COVID-19 vaccine rules spark confusion for some in Philly. Others are jumping the line.

As COVID-19 vaccination rolls out with mounting confusion and disorganization, the nation’s chain drugstores say they could be the shot in the arm that the massive effort needs.

About 40,000 retail pharmacies across the country are ready, willing, and federally certified to administer COVID-19 shots — whenever enough vaccine exists. The National Association of Chain Drug Stores says its members could “easily” administer 100 million doses of vaccine in 30 days if supplies were available.

But nothing happens easily during this pandemic.

A partnership between Rite Aid and the City of Philadelphia, intended to help get the vaccine to health-care workers, has enabled ineligible people to jump the line and get protection ahead of that top-priority group, called 1a, which is at high risk of exposure to the coronavirus.

Complaints “are coming to us from all angles that these [Rite Aid vaccine scheduling links] are being shared and people are using them even when they aren’t in 1a,” James Garrow, spokesperson for the Philadelphia Department of Public Health, said Friday.

Garrow and James Peters, chief operating officer of Rite Aid, said that barring ineligible people, either by denying access through the website or at the store, would be impractical. It would also be against company policy, Peters said.

Yet Philly Fighting COVID is adding such filtering to its sign-up process after confronting the same kind of line-jumping. The civic group has partnered with the city to run a mass vaccination site at the Pennsylvania Convention Center.

“If any individuals who self-identify as outside of the designated phased priority groups (currently 1a health care workers) attempt to create an [online] appointment for vaccination, that appointment will be filtered from the system,” Philly Fighting COVID said in an email Friday.

Peters, with Rite Aid, said: “We’re working as hard as we can to do the right thing. ... Consumers are confused.”

Understandably so.

Before the Pfizer-BioNTech and Moderna two-shot vaccines were authorized in December, the U.S. Centers for Disease Control and Prevention, states, and jurisdictions such as Philadelphia spent months drafting a priority system to make sure the initial limited supply of vaccine reaches those who need it most. Phase 1a included nursing home residents as well as health-care workers. Phase 1b was to include essential workers such as teachers and those age 75 and up.

The lame-duck Trump administration — which has left states to manage the pandemic response — upended that priority system on Tuesday. Health Secretary Alex Azar told the states to push to the front of the line a vast group of people he wanted to be there from the start — people age 65 and over — as well as younger people with chronic health conditions.

He also said the federal government would immediately ship out vaccine initially reserved for second doses. However, that reserve had already been depleted, the Washington Post reported Friday.

Whether the incoming Biden administration can bring order to the rollout remains to be seen, but Azar’s directive has abruptly increased variation in state vaccine policies, while feeding public perceptions that getting a shot is a dog-eat-dog competition.

New Jersey is among the states that have embraced Azar’s open-the-floodgates approach. Pennsylvania is considering it. Philadelphia is so far sticking to plans to finish 1a and move to 1b, keeping 65- to 74-year-olds in 1c.

It was to help finish vaccinating health workers not affiliated with hospitals that the city contracted with Rite Aid. The company provided a link to a website that could be used to schedule a shot at one of 26 Rite Aid stores in Philadelphia.

On Jan. 7, when the city began emailing the link to health-care workers, the website did not ask about eligibility or say that only health-care workers should sign up.

A 65-year-old Philadelphia woman, who is working remotely for a publishing company, signed up that first day after a relative forwarded the link. Like others who contacted The Inquirer, she asked for anonymity because of the ethical sensitivity of the issue.

“There were no restrictions,” she said. “I thought, ‘Geez, am I taking a spot from someone?’ I asked my colleagues at work and they all said, ‘Go for it’ because the important thing is that the vaccine is given to as many people as possible.”

The next day, this language was added to the webpage and highlighted in yellow: “Appointments are currently for homecare or healthcare workers only. By scheduling an appointment, you acknowledge that you are a healthcare provider and qualify to receive the vaccine per your jurisdiction’s requirements.”

Since then, Rite Aid has received 8,400 doses from the city and has administered about 4,300, Garrow said.

How many shots went to ineligible people is unclear, but more than a few.

“I have family members who signed up on the Rite Aid portal for the COVID vaccine. None of them are in the high priority group that the vaccine should be reserved for,” a woman emailed The Inquirer. “I called the Rite Aid on South 9th Street to check. ... The store does no pre-screening during the registration or when the customers come into the store.”

“There is no requirement to prove that you are actually in group 1a or any other group when making an appointment,” said a pharmacist who emailed The Inquirer. “I’ve been sent that link and/or asked about it by many people who have nothing to do with healthcare.”

“I was first made aware of the website and loophole by a patient late last week, and subsequently have had many patients tell me that they have signed up. I have tried to explain the ethical issues to those who have asked,” a primary care physician emailed The Inquirer.

As of Friday, about 31 million doses bought by the federal government had been distributed to the states, and 12.3 million had been administered, according to the CDC.

Because the rollout is so inconsistent and uncoordinated, Rite Aid does not try to be the gatekeeper, Peters said.

“Rite Aid does not determine how much vaccine we receive, who gets it, and we don’t disseminate the scheduling tool that we provide to the state or jurisdiction,” Peters said. “We don’t do any credential checking because it changes by the minute. It’s a very fluid situation.”