The Department of Health gave hospitals in Washington state a stern warning this week: offering vaccines outside of the state’s phases, including VIP access, could cost distributors access to shots in the future.

The department sent a letter, which the Washington State Hospital Association supported, that went out to all enrolled vaccine distributors on Monday, following reports from the Seattle Times last week of hospitals in the Puget Sound offering their foundation donors or volunteers special access to doses.

Spokane’s two largest hospital systems have not offered special access to vaccines for donors or volunteers, according to hospital representatives.

“VIP scheduling, reserving doses for inequitable or exclusive access, and similar practices are banned and will not be tolerated,” the letter says. “If we find out a provider is giving out vaccine inequitably or is doing behaviors listed above or similar, we may reduce or stop allocations to that provider.”

The state Department of Health is working to ensure that the vaccine is distributed in a fair and equitable manner, which means rolling out vaccine supplies in phases to certain populations.

The letter asks that hospitals do not distribute the vaccine through VIP or exclusive appointment scheduling, hold back doses for certain donors, family members or vaccinate people before they are eligible.

“We don’t support any of those special access kind of programs,” Cassie Sauer, CEO of the hospital association, said this week.

There are discussions happening with the association and the governor’s office about the potential for Gov. Jay Inslee to possibly issue an order prohibiting such activity as well, Sauer said.

In the Puget Sound region, Providence General Foundation donors were offered special access to vaccines, the Everett Herald reported last week.

That foundation is separate from the local Providence Health Care Foundation, however, which supports Providence hospitals in the Inland Northwest.

The Providence Health Care Foundation did not extend invitations to its donors, according to Providence spokeswoman Beth Hegde.

The vaccine clinic at Holy Family Hospital held in late January is, to date, the only public-facing clinic Providence opened to community health care providers, Providence caregivers, local Boards of Directors and anyone in the community. That clinic was only for Washington residents who were eligible to be vaccinated, but they did not need to be Providence patients to get vaccinated.

The Holy Family clinic was set up to administer 1,400 vaccines in a three-day timeline, and details about the clinic were sent to more than 800 local medical providers, including those not affiliated with Providence, according to Hegde. She said all the spots were filled within three hours after the notice went out.

MultiCare in the Inland Northwest does not offer any prioritized lines or access to the vaccines, according to MultiCare spokesman Kevin Maloney.

“Guided by our values of integrity and stewardship, MultiCare is committed to getting the COVID-19 vaccine out to the communities we serve as quickly as we can, in line with the guidelines put forth by the state of Washington,” a statement from Maloney says. “We are currently focused on offering the COVID-19 vaccine to those currently eligible in Phase 1A and Phase B, tier 1. We do not offer any prioritized line or access to vaccinations that is outside of Department of Health guidance.”