Exemptions for sale: How a central Washington doctor helped workers dodge vaccine mandate

An Ellensburg doctor removed her mask as she entered a small medical exam room in October and began signing a COVID-19 vaccine exemption form for a first-time patient, without asking a single question about her medical history.

It was just one week before thousands of unvaccinated Washington state, school and health care employees faced losing their jobs over a statewide vaccine mandate. 

The only way most workers who were opposed to being vaccinated against COVID-19 could potentially keep their jobs was to seek a religious or medical exemption before the Oct. 18 deadline. But such medical exemptions required documentation from a licensed physician, like Dr. Anna Elperin.

“Patient Taylor Mirfendereski due to a medical condition is exempt from getting the COVID-19 Vaccination,” wrote Elperin, a doctor of osteopathic medicine and the owner of the functional medicine clinic, Awake Health, in Ellensburg.

The patient, undercover KING 5 investigative reporter Taylor Mirfendereski who visited Elperin’s Kittitas County office on Oct. 11, does not have a medical condition that precludes her from getting the COVID vaccine. 

But Elperin never asked Mirfendereski if that were true. And she wrote her the exemption.

For a $150 cash fee, Elperin filled out and signed her name on three separate exemption forms that excused the undercover reporter from following local and state COVID mask and vaccine mandates because of doctor’s orders. 

A three-month KING 5 investigation found Elperin repeatedly signed and sold those mask and COVID vaccine exemptions to residents across Washington state, in some cases with no questions asked. The doctor wrote exemptions for patients who did not provide a legitimate medical reason to receive one, including people who sought to evade local and state pandemic-related mandates. Charging each patient from $150 to $200 for the forms, Elperin potentially raked in tens of thousands of dollars from medical exemption sales a month and profited from state, local and private company policies intended to reduce the spread of coronavirus.  

“What you just described is an ‘exemption mill,’” said Dr. Gabriel Bosslet, one of three national medical ethics experts consulted for this story and an associate professor at the Indiana University School of Medicine in Indianapolis. “You hand over money, and I ask no questions and give you a piece of paper that satisfies the state that you have an exemption.”  

This investigation is based on the experiences of four undercover journalists who received mask and vaccine exemptions signed by Elperin this fall. Reporters also interviewed three former Awake Health employees, who said they watched the doctor sell hundreds of COVID-related exemptions without asking patients medical questions or conducting any medical exams. 

Three of the four undercover journalists who made appointments at Awake Health in October and early November wore hidden cameras during their office visits with the doctor. The cameras captured video of Elperin signing the exemption documents. Washington law restricts recording conversations without consent so the cameras did not record audio during the appointments.

While most of the journalists who received medical exemptions didn’t ask for the paperwork until they were in the exam room, one journalist asked for the exemption forms while making his November appointment. The receptionist, without hesitation, quoted him a $200 price. 

An Awake Health medical assistant measured the journalists’ weight, height and blood pressure at the start of the visits. In a few instances, she asked some journalists to report any diseases that run in their families. 

Elperin, the doctor, did not ask the journalists medical questions related to the COVID vaccine or their medical history. Yet, she wrote in the exemption paperwork that each of the patients were exempt from the vaccine because of “a medical condition.”   

In one case, a journalist told the Awake Health medical assistant that he was healthy and did not have a qualifying medical condition that would preclude him from receiving the vaccine. Elperin signed his mask and vaccine exemption forms anyway.   

“This is a problem,” said Thaddeus Pope, a professor at Mitchell Hamline School of Law in St. Paul, Minnesota, who specializes in medical ethics and law. 

“We trust physicians to make all sorts of determinations all the time and sometimes….people pay for the conclusion that they want as opposed to the conclusion that the evidence actually warrants,” he said.   

Pope and two other national medical ethics experts said good clinical practice requires licensed medical professionals to conduct an examination of their patients and evaluate their medical history before making a determination about whether a medical exemption for any vaccine is necessary.  

“You should have a thorough workup of that particular patient,” said Ross Silverman, professor of health services administration and policy at Temple University’s College of Public Health in Philadelphia, Pennsylvania. “You wouldn’t give somebody a new medication with zero medical history just because somebody says, ‘I want this drug.’ It’s the same thing with this medical exemption.”  

The U.S. Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccination for anyone over the age of 5 to prevent the spread of the virus. 

Millions of people in the United States have safely received the COVID vaccines since they were first authorized by the U.S. Food and Drug Administration. And there are currently few medical justifications that, CDC officials say, may prevent someone from getting the vaccine or require that they take precautions before getting vaccinated. 

“There are two reasons that are generally accepted,” Pope, the medical ethics and legal expert, said. “One is that you’re allergic to one of the ingredients in one of the vaccines, and the other is that you actually had a severe reaction to the first dose, and then that might be a reason not to get the second dose.”  

It’s why medical ethicists and most practicing physicians believe there’s supposed to be a high bar to secure a medical exemption from a doctor. 

