Medical Examiner

How a 22-Year-Old’s Startup Botched Philadelphia’s Vaccine Rollout

A sticker that reads, "I've been vaccinated for COVID-19" stuck to the floor.
Gabriella Audi/Getty Images

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The company known as Philly Fighting COVID started out in an almost heartwarming way. It was one of those neighbors helping neighbors stories you’d hear about at the beginning of the pandemic. Andrei Doroshin, the founder of Philly Fighting COVID, and some friends started 3D-printing face shields for hospitals that were short on PPE. A couple of months in, Philly Fighting COVID pivoted to start testing people in underserved areas. Before long, the organization had pivoted again, to vaccine distribution, making elaborate plans to get Philadelphians vaccinated. But Philly Fighting COVID had no medical experience. It dispensed vaccines for just a couple of weeks before the Department of Public Health cut ties.

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As the vaccine rollout struggles along across the country, the story of what happened in Philly is an example of just how many ways vaccine distribution can go wrong. On Monday’s episode of What Next, I asked Nina Feldman, a reporter at the local public radio station, to explain what happened. Our conversation has been edited and condense for clarity.

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Mary Harris: So, Philly Fighting COVID helped launch Philadelphia’s community vaccination program, setting up a huge clinic in the Philadelphia Convention Center, where they invited the press to a big announcement. Tell me about that event.

Nina Feldman: It was exciting. It was this big moment. Up until then, we knew people were getting vaccinated, but it was just at hospitals. And this was the first time that it was happening in the community. You had the mayor and the deputy health commissioner and a handful of City Council members, standing in front of a podium in the in the convention center alongside Philly Fighting COVID announcing this big, first mass vaccination clinic. And we felt hopeful. Pretty soon, hearing Doroshin talk, little things he was saying started making my ears perk up. He just made a couple of claims that were patently not true. He claimed to be doing half of the city’s testing at one point, and the numbers he gave to support that just didn’t match up with what half of the city’s testing numbers would be.

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And you knew it immediately. 

I thought, OK, maybe that was a mistake. After the press conference, I asked somebody: How much does it cost per day to run? Because the entire thing had been framed as a public-private partnership. Everybody kind of shrugged it off and said, “Oh, you have to ask Andrei.” And I thought, That’s weird. So I went and asked Andrei, and he wouldn’t tell me. I said, “Isn’t it the city’s money?” And he said, “No, it’s my money. I’m paying for this whole thing.” And he wouldn’t tell me how much it cost. Just the secrecy, and the fact that the city wasn’t paying for this whole thing, and that it wasn’t bound by any sort of contract, which meant there was less oversight—all of that just seemed, if nothing else, worth looking into more. I have to say my Spidey senses went up and that was when I started digging.

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You found that some of the claims made by Doroshin seemed spurious. He’d said he was a filmmaker, a real estate investor, and entrepreneur. But, for instance, the “Rancho Mirage Film Department” he said he’d founded was at his high school. And the nonprofit he’d started to improve air quality had failed. Then, you tracked down Debbie Flamholz, who had just left Philly Fighting COVID out of frustration.   

Yes, Debbie was somebody who was often, as she described it, on the testing site, the only one or one of very few people who had any sort of clinical health care experience. She was surrounded by a lot of volunteers who were college kids—some of them premed, but many of them not even.

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So the people sticking the swabs up your nose were just volunteers, potentially?

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Correct. And the people who are taking down your information and registering it, which might not sound like the most clinical of medical procedures. And it’s not. But there are certain practices within the medical field that are standard, that are understood to be incredibly important, having to do, for instance, with patient privacy. And that was something that Debbie described to me being handled very carelessly and without those priorities at all.

What happened when she spoke up about this?

She would have a site supervisor who she described as disengaged, often distracted, sometimes asleep. These are not people who are necessarily doing a ton of oversight for that type of due diligence. She described speaking up about it, asking questions about it, and being brushed off.

