- The CDC has given Deloitte $ 44 million as a federal contractor to build a vaccine appointment website.
- Most states chose not to use the instrument due to concerns about its performance, but nine states preferred.
- Several health officials from the countries say they are experiencing technical errors, including site accidents and canceled appointments.
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Americans who are eligible for coronavirus vaccinations are still struggling to get appointments.
“Every clinic, every hospital has its own mechanism for communicating, recruiting and setting up appointments,” said Dr. Mississippi State Health Officer Thomas Dobbs said in a press briefing Thursday. “This is the real challenge, because we have basically 100 different ways of doing the same thing.”
It was not supposed to be that difficult. In May, the Centers for Disease Control and Prevention signed a $ 16 million agreement with consulting firm Deloitte, a top federal IT contractor, to create a centralized website that allows states to plan their vaccinations for vaccines. The system was also intended to monitor the vaccine supply and report each shot as administered. Deloitte received another $ 28 million for the project in December, bringing the total to $ 44 million.
The tool that the company has manufactured is called the Vaccins Administration Management System (VAMS). Government officials and health clinics can use the site for free to organize their vaccination. In the end, only nine states voted in favor, while the rest – Mississippi included – decided against VAMS. Many said no to the system due to concerns about its operation.
“We refused to use VAMS after researching it in January and spending a lot of time on it and kicking the tires,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said at the Thursday briefing. “We found it to have several limitations and therefore we did not activate it at all.”
Most states are now left without a centralized system to streamline their responses. But of the nine states that did start using VAM – including Connecticut, New Hampshire, South Carolina, Virginia and West Virginia – many experienced technological glitches, including website crashes, canceled appointments, and reporting issues.
Since mid-December, VAMS has helped deliver about 4% of total shots in the U.S., or more than 1.5 million.
Canceled appointments and no confirmation email
Healthcare workers receive the Pfizer-BioNTech COVID-19 vaccine at the Legacy Emanuel Medical Center in Portland, Oregon, on December 16, 2020.
Paula Bronstein / Getty Images
States experienced problems with VAMS shortly after vaccinations began in December.
Marshall Taylor, acting director of the South Carolina Department of Health, told Greenville News that the system would cancel appointments spontaneously and could not distinguish a first or second dose (both Pfizer and Moderna vaccines require two shots) .
VAMS, he said, ‘became a buzzword’ at his department.
Lorrin Pang, the district health officer in Maui, Hawaii, told MIT Technology Review that the tool does not allow him to send instructions to people on how to prepare for their vaccination appointments. The system often shut him down for clinic administrators outside the dashboard, he added. Pang’s penetration clinic returned quickly to record vaccinations by hand.
In New Hampshire, residents reported receiving no confirmation emails for their second dose of appointments.
“The VAMS system is clearly having problems. It’s awkward, it’s messy and we really can not control it,” New Hampshire Government Chris Sununu told union leader New Hampshire
Officials say VAMS has not kept its promises’
People are sitting in a waiting room on January 12, 2021 after their vaccinations with COVID-19 in Las Vegas, Nevada.
Ethan Miller / Getty Images
A Deloitte spokesman told Insider that VAMS was originally designed to help the CDC track the distribution and administration of vaccines at a limited number of pre-selected locations. But thanks to states without the time or means to create or acquire their own scheduling systems, he added, the CDC has given them the option to use VAMS.
“Since its implementation to support the critical first phase of vaccinations, VAMS has not had any downtime due to system issues or performance issues,” the Deloitte spokesman said. “Although some users have reported challenges, VAMS does not cancel appointments spontaneously.”
The CDC did not respond to a request for comment.
According to Shah, VAMS was supposed to be available to anyone who wanted to register for an appointment. But the instrument “really did not live up to its promises,” he said. Without a centralized system, the process of getting a vaccine appointment in Maine is ‘suboptimal’, Shah added.
‘One can hope that there will be a successor [to VAMS] in the future, ‘he said.
According to Pouria Sanae, CEO of ixlayer, a healthcare software industry that helps streamline COVID-19 testing and some vaccinations for businesses, healthcare systems and government branches, setting up a centralized, government-controlled website is ‘super’.
“Take tax as an example,” Sanae told Insider. “We do not have a centralized tax platform, and that is something we do every year.”
A ‘Google-like’ attempt with ‘old-school’ technology
People wait in line at the opening day of the Disneyland COVID-19 vaccination site in Anaheim, California.
Valerie Macon / AFP / Getty Images
The CDC has identified Deloitte as the only “responsible source” that could build a centralized vaccination platform, so the company does not have to bid on the project. However, many software experts believe that VAMS would have been in better hands in a better technology business.
“It’s an effort like Google,” Sanae said. “It’s not meant for government organizations.”
To prevent bottlenecks in the explosion of vaccines, he added, say states need a website that can be consistently updated while in use. This way, if a patient misses an appointment or clinics receive low doses, the barriers will not delay the entire vaccination process.
Deloitte’s technology, on the other hand, is ‘old-school’, Sanae said. It relies on a fixed “waterfall model” that usually can’t handle much change.
“There’s a reason Apple and Windows overwhelm us with these updates: because it repeats,” he said. “We really need it for any software that is going to support vaccination.”
VAMS is likely to create more bottlenecks along the way, Sanae thinks, as people return for their second shots.
“One thing you will see in a month, I guarantee you, is people who have the first dose that appears in different places, with different vaccines, that arrive in different states,” he said.
Switching systems present new challenges
ER nurse David Wilson will receive the Pfizer-BioNTech COVID-19 vaccine outside the Chatham County Department in Savannah, Georgia, on December 15, 2020.
Sean Rayford / Getty Images
At least one state, Virginia, is already moving from VAMS to another vaccination system called PrepMod, which is also used by several other states. Tammie Smith, a spokeswoman for the Virginia Department of Health, told Bloomberg that the platform is “more adaptable” than VAMS.
In early February, a lack of the PrepMod system still enabled a handful of residents in Roanoke Valley, Virginia, to sign up for vaccinations before being eligible. The local television station WSLS reported that the residents had received a registration link that was not intended to be sent out.
According to the Los Angeles Times, clinics and nursing homes in California also had difficulty accessing the PrepMod system.
Sanae said PrepMod found it to be a “slightly troublesome” patient. He added that states can also find it difficult to transfer VAMS patient data to a new platform. He compares the process of switching each person’s Gmail account to Yahoo.
Changing appointment systems can also be costly.
“At some point with IT solutions, there is a bit of a lock-in effect and there may be costs involved in switching from one registration platform to another,” Shah said.
But he added that some states are still trying to get rid of VAMS as soon as possible.
‘I spoke to at least one of my peers, where their state did activate [VAMS], and they can not wait to find another solution, ‘Shah said.
Mauric Fitzgerald, a spokeswoman for the Connecticut Department of Public Health, told Bloomberg that her state is investigating alternative systems. New Hampshire also plans to launch a new scheduling system by March.