“It’s not a rubber stamp. You don’t just come and say, ‘I need an exemption,’ and as a physician, I say, ‘Ok, great. I’ll sign that,’” said Bosslet, the Indiana University professor who is also a pulmonary and critical care physician. “There are medical reasons that would compel me to sign a document saying, ‘This person should not have the COVID-19 vaccine.’ It’s just that those, in my mind, are pretty few and far between.” 

During a Nov. 12 interview, Elperin explained that writing medical exemptions for the COVID-19 vaccine is an “individual” process that consists of a doctor carefully reviewing a patient’s medical history and current health conditions to determine whether an exemption is “advisable.”

“I don’t do cookbook medicine,” Elperin said. “When patients come in and they would like to be evaluated for a COVID vaccine exemption, we sit down and we talk and we come up with a treatment plan.” 

The four undercover journalists, who say they don’t have medical conditions that qualify them to be exempt from receiving the vaccine, paid a total of $750 for Elperin’s COVID vaccine and mask exemptions. 

On the day of the state vaccine mandate deadline, reporters found Elperin upped her price. She began charging her patients $200 for vaccine and mask exemptions — $50 more than Mirfendereski paid a week earlier. 

When confronted about the medical exemptions she signed and sold to KING 5’s undercover journalists, Elperin unequivocally denied that she is running an “exemption mill.” 

The doctor said she has “no idea” if she wrote exemptions for the journalists without asking them medical questions or conducting medical exams because she would have to “go back and carefully review the chart.” 

“I would have no way of knowing any of this based on just the vaccine exemption form...I don’t have that information stored in memory,” Elperin said. “Just because a person claims to you that it happens doesn’t make it such.”  

WATCH: Dr. Elperin confronted about vaccine exemption sales

At the conclusion of the interview, KING 5 provided Elperin copies of medical exemption forms she signed to give her a chance to further review the documents and examine her medical chart. 

When contacted via email on Nov. 15, three days after the sit-down interview, the doctor did not answer a list of detailed further questions about her actions. Instead, she responded Friday, saying: 

“You should be ashamed of yourself. You are a disgrace to the profession of investigative journalism, and to the values of the United States of America.” 

A former Awake Health office manager, a medical assistant, and an aesthetician, who all quit the functional medicine practice in late September, said Elperin wrote COVID vaccine exemptions for dozens of patients each week over the course of several months.    

Abby Jamison, Awake Health’s former master aesthetician, said Elperin started writing exemptions in late spring 2021 as the COVID vaccine became more widely available and talk of mandates started to escalate. She said demand for Elperin’s mask and vaccine exemptions increased dramatically in August and September, as the state’s Oct. 18 vaccine mandate deadline grew near.  

“About 90% of Dr. Elperin’s patients every day were COVID exemption patients,” Jamison said.  “Anyone off the street could get it. There was no medical history reviewed….It was just like, ‘Here’s a piece of paper.’” 

State records show Elperin was under scrutiny from state investigators shortly before most of her staff members said they left their jobs. Jamison said she quit Awake Health because she was concerned that continuing to work for Elperin under the circumstances could jeopardize her professional license. 

“She was going about it all wrong by not doing a medical exam prior to the exemption being given,” Jamison said. 

Jamison and the two other former employees who spoke with reporters in separate conversations about the doctor’s conduct said many of Elperin’s exemption “customers” were first-time patients who drove multiple hours from faraway locations like Bellingham, Seattle and Spokane — and who sometimes waited even longer in the office to see the doctor. 

They said a lot of her patients who sought medical exemptions worked in professions that were subject to state or local vaccine mandates, including police officers, firefighters, teachers, health care professionals and state employees.  

“I don’t agree with selling exemption forms like candy,” Jamison said. “I knew it was a problem because I had people driving four hours away to see her. I’m like, ‘If other physicians were giving these exemptions out, they wouldn’t be coming all this way.’

“It kind of spread like wildfire,” she added.  

When asked via email if it was typical for the doctor to write medical exemptions for first-time patients, Elperin did not respond. 

Elperin signed 20% of all exemptions filed at Ellensburg’s largest employer, Central Washington University, where proof of vaccination is now required for all students and employees. About one of every five of the 85 vaccine and mask exemptions submitted by the university’s students and staff came from Awake Health, according to public records. 

But medical exemptions for the COVID-19 vaccine aren’t always granted. 

Of the 17 mask and vaccine Awake Health waivers submitted by students and staff, Central Washington University approved five student exemptions and none from university employees. 

Each agency, organization and private company with a vaccine mandate sets its own process for reviewing and granting or denying exemptions. Some employers may conclude there’s insufficient medical proof that a person can’t receive the COVID-19 vaccine or they may request additional information about a person’s diagnosis. And even if workers are granted an exemption, they may still be fired if accommodations can’t be found for them in less public-facing positions. 

For instance, there were more than 1,300 Washington state agency employees who requested a medical exemption from the COVID vaccine, according to the latest data from the Washington State Office of Financial Management. The state approved 881 of those exemptions, but as of Nov. 1, less than half of those workers had received accommodations. 

