SEATTLE — Last Friday, Molly Stearns, chief development officer at Overlake Medical Center & Clinics, emailed about 110 donors who gave more than $10,000 to the Eastside hospital system, informing them that highly coveted vaccine slots were available.

“Dear Overlake major donors...” the email read. “We’re pleased to share that we have 500 new open appointments in the Overlake COVID-19 vaccine clinic, beginning this afternoon and tomorrow (Saturday, Jan. 23) and next week.”

The email gave the donors an access code to register for appointments “by invite” only. Last week, the public-facing Overlake registration site was fully booked through March.

The email — and the appearance of favoritism that an Overlake leader acknowledged was a mistake — raised eyebrows. Overlake shut down online access to the invite-only clinic after getting a call from Gov. Jay Inslee’s staff.

Overlake says the vaccination slots were not offered exclusively to donors, but also to Overlake board members, some patients, volunteers, employees and retired health providers — some 4,000 people in all. All who registered were supposed to be eligible for the vaccine under current state rules, the email said.

The invitation was a quick-fix solution after the hospital’s scheduling system failed, said Tom DeBord, the medical center’s chief operating officer.

“We’re under pressure to vaccinate people who are eligible and increase capacity,” DeBord said. “In hindsight, we could certainly look back and say this wasn’t the best way to do it.”

The state’s glitchy effort to vaccinate millions of Washingtonians has relied heavily on hospital systems, who have been provided little logistical support, an unreliable supply of vaccine and fast-changing guidance on who qualifies and how to reach them.

Now, after state officials expanded eligibility, a crush of seniors angling to book appointments has added to the strain for hospitals, which have been left to their own devices to manage the chaos. The Overlake invitations raise questions about whether the messy system gives those with influence, access or technical know-how a better shot at the vaccine.

‘Most efficient way’

Last week, after the governor opened vaccine eligibility to anyone 65 and over, a flood of seniors crashed the medical systems’ scheduling software.

“Our system was overtaxed,” DeBord said.

Overlake, which shuttered an urgent care clinic to ramp up its vaccination efforts, was forced to launch a new scheduling system, but still had 1,400 vaccine slots to fill that weren’t easily listed in the old or new systems because of technical troubles.

In an effort to fill as many slots as possible, and fast, DeBord said the medical system simply contacted people whose emails were on hand, including some patients, retirees, major donors, and board members.

“We thought that was the most efficient way to add slots,” DeBord said, adding that he understood why it was being perceived negatively, but that “it was never intended to be a donor event.”

A policy adviser to Gov. Jay Inslee called Monday afternoon and encouraged Overlake to cut access to the exclusive appointments, which it did on Tuesday morning, freeing some slots for the general public.

Said Inslee in a news conference Tuesday:

“If in fact they were giving preference to some VIP list, that’s not the way to do it. That is not acceptable for us. We need to give everybody a fair shot at the vaccine ... We’ve got to maintain public credibility in the system. I’m told that whatever they were doing has stopped, and that’s good news.”

Regardless of intention, Overlake’s inclusion of donors and board members reflects circumstances across the nation of rich people gaining access to vaccines.

Hospital systems in Florida have offered vaccines to donors ahead of the general population, according to reporting from the Miami Herald, sparking frustrations from some Florida seniors unable to schedule a vaccination appointment.

A Florida nursing home has also come under scrutiny after the New York Post reported that real estate moguls Bill and David S. Mack allegedly arranged for friends to receive vaccines through the facility, where David Mack is chairman.

”The whole idea of jumping the line because you’re rich is morally reprehensible,” said Arthur Caplan, director of the Division of Medical Ethics at the New York University Grossman School of Medicine. “When you’re trying to combat a plague with scarce resources you really have to expect hospitals and their donors — and others connected with them — should have to wait with everyone else.”

Guidance from state and federal governments generally focuses on prioritizing vulnerable populations, and does not specifically address line-jumping for connected individuals, Caplan said.

One exception is in New York, where Gov. Andrew Cuomo threatened to revoke medical licenses and levy sanctions of up to $1 million against providers who administered the vaccine unethically. But Caplan said it was more “saber-rattling” than actual policy, and he was not aware of that state — or any others — taking such actions.

”Washington does not have penalties of this nature,” Department of Health (DOH) spokesperson Danielle Koenig said in an email. “We want providers to work to ensure they are giving out the vaccine equitably and in a manner that protects those who are most impacted by COVID-19 and in keeping with current phase guidance.”

Navigating the chaos

Washington state is simply not receiving enough doses of vaccine from the federal government to provide instant access to the more than 1.5 million people who qualified for vaccination last Monday, when the state moved into the first tier of phase 1B, which includes seniors and anyone over 50 in a multigenerational household.

The state launched PhaseFinder, an online tool to determine eligibility, but some people are struggling to access it or find anywhere nearby that has doses.

Some vaccine sites offer a wait list. Some don’t. Online scheduling tools differ among sites. Hospitals are struggling to manage a wave of phone calls. The state’s own hotline couldn’t keep up on Monday.

State officials acknowledged that opening up access would create confusion and some appointments would have to be canceled due to spotty supply.

Some seniors, or caretakers, are booking multiple appointments to see which pans out first. And concern has grown that those who are most adept at navigating the chaos, or those with special connections, are most likely to get through the hurdles.

Ellen Rubin, 68, a retired nurse and Overlake patient, said she was able to schedule a vaccination appointment for herself and her husband this week after receiving an invite from Overlake through MyChart, the online medical messaging system.

But the retired nurse is concerned about elderly people who aren’t as technologically adept as she is.

”The systems are just so that anyone who’s computer-savvy and system-savvy can figure things out,” Rubin said. “But if you’re not, you’re kind of screwed.”

It wasn’t clear to some who received the link for special access from Overlake on Friday that they had gained a unique opportunity.

A donor reached by phone Tuesday afternoon said her husband received the email and the two set up an appointment. She said she assumed the general public received notice of the same thing — “hopefully everybody,” she said.

But another person spread the link widely, including to those without connections to Overlake.

The person, who spoke to The Seattle Times on the condition of anonymity, received an invite-only link from a donor and was able to sign up and receive a vaccination Friday. That person said they then signed up dozens of others within days, primarily people of color over 65 who were unable to get appointments elsewhere.

Some Overlake patients did not receive the opportunity.

Paul Benefield, 80, and his 77-year-old wife, Earlene, both have heart conditions, and she has diabetes. They have been seeing primary care doctors at Overlake Medical Clinics for about four years, and are registered on the Overlake online portal, but said they haven’t received guidance from the hospital system.

By chance, a friend forwarded them a link to the public Overlake vaccination website, and they were able to schedule February appointments for their first vaccines. On Friday — the day Overlake notified donors and others they could make side-door appointments — he saw his primary care doctor.

”I unloaded my frustrations, and he had nothing to offer,” Benefield said.

When he later learned about the special access, he said, “Neither one of us got any indication of this.”