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A fair process for deciding who gets early access to the Covid-19 vaccine is a moral test, and we're muddling through it.
Of the states w/ their criteria online, most adopt the CDC Immunization Practices Advisory Committee's guidance:
Place at the front of the line "paid & unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients."
Place at the front of the line "paid & unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients."
That's . . . not exactly a model of clarity. And it leads to situations like this: https://www.sfgate.com/bayarea/article/Stanford-COVID-vaccine-residents-protest-15814131.php
And this: https://www.al.com/news/birmingham/2020/12/former-gov-robert-bentley-receives-covid-19-vaccine.html
(AL ex-governor, now a private-practice dermatologist)
(AL ex-governor, now a private-practice dermatologist)
Side note: only 2 of the CDC advisory cmte's 55 members & liaisons have law degrees. Neither is a practicing lawyer. If states are going to adopt this CDC guidance whole-cloth, more thought needs to go into its drafting.
The CDC cmte hasn't issued guidance for later stages. So some states are rushing in. Here's Alabama again, planning on just giving doses to big companies and hoping their CEOs distribute them internally in the public interest. 
https://www.politico.com/news/2020/12/18/cutting-in-line-covid-vaccine-448048
https://www.politico.com/news/2020/12/18/cutting-in-line-covid-vaccine-448048
Later, primary care doctors will be able to determine which of their patients qualify for earlier access. Obvious potential for abuse here. https://www.latimes.com/california/story/2020-12-18/wealthy-patients-scramble-covid-19-vaccine
In theory, the False Claims Act could act as a partial deterrent. The feds are paying for the doses, after all. But there's a circuit split re whether a physician's clinical opinion can be "false" under the FCA.
Best solution might be for the states -- which pay $ to manage vaccine distribution w/in their borders -- to amend their "little FCAs" for this situation.
E.g., increase bounties for whistleblowers. Right now, the potential recovery re a few dozen misdirected doses is just too low to motivate reporting. (What are damages? 3x marginal cost to govt of the misappropriated doses?)
Bottom line: states need detailed CDC guidance, ideally involving lawyers in the drafting to identify ambiguities. States then must announce clear penalties to deter line-cutting. Otherwise, this could have all the fairness and forethought of the Vietnam-era draft. (/end rant)