It’s not clear how many employers across the state accepted COVID medical vaccine and mask exemptions that Elperin signed or how many other doctors across the state are providing them. 

In September, the Washington Medical Commission (WMC) issued a public statement against COVID-19 misinformation. The state medical board promised to scrutinize any complaints about practitioners granting vaccine or mask exemptions that are “not based in established science or variable fact.” 

“A practitioner who grants a mask or other exemption without conducting an appropriate prior exam and without a finding of a legitimate medical reason supporting such an exemption within the standard of care, may be subjecting their license to disciplinary action,” the state medical board declared in the Sept. 27 statement. 

As a doctor of osteopathic medicine, Elperin isn’t licensed by the Washington Medical Commission. She answers to the Board of Osteopathic Medicine and Surgery. Both boards fall under the Washington State Department of Health (DOH).

DOH, the agency responsible for regulating the state’s health care providers, is currently investigating at least two COVID-related complaints about Elperin, according to public records. It remained unclear, however, if those investigations stem from the exemptions. 

Citing the ongoing disciplinary process, a DOH spokesperson declined an interview request and did not share details about the allegations against the doctor. 

When asked about the DOH investigations, Elperin explained she’s under investigation because of a “disgruntled employee” who made “completely untrue statements” to investigators. 

State records show the agency has received a total of 12 mostly COVID-related complaints against Elperin since July 2020. DOH closed 10 complaints without action. 

But it referred one of those closed complaints to a different state agency, which did take action against the doctor this fall. 

The Washington State Department of Labor and Industries (L&I), which regulates worker and workplace safety in the state, fined Elperin $3,000 in September for “a serious violation” of COVID safety protocols.

An agency spokesperson said L&I got involved after receiving a direct complaint that workers were being put at risk because Elperin “refused to wear a mask” and “employees and patients, including some who were sick with COVID-19, were not required to wear masks.”

When an L&I investigator visited Elperin’s medical practice on Sept. 3, she observed the doctor, staff members and some patients weren’t wearing face masks, according to the inspector’s handwritten notes. The investigator documented that Elperin “refused” to put a mask on. She also observed the office lacked protective barriers and did not have any health screening protocols like temperature checks for patients and staff, according to the L&I report. 

“I asked the inspector to leave the premises,” Elperin said. 

In spite of receiving that hefty fine in September, Elperin continues to defy the Washington state mask mandate, and she’s not shy about it.  

“I personally don’t feel that masks are protecting or helping me in any way, shape or form. In fact, they increase my anxiety,” Elperin said during the Nov. 12 interview with reporters. “If my staff would like to wear a mask, they certainly can. If they would like not to wear a mask, they do not have to do it. 

“It is not my job to police others,” she said.  

During three of the four undercover journalists’ office visits, Elperin did not wear a mask while walking throughout the medical office. When KING 5 reporter Mirfendereski visited the office on Oct. 11, Elperin temporarily wore a mask but immediately removed it upon walking into the patient exam room. 

Throughout the pandemic, Elperin has been publicly outspoken about her views on COVID-19, the vaccine and what she calls “unconstitutional” government mandates. 

She has repeatedly made baseless statements about COVID that are unsupported with scientific evidence and she has minimized the seriousness of the pandemic in social media posts, at public events and in an interview with reporters. 

“This is a scamdemic. This has little to do with public health at this point. It has more to do with government control,” said Elperin, who likened the situation to her experience growing up in Estonia, where she said she was raised by a Russian family. 

“Based on my personal background of knowing what it’s like to live in a country where the government controls what you are able or not able to do, that kind of gave me the courage to start openly speaking about how I feel about it,” she added.  

Elperin’s former patients, Jeff and Shelley Ghan, said the doctor openly ranted about her unconventional views on COVID-19 for the duration of Jeff’s annual physical exam in April 2021 instead of attending to his medical care. 

“I didn’t even have time to talk about the issues I was having — medical issues — nor did she ask about how I was feeling,” Jeff Ghan said. “I felt that I had to come up with a solution for my own medical diagnosis.”

They said the doctor compared coronavirus to the flu, talked about her lack of trust in the COVID-19 vaccine and complained about COVID-related business closures. 

“From a professional perspective, it was a little unsettling,” Jeff Ghan said. “I thought, 'Well, maybe she’s not really the right doctor for us.'” 

Elperin did not respond to a question about Ghan’s claims.

In October 2020, another former Awake Health patient wrote a negative review about Elperin on Facebook, raising concerns that Elperin refers to the COVID-19 pandemic as a “scamdemic.” The patient, Ashton Asbury, also complained that the doctor and her staff did not wear masks during her appointment.  

Asbury said she received a “dismissal letter” from Awake Health the next month. 

“I regret to inform you that I will no longer be able to be your doctor, as of Nov. 23, 2020,” Elperin wrote, according to a copy of the November 2020 letter Asbury shared with KING 5.  

Elperin denies that she dismissed any of her patients for disagreeing with her views. 

“Absolutely not,” she said. “This is the kind of space where you come in and my job is to make you feel welcome and open, and my job is to help you to the extent that I can.”