, or essential workers who enter
the United States for their jobs.
That cross-border traffic, and
the severity of Mexico’s coronavi-
rus outbreak, were among the
reasons, for some time, Southern
California had among the coun-
try’s highest caseloads. Next
month, the border will reopen to
nonessential traffic, raising new
concerns about viral spread. Offi-
cials in California and Mexico are
exploring ways to bring Mexicans
across the border to be vaccinated
in San Diego.
Across the United States, state
health officials have repeatedly
asked the federal government
about the possibility of sharing
expiring U.S. vaccine doses with
nations in need. Those conversa-
tions became more urgent this
summer as coronavirus cases
spiked in India, while some U.S.
states sat on unused stockpiles.
Johnson & Johnson vaccines, inJOEBETH TERRIQUEZ/EPA-EFE/SHUTTERSTOCK
People wait at the offices of the Federal Welfare Secretariat to request a certificate of vaccination
against the coronavirus in Tijuana, Mexico, on Tuesday. Demand for vaccines in Mexico has increased.BY KEVIN SIEFF
AND DAN DIAMONDmexico city — For months,
health officials and hospital exec-
utives in Southern California
watched as coronavirus vaccines
neared their expiration dates un-
used while demand for doses
waned.
A small group around San Di-
ego had an idea: It w ould donate
thousands of shots to Mexico, a
short drive away, where the vac-
cine rollout had been much slow-
er and the infection rate re-
mained high.
But as the plan was readied, it
was blocked by the White House
Vaccine Task Force. The doses
were instead discarded.
State and local officials across
the country have run into the
same problem, as the Biden ad-
ministration has prevented ef-
forts to donate leftover vaccine
doses t o India and other countries
suffering from acute outbreaks.
The reason, White House offi-
cials say, is that vaccines in the
United States are the property of
the federal government, not the
cities or states in which they are
distributed. That means the fed-
eral government is liable for their
use, and donation efforts must be
run out of Washington. The White
House runs its own program to
donate vaccines, usually through
the State Department and the U.S.
Agency for International Devel-
opment.
The United States has given
away more than 200 million vac-
cine doses abroad, carrying out
President Biden’s pledge to be
“the arsenal of vaccines for the
rest of the world.” But it has de-
nied multiple requests by local or
state governments to donate
soon-to-expire doses.
The policy has been particular-
ly frustrating for health workers
along the southern border, who
have seen up close the demand for
vaccines in Mexico, and the ease
with which unneeded doses could
be driven to Mexican vaccination
sites in border cities such as Tijua-
na and Mexicali.
“It seemed like a win-win and
something consistent with the
Biden administration’s goals,”
said Adolph Edwards, CEO of El
Centro Regional Medical Center
in California. “On the Mexican
side, they were begging us for
help. It’s infuriating that we had
to say no, when it would have
been so easy to make a difference.”
The conflict began several
months ago, when health profes-
sionals and officials in San Diego
County helped to identify 10,
expiring vaccine doses and
worked with their Mexican coun-
terparts in Baja California, who
agreed to receive, transport and
deliver them. A vaccination site
was identified — a shopping mall
near the border in Mexicali —
before the message arrived from
Washington.
“I contacted the White House
Vaccine Task Force and was told it
was not possible,” said Eric Mc-
Donald, chief medical officer for
San Diego County.
The White House says legal
liability means vaccines can be
exported only by the federal gov-
ernment. If California, for exam-
ple, distributed damaged vac-
cines, administration officials say,
the federal government would be
responsible.
“Given chain-of-custody con-
siderations, moving doses out
from more than 80,000 providers
would involve significant legal
and logistical challenges,” said a
U.S. of ficial, who spoke on the
condition of anonymity because
they were not authorized to dis-U.S. blocks Calif.
group from d onating
vaccines to Mexico
Federal government,
liable for their use,
controls distributionBY ELLEN FRANCISEcuador’s attorney general is
investigating President Guiller-
mo Lasso after an opposition poli-
tician filed allegations of tax fraud
against the president on the basis
of the Pandora Papers.
There was no immediate com-
ment from Lasso, who insists that
his tax record is clean. He did not
show up to testify this week before
the legislature, which has
launched a separate probe into
his offshore finances in light of
the revelations.
Disclosures based on the Pan-
dora Papers — a trove of more
than 11.9 million documents —
sparked calls for investigations in
other countries after The Wash-
ington Post and media partners
led by the International Consor-
tium of Investigative Journalists
(ICIJ) published stories this
month revealing the shadowy off-
shore financial universe of the
wealthy and powerful.The reports have rocked Czech
elections, kicked off an impeach-
ment bid in Chile and prompted
pledges of a crackdown on dirty
money in the United States.
In Ecuador, the secret files from
14 companies that provide off-
shore financial services showed
that former banker Lasso, who
took office as president in May,
had ties to offshore companies
and trusts including in Panama
and the U.S. state of South Dakota.
The investigation by The Postand the ICIJ found that a bur-
geoning American trust industry
is increasingly sheltering the as-
sets of international millionaires
and billionaires by promising lev-
els of protection and secrecy that
rival or surpass those offered in
overseas tax havens. That shield,
which is near-absolute, has insu-
lated the industry from meaning-
ful oversight and allowed it to
forge new footholds in U.S. states.
The inquiry by a commission of
the National Assembly of Ecuadorthis month will look into whether
Lasso broke a 2017 law that bars
presidential candidates and pub-
lic of ficials from holding assets in
foreign tax havens.