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You’ve written that one of the early warning signs about this organization came when Philly Fighting COVID pivoted from running test sites to talking about vaccine sites. What happened as they started to think through that change that started to raise red flags?

The city tapped the group way earlier than expected, and they abandoned their entire testing operation.

Like they just stopped running them?

They had sites set up, they had dates set up with community members in predominantly Black and Latino neighborhoods in Philadelphia that were depending on these groups to test their community members, and they canceled or they pulled out. In some cases, they just didn’t show up with a half an hour notice. We talked to community members who describe being just totally ghosted by them. Even at the convention center when Andrei Doroshin was talking about the group’s credibility as a testing organization, he talked about how they were opening up more testing sites and how they were going to start doing free rapid testing for the entire city.

Was that true?

No. Little did anybody know, at that point he was in the process of or had already canceled testing operations for the entire organization. They also sent an email basically letting their entire testing staff go the day before those folks were supposed to show up at testing sites, saying we have to focus on vaccine distribution. It was a 180 pivot.

Did Andrei Doroshin explain himself at all?

They explain themselves to the community members by saying that the city had tapped them to do vaccination efforts and this was more important. And one of the community groups that we talked to about that said that they did actually offer to do the event that they had planned but do vaccines instead of tests. But this is a predominantly Black neighborhood in Philadelphia, and the community leaders who are organizing the event said, “Listen, our folks aren’t ready for that yet. There’s a lot of hesitancy here about the vaccine. Testing is what our community is saying that they need.” Doroshin told them that he didn’t believe in testing anymore, that it just caused panic, that it wasn’t relevant to heading off the virus. The vaccine was the tool that people needed to rely on. Doroshin has said he never would have said that and that they must have misinterpreted him, but we had a number of people who are in the room who recounted that happening.

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Listening to you, it feels like there are ample warning signs that Philly Fighting COVID is maybe not the best organization to get additional responsibilities in the city, but it seems like the department of health didn’t know about any of this and they moved forward with contracting with this group to distribute vaccines in January. Are there any good indicators about why they made that decision?

That’s the biggest question that everybody’s asking right now. What we do know is that there wasn’t an official contract between the city and Philly Fighting COVID to distribute vaccines. And that’s because Philly Fighting COVID was not receiving any money from the city.

It seems to me like the city didn’t have the support they needed or the money they needed to do a more formal arrangement that someone who had done this before might require. And so in that vacuum, here comes this very young organization that just wants the opportunity to get their hands on some vaccine.

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Right, this group looks like they have a plan. Let’s just go with them and get this moving. That’s a little bit of speculation because we don’t exactly know what the process was, but it kind of makes sense. There’s this enormous urgency for everybody in the city to get vaccinated. Along comes a group with a plan and you say, “All right, let’s work with them. They seem as good as anybody else.”

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One question that a lot of people are asking right now is: Why not choose somebody else? It’s not like this group was the only option. Philadelphia is a renowned meds and eds town. We have four major medical institutions within city limits. The health commissioner never explicitly asked one of them to man this type of clinic. He says that they probably would have said no because they were vaccinating their own staff and they were dealing with COVID case spikes. But, it’s unclear if those conversations happened in any detail. There’s also a group that has been really proactive in testing the African American community in Philly called the Black Doctors COVID-19 Consortium, which a lot of people thought was a natural fit to do a clinic like this at the convention center. They have gained an enormous amount of trust, especially among the Black community. And the fact that they were passed over has a lot of people scratching their heads because they seemed like they would have been a very logical fit and a group made up of medical practitioners with years and years of experience versus a bunch of self-described college kids.

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Philly Fighting COVID was vaccinating people at the city’s convention center for about two weeks before the city cut ties. Officials cited  an issue with the company’s privacy policy and its quiet pivot from nonprofit to for-profit status. But the announcement that Philly Fighting COVID no longer had the backing of Philly came as a surprise, right? 

