Vault Health rode a Rutgers saliva test from 43 staff to 500 in 18 months

March 12, 2020 was supposed to be Vault Health's day: the men's-health startup had a rebrand and national rollout planned, and founder Jason Feldman stood on the NYSE floor for photos. Instead he watched the worst single-day market percentage drop since 1987. Nine months after launching the brand, he went back to the office wondering how the company — about 43 employees, roughly $10 million in the bank from its Series A — would survive.

The pivot came from inventory already on the shelf: partner Rutgers University was developing a COVID-19 saliva test, but at-home testing was blocked because the FDA had halted it. Vault proposed a compliant workaround — a telehealth visit where a practitioner watches the customer spit into a tube at home — and persuaded UPS to speed delivery. By mid-April 2020 Rutgers had an FDA-approved saliva test and Vault was distributing it, then signing government agencies that needed sample collection, lab processing and results management.

Eighteen months later the company had grown from 43 to more than 500 employees spread across the country, with another 100 openings expected to be filled the next year, and was fielding requests for workplace programs to track vaccination status and manage virtual, mail-in testing. Vault also diversified its suppliers as pandemic shipping slowed — a hedge that compounded the pivot.

Headcount grew from about 43 employees with $10 million in the bank to more than 500 workers, with another 100 openings expected to be filled the following year.

The pivot was built on compliance imagination: the FDA ban on at-home testing was designed around, not ignored, by putting a practitioner on the screen.

Speed came from existing assets — a partner lab (Rutgers), a telehealth platform and a logistics deal (UPS) — rather than anything built from scratch.

The growth numbers are the proof: 12x headcount in about 18 months for a company that on crash day was wondering how it would live.

A pivot is a recombination of assets you already have: telehealth visits + a partner lab + UPS turned a banned category — at-home testing — into a compliant product within weeks.

By late 2021 Vault was positioning its workplace coronavirus-management programs — vaccination tracking, virtual and mail-in testing — for the Biden administration's vaccine-or-test mandate covering companies with more than 100 employees, alongside continued government agency work.