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The Vaccine Had to Be Used. He Used It. He Was Fired.

The Texas doctor had six hours. Now that a vial of Covid-19 vaccine had been opened on this late December night, he had to find 10 eligible people for its remaining doses before the precious medicine expired. In six hours.

Scrambling, the doctor made house calls and directed people to his home outside Houston. Some were acquaintances; others, strangers. A bed-bound nonagenarian. A woman in her 80s with dementia. A mother with a child who uses a ventilator.

After midnight, and with just minutes before the vaccine became unusable, the doctor, Hasan Gokal, gave the last dose to his wife, who has a pulmonary disease that leaves her short of breath.

For his actions, Dr. Gokal was fired from his government job and then charged with stealing 10 vaccine doses worth a total of $135 — a shun-worthy misdemeanor that sent his name and mug shot rocketing around the globe.

“It was my world coming down,” Dr. Gokal said in a telephone interview on Friday. “To have everything collapse on you. God, it was the lowest moment in my life.”

The matter of Dr. Gokal is playing out as pandemic-weary Americans scour websites and cross state lines chasing rumors, all in anxious pursuit of a medicine in short supply. The case opens wide to interpretation, becoming a study in the learn-as-you-go bioethics of the country’s stumbling vaccine rollout.

Late last month, a judge dismissed the charge as groundless, after which the local district attorney vowed to present the matter to a grand jury. And while prosecutors portray the doctor as a cold opportunist, his lawyer says he acted responsibly — even heroically.

“Everybody was looking at this guy and saying, ‘I got my mother waiting for a vaccine, my grandfather waiting for a vaccine,’” the lawyer, Paul Doyle, said. “They were thinking, ‘This guy is a villain.’”

Dr. Gokal, 48, immigrated from Pakistan as a boy and earned a medical degree at SUNY Upstate Medical University in Syracuse. After working at hospitals in Central New York, he moved to Texas in 2009 to oversee the emergency department at a suburban Houston hospital. His volunteer work has included rebuilding homes and providing medical care after Hurricane Harvey in 2017.

In recent years, Dr. Gokal split his time between two area hospitals. But when the pandemic hit in early 2020, he lived for a month in a hotel and an apartment rather than risk infecting his wife, Maria, 47, who has pulmonary sarcoidosis, a disease in her lungs that leaves her winded after even minimal activity.

“I was petrified to go home and bring Covid to my wife,” he said.

Fortunately, he said, the Harris County Public Health department recruited him in April to become the medical director for its Covid-response team. The job paid less, but he was eager to protect his wife by limiting his exposure to the coronavirus in emergency rooms.

On Dec. 22, Dr. Gokal joined a conference call in which state health officials explained the protocols for administering the recently approved Moderna vaccine. The 10 or 11 doses in a vial are viable for six hours after the seal is punctured.

Dr. Gokal said the advice was to vaccinate people eligible under the 1(a) category (health care workers and residents in long-term-care facilities), then those under the 1(b) category (people over 65 or with a health condition that increases risk of severe Covid-related illness).

After that, he said, the message was: “Just put it in people’s arms. We don’t want any doses to go to waste. Period.”

On Dec. 29, a mild Tuesday, Dr. Gokal arrived before dawn at a park in the Houston suburb of Humble to supervise a vaccination event intended mostly for emergency workers. In part because of minimal publicity, the pace was slow, with no more than 250 doses administered. But this was the county’s first public event, he said. “We knew there would be hiccups.”

Around 6:45 at night, as the event wound down, an eligible person arrived for a shot. A nurse punctured a new vial to administer the vaccine, which activated the six-hour time limit for the 10 remaining doses.

The chances of 10 eligible people suddenly showing up were slim; by now, workers were offsetting the darkness with car headlights. But Dr. Gokal said he was determined not to waste a single dose.

He said he first asked the event’s 20 or so workers, who either refused or had already been vaccinated. The paramedics on site had left, and of the two police officers, one had been vaccinated and the other declined the doctor’s offer.

Dr. Gokal said he called a Harris County public health official in charge of operations to report his plans to find 10 people to receive the remaining doses. He said he was told, simply: OK.

He said he then called another high-ranking colleague whose parents and in-laws were eligible for the vaccine. They weren’t available.

The hours were counting down.

The doctor figured that if he returned the open vial to his department’s almost certainly empty office at this late hour, it would go to waste. So as he started the drive to his home in a neighboring county, he said, he called people in his cellphone’s contact list to ask whether they had older relatives or neighbors needing to be immunized.

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“No one I was really intimately familiar with,” Dr. Gokal said. “I wasn’t that close to anyone.”

When he reached his home in Sugar Land, waiting outside were a woman in her mid-60s with cardiac issues, and a woman in her early 70s with assorted health problems. He inoculated both.

Eight doses to go.

The doctor got back in his car — his wife insisted on going with him — and drove to a Sugar Land house with four eligible people: a man in his late 60s with health issues; the man’s bed-bound mother, in her 90s; his mother-in-law, in her mid-80s and with severe dementia; and his wife, her mother’s caregiver.

He then drove to the home of a housebound woman in her late 70s and administered the vaccine. “I didn’t know her at all,” he said.

Three doses remained, but three people had agreed to meet the doctor at his home. Two were already waiting: a distant acquaintance in her mid-50s who works at a health clinic’s front desk, and a 40-ish woman he had never met whose child relies on a ventilator.

As midnight approached, Dr. Gokal said, the third would-be recipient called to say that he wouldn’t be coming: too late.

Tired and frustrated, Dr. Gokal said that he turned to his wife, whose pulmonary sarcoidosis made her eligible for the vaccine. “I didn’t intend to give this to you, but in a half-hour I’m going to have to dump this down the toilet,” he recalled telling her. “It’s as simple as that.”

He said his hesitant wife asked whether it was the right thing to do. “It makes perfect sense,” he said he answered. “We don’t want any doses wasted, period.”

With 15 minutes to spare, Dr. Gokal gave his wife the last Moderna dose.

The next morning, he said, he submitted the paperwork for the 10 people he had vaccinated the previous night, including his wife. He said he also informed his supervisor and colleagues of what he had done, and why.

Several days later, the doctor said, that supervisor and the human resources director summoned him to ask whether he had administered 10 doses outside of the scheduled event on Dec. 29. He said he had, in keeping with guidelines not to waste the vaccine — and was promptly fired.

The officials maintained that he had violated protocol and should have returned the remaining doses to the office or thrown them away, the doctor recalled. He also said that one of the officials startled him by questioning the lack of “equity” among those he had vaccinated.

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What You Need to Know About the Vaccine Rollout

    • Providers in the U.S. are administering about 1.3 million doses of Covid-19 vaccines per day, on average. Almost 30 million people have received at least one dose, and about 7 million have been fully vaccinated. How many people have been vaccinated in your state?
    • The U.S. is far behind several other countries in getting its population vaccinated.
    • In the near future, travel may require digital documentation showing that passengers have been vaccinated or tested for the coronavirus.
    • When can you get the vaccine? What are the vaccine’s side effects? Is it safe to take during pregnancy? We’ve have answers to many of your questions.

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