The final day at the convention center they did not know it was going to be their final day. I have multiple sources talking about the final hour or half-hour with those leftover doses. You had people who were not supervised, who were not licensed or properly accredited to be administering vaccines, basically just injecting each other with it. And at the end of the day, a nurse I spoke with who was volunteering on site saw as Andrei Doroshin walked across the room over to the vaccine area and pocketed a few of them. She wasn’t sure how many. She guessed maybe 10 to 15, and put them in his bag with the CDC registration cards that go along with them and left. And later that night there was a photo that had circulated on Snapchat of Doroshin in a private residence, syringe in hand, appearing to be about to or having just administered the vaccine to a friend.

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And he’s not a nurse. He’s not a doctor.

He’s not a nurse. He’s not a doctor. Taking those off site is against CDC protocol. It’s against city protocol. City policy is any unused doses should be returned to the health department. At first he denied having done this at all. And then he later admitted to it and said he took four doses, and he then further later admitted to it and said that he gave one of them to his girlfriend but that was it. But he also stands by the decision. He says that he would he would have done it again. They were going to go to waste. And there was no reason for him not to have done it.

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Part of the problem to me here seems to be the fact that the city was popping up all of these relationships with different groups to do the job of testing and vaccinating ad hoc. And to me, it raises this question of why they were even doing that. The city has a department of health. Why couldn’t they distribute the vaccine themselves? And was that even considered?

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At a hearing on Friday, the health commissioner was asked that question, and he said he didn’t know if that had been considered. And he wants to know just as badly as anybody else why it wasn’t if it wasn’t. Health Commissioner Tom Farley has said he doesn’t know the answer to a lot of questions that everybody wants answered, putting some distance between himself and the decisions that were made that led to this group having any amount of responsibility or power.

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One thing that he has made abundantly clear through practice is that the health department could have done that work because it’s now doing it in order to fill the gaps for people who have received their first dose from Philly Fighting COVID. The health department is basically taking up the mantle where PFC left off and is running a clinic at the convention center to give people second doses. So they’re doing it. There’s no question about whether they could or couldn’t because they are.

A lot of reporting in Philadelphia has focused on the fact that what has happened here could really break the public’s trust with their health systems, especially in Black communities. And I’m wondering if, as you talk to regular people, they feel like this incident makes them more or less likely to get vaccinated or trust the process.

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That’s an enormous concern. You have a city here in Philadelphia that’s 44 percent Black, and the most recent numbers I saw, it’s, like, 12 percent of the people who have been vaccinated are Black. That’s an enormous, enormous disparity. And we know that there’s a greater rate of hesitancy among African American communities. People who were wary of this entire process because they have historical mistrust of the medical system watch how this all went down, and they say, “See, I told you. That is why I didn’t want to do this. This is how the process works. They hand the reins to these kids for no reason. And I’m sure glad I didn’t sign up for this.”

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I mentioned the Black Doctors COVID-19 Consortium, and that’s a group that the city has leaned on really heavily to get the message out to the to the Black community here about the risks of COVID, about where you can get tested. And I think they want to do the same for the vaccine. But the fact that they didn’t partner with that group and they partnered with this group and now they’re sort of asking that group to help clean up their mess, in a sense, it puts them in a disadvantaged position. So it’s a big hole to climb out of.

There’s a real startup, Silicon Valley vibe to the way Andrei Doroshin was running his business. Philly Fighting COVID promised to speed up vaccine distribution and get rid of unnecessary paperwork. It was slick, ambitious, proudly disruptive. But there are some things that are worth doing slowly, or at least deliberately.

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Everybody is anxious to get the vaccine. Everybody is eager for life to return to something resembling normalcy as soon as possible. But that doesn’t mean you can cut corners. The best practices that Doroshin was so committed to disrupting and throwing out the window in this case, especially in the health care field, are there for a reason. There’s this constant balance between getting things done quickly and getting things done in a right and equitable way. That’s a tricky act to balance. And in Philadelphia, we got it wrong. The scales tipped toward efficiency and now we’re paying the price. It’s important to remember there is a reason to be patient, and in the long run, those things will pay off.

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