Just a day after NPR reported that SF-based healthcare startup One Medical had given COVID vaccines to ineligible patients, non-patient-facing staff, and friends and family of company leadership, the public health departments of San Francisco, San Mateo, and Alameda counties have announced they are ending their vaccine partnerships with the company.
According to NPR's reporting via internal emails among doctors and staff, One Medical began receiving an allocation of vaccine and distributing it to members in early January. One Medical apparently allowed members — who pay an annual fee of $199 to receive concierge-style care — to make vaccine appointments for two weeks without attesting to their eligibility (though proof of eligibility might have demanded in person), and an internal email allegedly discouraged medical staff from "policing" the eligibility of patients. A button was reportedly added to the appointment portal on January 14 for patients to attest to being either healthcare workers or otherwise eligible, but NPR had leaked emails that suggested One Medical doctors were raising alarm bells in recent weeks about healthy patients in their 20s or 30s receiving vaccines through the company, in defiance of state and local protocols for vaccine priority.
Forbes had broken the story two weeks earlier, citing a comment from one anonymous employee who said that when someone dishonestly attests to eligibility and shows up for their appointment, "the policy is still we do not turn [patients] away."
The San Francisco Department of Public Health (SFDPH) issued a statement to NPR saying it had allocated 12,000 vaccine doses to One Medical specifically for distribution to workers performing "in-home support services... and healthcare workers." And it said the department "expects all its vaccine provider partners to follow State and SF DPH vaccination eligibility guidelines."
But now, as NBC Bay Area reports, three Bay Area counties including San Francisco have halted all vaccine allocations to One Medical.
"The issues with One Medical were [a] disappointment but are not representative of the county’s robust and successful vaccination effort,” San Mateo County officials said in a statement to NBC.
As the Chronicle reported Wednesday, SFDPH has asked One Medical to return 1,600 doses that it hasn't yet given out. ABC 7's Kate Larson obtained a copy of the very cordial letter sent by SFDPH, which does not do any scolding for wrongdoing and closes with, "We appreciate your ongoing work in the overall response to this pandemic, and we will be in touch if we are ready to allocate additional doses to One Medical for administration at a future date."
This is the letter San Francisco's Department of Public Health sent One Medical on Monday, directing them to RETURN 1600 doses of the Pfizer vaccine, after reports in the media surfaced, that One Medical may be allowing people to "skip" the vaccine line. pic.twitter.com/N026fBESqP— Kate Larsen (@KateABC7) February 25, 2021
One Medical announced Wednesday that it had terminated some employees who were allegedly responsible for improperly distributing vaccine doses, as ABC 7 reported. But they simultaneously suggested that media reports about about improper distribution have "impugned our company values."
"Any assertions that we broadly and knowingly disregard eligibility guidelines are in direct contradiction to our actual approach to vaccine administration," a One Medical spokesperson said in a statement, which goes on to list various methods the company takes to screen patients and confirm vaccine eligibility. "Our data currently shows nationally 96% of individuals vaccinated by One Medical have eligibility documentation, and 4% generally were vaccinated in accordance with zero wastage protocols."
One Medical also said that its dues-paying members did not represent the majority of people the company had vaccinated.
"The majority of individuals vaccinated by One Medical across the US are not our own annual due-paying members, but have been referrals from departments of health, including health care workers, nursing home patients, educators, and the homeless," the spokesperson said.
Still, the company terminated "several" employees for disobeying protocols, per ABC 7, saying it had a "zero tolerance policy" for such actions.
Issues around equity and distribution protocols are likely to arise many more times in the coming months.
"I think we have to be very vigilant from an ethical point of view, not just looking at what the regulations say, but what are the factors and the ways structural racism is actually built into the way the distribution channels are being set up," says David Magnus, the director of the Stanford Center for Biomedical Ethics, speaking to ABC 7. And he suggests that it is everyone's personal responsibility to wait their turn and not try to cut the line before they're eligible.
Photo via One Medical