The stores’ online appointment portals usually don’t make explicit how the companies will use the information customers are providing. Privacy watchdog groups and some members of Congress have expressed concern about whether the pharmacy chains will use that data for marketing, like selling ibuprofen or other products to deal with aftereffects of the shots. And they caution that less tech-savvy patients hunting for appointments may unwittingly join pharmacy loyalty programs that could bombard them with unexpected marketing emails and texts.
“We don’t want to see folks in their desire to get vaccinated — and frankly, protect themselves and their loved ones — be in any way taken advantage of,” said Andrew Crawford, a lawyer at the Center for Democracy and Technology.
Some prominent consumer rights organizations, including the Electronic Privacy Information Center, on Friday sent a letter urging a group of Democratic state attorneys general to investigate how major pharmacy retailers are using data from Covid vaccine sign-ups. They’re also pressuring those retailers to keep that information separate from marketing or business databases and only collect the minimum amount of information necessary for vaccine appointments.
The Biden administration has bet big on retail pharmacies, this week announcing plans to more than double to 40,000 the number of pharmacy sites providing Covid vaccinations through a federal program. Federal data show that the sites are popular with Americans, who have increasingly grown accustomed to getting annual flu shots at their local pharmacies. The White House did not respond to questions about pharmacies’ use of data from Covid vaccine appointments.
The pharmacies say the data they are collecting is important for efficiently getting people in for vaccinations and that they are following health privacy rules. And some privacy attorneys point out that pharmacies have wide latitude to collect and use customer data, so long as they’re not mining sensitive health information.
But consumer advocates say there should be stronger limitations on how pharmacies use Covid vaccination data, given the urgency of the health crisis and how hard it is to find an alternative vaccination site in many cases.
The federal law regulating use of patient’s health information, HIPAA, prevents pharmacies from sharing customers’ health data for marketing purposes. But they can use the information to send coupons and promote health services they may already offer, like checkups or flu shots. There are fewer limitations on what they can do with the data once they scrub it of identifying details, like names and contact information, including potentially to make business decisions, legal experts said.
“I don’t want to dismiss people’s privacy concerns, but this just seems part and parcel of what pharmacies do on a daily basis,” such as reminders about flu shots and other services, said Trish Wagner, a privacy attorney with the firm Epstein Becker Green.
“As long as the outreach is in the confines of the [HIPAA] privacy rule, they may make that outreach,” she added.
Yet Doriann Cain, a partner with the Faegre Drinker Biddle & Reath law firm, said things like mandatory online sign-ups to book or search for appointments go beyond what pharmacies typically require for other services like flu shots, when people can often just drop in.
“The sheer volume of information they’re getting is probably pretty valuable to them,” Cain said.
The pharmacies can’t charge patients for vaccinations — the government is covering those costs. However, they can bill insurers and the government for the cost of administering vaccines.
The bigger business play for the companies appears to be the opportunity to line up repeat customers. During an earnings call in February, CVS chief officer Jon Roberts described the company’s “opportunity with the vaccines” to convert newcomers into long-term customers, starting with the 15 minutes patients are supposed to wait in the store after receiving a Covid shot. During that observation period, he said, store employees could try to sell patients on the company’s MinuteClinics for regular health care visits and CarePass, its paid pharmacy membership service.
“We have their email, we have their text message, and we have the ability to communicate with them regularly,” Roberts said.
CVS spokesperson Michael DeAngelis said the company is now using customer data for Covid vaccinations just for appointment confirmations and reminders, but he said using that information for marketing is “an option for the future.” CVS doesn’t ask vaccine seekers to create an online profile until they are ready to schedule an appointment — a phone number is mandatory, but email is optional.
“What I can say generally about our patient programs is that they’re opt-in, so everything we do is with the consent of our customers,” DeAngelis added.
A spokesperson for the Federal Trade Commission, who didn’t say if the consumer protection agency is examining how retail pharmacies are using data from Covid vaccinations, said companies could be investigated if they mislead customers about how their information is being used.
“If companies tell consumers they are collecting data for only one purpose, they cannot then use that data for another purpose,” the spokesperson said.
Some lawmakers have recently introduced bills aimed at curbing companies’ use of data collected for the pandemic response, warning that efforts to fight the virus have been hindered by people’s fears about how their personal information might be used. One of those measures, the Public Health Emergency Privacy Act, would limit how retailers use vaccine scheduling data.
“Data should be used as intended, with public health agencies and tech companies deploying new digital tools to fight the spread of COVID-19,” said bill co-sponsor Rep. Suzan DelBene (D-Wash.).
The federal government began shipping Covid vaccines directly to retail pharmacies in early February, but discussions about the arrangement began under the Trump administration last fall. Twenty-one national chains and independent pharmacy networks are participating in the federal program, and states have also directed some of the doses they receive from the federal government to pharmacies. CVS and Walgreens are also managing vaccination programs for long-term care staff and residents through an agreement struck with the Trump administration.
Concerns around how pharmacies may use customer data didn’t come up in early discussions with the federal government, said Mitchel Rothholz, chief of staff for the American Pharmacists Association, the industry’s largest trade group. At the time, he said, the chief concern was whether pharmacies would use the data to prioritize their existing customers for vaccine slots, rather than follow guidelines set by states, he said.
In some cases, vaccine seekers could feel incentivized to sign up for customer accounts at the pharmacies. Rite Aid, for instance, doesn’t require people to make an account to book an appointment, but the company does notify registered customers by phone if their health records suggest they’re eligible for vaccines when there are unused doses available, a spokesperson told POLITICO.
Privacy experts said that some retail pharmacies have been better than others at separating vaccine appointments from marketing efforts. The grocery chain Albertsons, at the point of securing a vaccine slot, allows people to opt-in to receive Covid-related marketing information about vaccines or general marketing outreach, rather than register them automatically.
Of the chains that require that people create user accounts before searching for an appointment, Walgreens and Health Mart make people enter both their phone numbers and emails. Walmart and Sam’s Club did not respond to multiple questions about what data they collect and how it’s used.