The complaint that led to the
second probe, by the attorney gen-
eral ’s office, came from a former
presidential hopeful and Indig-
enous leader, Yaku Pérez. He
urged authorities on Thursday to
examine allegations of tax evasion
linked to offshore firms, noting
that the cache of records alsonamed Lasso’s wife and children.
But the 65-year-old president
has said he ended his involvement
in the firms identified in the Pan-
dora Papers when he ran for head
of state again. (He had previously
run for president twice.) He is
reported to have said in a letter to
the legislature that he would
speak to lawmakers at the presi-
dential palace once he was aware
of all the allegations made in the
case.
[email protected]Ecuador’s president faces tax inquiry in wake of P andora Papers
BY KARLA ADAM
AND ERIN CUNNINGHAMlondon — Queen Elizabeth II
was resting and undertaking light
duties on Friday after she spent a
night in the hospital for some
“preliminary investigations” —
causing a bit of a stir in a country
glued to any reports of her health
— before returning to Windsor
Castle.
Britain’s 95-year-old monarch
was admitted to a London hospital
on Wednesday afternoon, widely
assumed to be London’s King Ed-
ward VII Hospital, a p rivate hospi-
tal favored by royals, and dis-
charged the following day. It was
her first overnight stay in a hospi-
tal in eight years.
“Following medical advice to
rest for a f ew days, The Queen
attended hospital on Wednesday
afternoon for some preliminary
investigations, returning to Wind-
sor Castle at lunchtime today, and
remains in good spirits,” the pal-
ace said.
Her stay was only revealed after
Britain’s Sun newspaper broke the
story late Thursday. As the only
monarch the vast majority of Brit-
ons have ever known, the queen
has been a reassuring presence in
people’s lives, and any hint of med-
ical issues is ta ken very seriously.
The BBC’s royal correspondent
Nicholas Witchell, who was criti-
cized on social media for wearing
a black suit and tie, told “BBC
Breakfast” on Friday that the situ-
ation was “quite difficult to read.”
“We were led to believe on
Wednesday by Buckingham Pal-
ace that the queen was resting”
when she was, in fact, in the hospi-
tal, he said. “We weren’t given the
complete picture then.” He added
that while the palace would argue
the case for medical privacy, “the
problem it seems to me is that
rumor and misinformation al-
ways thrives in absence of proper,
accurate and trustworthy infor-
mation.”
It’s not surprising that the pal-
ace didn’t issue a medical bulletin
immediately. It normally doesn ’t
say anything when royals go to the
hospital for checkups or tests, but
it will issue statements when roy-
als have procedures or operations,
or if events are canceled, to ex-
plain the no-show. But after the
Sun got a leak about the queen ’s
hospital stay, the palace respond-ed.
This week, the palace did an-
nounce the queen canceled a two-
day visit to Northern Ireland after
accepting medical advice to rest
for the next few days.
A palace official, speaking on
the condition of anonymity to dis-
cuss private interactions, said that
the queen had stayed in hospital
overnight for practical reasons
and that her medical team was
taking a cautious approach.
The of ficial on Friday said that
the situation was the same as onThursday, with the queen expect-
ing to rest and undertake light
duties. She is currently residing at
her Windsor Castle home.
Her last official event was on
Tuesday, when she welcomed
business leaders and diplomats at
the castle for a government-spon-
sored investment summit. In a
video posted on the royal family’s
Twitter account, the queen ap-
peared in good spirits, smiling and
chatting with guests.
The queen had returned to
Windsor Castle from Balmoral,the royal residence in Scotland
where she spends her summers,
this month. Since then, she has
maintained a b usy schedule, trav-
eling to Cardiff and Edinburgh to
address the Welsh and Scottish
parliaments and to Ascot for a day
at the races. She also held several
diplomatic “audiences” via video
link.
Prime Minister Boris Johnson
said that he understood that the
queen was back at work on Friday.
“I think everybody sends Her Maj-
esty... our very, very best wishes,everybody does and certainly we
have from the government,” he
told reporters during a trip to a
vaccination center.
“I am given to understand that
actually Her Majesty is, character-
istically, back at her desk at Wind-
sor as we speak,” he said.
Robert Hardman, author of the
forthcoming “Queen of Our Times,”
said it was hard to know if the
queen might slow down, but that
there were certain “core” duties she
would be loa th to give up on.
“She genuinely likes doing the
job,” he told The Washington Post.
“The absolute core functions she’d
never give up on are: talking to the
prime minister once a w eek, open-
ing p arliament if she can, honor-
ing the war dead every remem-
brance Sunday and addressing the
nation at Christmas. Those are the
core functions she will be keen to
continue and everything else on
top of th at, will be subject to doc-
tors orders and common sense.”
He added that the queen has a
“real horror of letting people
down,” and recalled how, years
ago, she had to cancel an event at
the last minute at Arsenal soccer
stadium because of back trouble.
A month later, the soccer club got a
call from the palace inviting the
squad to the palace for tea with the
queen.
“If she does let people down, she
hates doing it and tries to make it
up to them. I have no doubt having
not going to Northern Ireland this
week, Northern Ireland will get a
visit in due course,” he said.
The queen was last hospitalized
in 2013 after displaying symptoms
of gastroenteritis, which forced
her to cancel her trip to Rome.
[email protected]
[email protected]Jenn ifer Hassan in London
contributed to this report.Queen Elizabeth II resting with light duties after hospital discharge
KIRSTY WIGGLESWORTH/ASSOCIATED PRESS
Street lights in the design of a crown hang near Windsor Castle, where Queen Elizabeth II is said to be resting after a hospital stay.