San Francisco-based healthcare startup One Medical is the latest organization being called out for unethical practices in the distribution of still very limited supplies of COVID-19 vaccine — allegedly including giving vaccine shots to friends and family of company leadership, ineligible patients in their 20s and 30s, and non-patient-facing support staff.

It was inevitable that as we close out the first year of this pandemic in America with not enough vaccine to go around, there would be plenty of stories of shadiness among the privileged cutting in line to receive the vaccine. The latest comes from an NPR investigation of One Medical, where leaked internal communications appear to show that the company has mishandled its vaccine allocations in numerous ways.

One Medical doctors in California and Washington State have reportedly been trying to alert colleagues about patients obtaining vaccines before they're eligible, pushing past older and more vulnerable patients who are still waiting for their turn. The Washington State Department of Health has in fact halted its distribution of vaccine supplies to One Medical due to a complaint it received last month.

Also, as NPR reports, One Medical made the decision to give vaccine shots to all of its San Francisco-based employees regardless of their roles — including, allegedly, IT staff and work-from-home administrative staff. Friends and family of company leadership also were allegedly allowed to cut the line, though NPR's evidence of this seems anecdotal.

Forbes ran a story two weeks ago about One Medical's alleged practices with vaccine distribution, via reports from two anonymous employees.

The company, founded in 2007 and riding a trend in concierge medical service, allows members access to quick in-person and telemedicine appointments for a $199 annual fee, and this past year it's also given members sometimes easier access to COVID testing than is widely available in some places. The company went public in 2020 at $14 a share, and the stock has since soared to $53, giving it a valuation of around $6 billion.

Reports of unethical vaccine distribution have been popping up for over a month. One notable story about Good Samaritan Hospital in Los Gatos giving early vaccines to teachers in the local school district has produced an odd story, as the Mercury News reported this week, in which the hospital had quietly arranged the vaccines in a quid pro quo because of work teachers did to raise money for meal program to feed hospital staff last year.

For the first two weeks of January, according to NPR, One Medical was administering vaccines via appointments on its website without asking a question about a patient's eligibility — the question about one's eligibility didn't get added to the appointment portal until January 14. And a company employee allegedly sent around a directive telling staff that it wasn't their job to do any "policing" of patients' eligibility.

"Why are young patients without health problems, on a trial membership... allowed to book and receive a covid vaccine while healthcare workers are being waitlisted?" asked one medical professional in a leaked email obtained by NPR. "I just saw two appointments for such."

A One Medical doctor in Washington State reportedly sent a similar email saying that they "had two [patients] today, both in their 20-30s without risk factors and are tech workers who have gotten their covid vaccines. One was thru us."

An estimated 12,000 vaccine doses have been given so far to One Medical from the county of San Francisco. The San Francisco Department of Public Health issued a curious statement to NPR saying that One Medical was "engaged primarily to provide vaccine to in-home support services... and healthcare workers," in other words, not to any patient population at large. "SF DPH expects all its vaccine provider partners to follow State and SF DPH vaccination eligibility guidelines," the department said.

One Medical has issued statements refuting NPR's reporting, saying it has never "knowingly" distributed any vaccine to someone who was ineligible.

Chief medical officer Andrew Diamond said in a statement, "There was never guidance that said 'do not verify'... that would be counter to our principles." But when the NPR reporters showed they had internal communications suggesting otherwise, he replied, "that's clearly not the guidance, nor is that the intent of the guidance. We've been far clearer since then."

"We are doing absolutely everything in our power to vaccinate as many eligible people as possible," Diamond continued, blaming the "fog of war" and various "conflicting jurisdictional guidance and profound public anxieties" for any possible mistakes in eligibility verification.

So, right now it's late February and vaccine supplies are tight across California. Imagine the tsunami of stories that await us as these next eligibility phases create even more ways to fudge one's eligibility — including the phase that begins on March 15 in which it's up to doctors' discretion whether a patient's underlying condition qualifies.

Photo courtesy of One Medical