Some primary care physicians are being left out of the first wave of COVID-19 vaccinations, even if they are treating patients with the illness. Medical ethicist Art Caplan told Boston Public Radio on Wednesday the issue is a “snafu” in the distribution plans that routed much of the initial doses to hospitals, and left out doctors with no hospital affiliation.

“If you write rules for the states, like the CDC, or the states adopt rules that say give the vaccine first to nursing homes then to healthcare workers, then you’re giving them out at hospitals and nursing homes,” said Caplan. “The reason they’re getting missed even if they have patient populations that have a lot of COVID … it’s just not where they are.”