In the rush to make an evasive vaccine appointment, the excess dose became the stuff of pandemic.
Extra shots – which should be used within hours of being taken out of the cold room – were handed out to drugstore customers who buy midnight snacks, people who are friends with nurses and those who arrive at certain grocery stores and pharmacies at closing time. On some larger vaccination sites, the race to use each dose leads to a flurry of end-of-day calls.
In any case, if the excess dose does not find an available arm, it should go in the trash.
A startup in New York is aiming to give some order to the rush for remaining doses. Dr. B, as the company is known, adapts corresponding vaccine suppliers who find extra vaccines in people who are willing to get it in an instant.
Since the service started last month, more than 500,000 people have submitted a lot of personal information to sign up for the service, which is available for free and is also free to providers. Two vaccines began testing the program, and the company said about 200 other providers applied to participate.
Dr. B is just one attempt to coordinate the chaotic patchwork quilt of public and private sites that makes it possible for qualifying people to find vaccinations. Critics have said that the current system is confusing, unreliable and that it often requires internet access, as well as the time spent searching for sites for the rare appointment. In many places, it also ignores people who are not yet eligible for a shot, and misses the opportunity to get them on a formal waiting list.
Although dr. B does not solve all these broader problems, it could be an example of a better, fairer way to plan vaccinations if it solves the way some hope it magnifies.
“I think it’s a great idea,” said Sharon Whisenand, the administrator of the Randolph County Health Department in rural Missouri.
Me. Whisenand said 60 to 80 people did not turn up at the province’s first mass vaccination event in late January, prompting her staff to make dozens of calls to people on a waiting list at the end of the day. “We sounded a bit like a call center,” she said. The workers eventually found enough people to administer the most extra doses, but some shots were fired.
Dr. B is a for-profit, established as a public benefit enterprise that includes efficient and equitable distribution of vaccines in its mission. But the founder, Cyrus Massoumi, a technical entrepreneur, told dr. B’s business model not yet described. He said he was financing the project out of his own pocket and did not plan to collect revenue. The company was named after his grandfather, who was nicknamed Dr. Bubba and became a doctor during the 1918 flu pandemic.
Mr. Massoumi is a founder and former CEO of ZocDoc, which helps patients find doctor appointments, and founder of Shadow, a company that reunites lost pets with their owners through technology and local volunteers. Like both of these efforts, Dr. B wants to make connections between groups that need something from each other.
“Ultimately, patients need this vaccine, and there are providers who need help to get it from the people of priority,” he said. Massoumi said in an interview. “That’s my motivation.”
After coming up with the idea for dr. B came forward, Mr. Massoumi recruited several engineers from Haven, a collaborative healthcare collaboration among Amazon, Berkshire Hathaway and JP Morgan, to build its website and underlying database. Amazon also donated web services, Massoumi said.
The half a million people who signed up for the service entered basic biographical information, such as their date of birth, address, underlying health conditions and the type of work they do. If vaccine providers near you have extra doses, they will be notified by sms and they have 15 minutes to respond. Then they must be willing to travel quickly to the vaccination site.
The company’s database sorts people according to local rules on vaccine priority, giving providers a better chance of administering their surplus shots to those most in need.
For many providers, the orderly procedure is a welcome change from the random systems they now use. At some pharmacies and supermarket chains, workers tried to comb the shopping malls to find people willing to get a vaccine for the last minute. Elsewhere, hopefuls are waiting for vaccines at the end of each shift, which could pose a risk of infection, especially for the vulnerable.
Despite the fact that younger, healthier people are skipping the line by taking up leftover doses, public health experts and many ethicists believe that the most important thing is that the vaccines do not go to waste. Earlier, during the explosion of vaccines, some politicians, such as Governor Andrew M. Cuomo of New York, threatened sanctions against suppliers for not exactly following the priority rules, and a Texas doctor lost his job after giving expired doses. to people with medical conditions. , including his wife.
For those who are offered a vaccine at the last minute, ‘the person should not say no, because they want it to go to someone else,’ says Dr. Shikha Jain, an assistant professor of medicine at the University of Illinois at Chicago, and an associate. founder of IMPACT, a group that worked to improve the equitable distribution of vaccines. “However, it is very important to be intentional and fair,” she said.
Mr. Massoumi said he had taken several steps to ensure the service would be fair. This included rejecting early media requests from mainstream publications and that dr. B on Zoom calls with representatives of groups such as black churches and Native American community groups are being promoted as the pandemic has affected non-white groups excessively.
“It was very important to him to possibly get these communities at the front of the queue, or to get the information early,” said Brooke Williams, who is Black, and a member of the Resistance Revival Chorus in New York. , said. She joined one of the early Zoom calls and started spreading the word.
“Hearing about shots being fired was just heartbreaking and furious,” she said.
However, the service suffers from the same obstacles that have so far hampered the vaccination efforts. Although it is simple to log in, it is an internet connection and access to a mobile phone. Due to the last minute of the remaining doses, participants must have flexible schedules and access to transportation.
“It’s still very much dependent on the Internet, so it’s going to depend on who hears it,” said Arthur Caplan, a medical ethicist at New York University’s Grossman School of Medicine. “It seems like he’s trying to solve a problem and doing well, but I’m sad that governments – provinces, cities, national organizations – did not prepare for that and then did not respond more quickly to give advice and guidance.”
Mr. Massoumi noted that people like volunteers in the community can report the site on behalf of others. The website is also available in Spanish.
He noted that setting up the program, which enables people to sign up and then wait for a notice based on priority, is better than other sites that require hours of refreshing sites, with the chance that it ‘ is a rare opening.
What you need to know about rolling out vaccines
Some local health authorities, including Washington, DC and West Virginia, are moving to a similar pre-registration system, which could help level the playing field.
“There’s a feeling where you do not know where you stand, and the only way to secure your place is by refreshing a browser,” said John Brownstein, a Boston Children’s Hospital researcher who VaccineFinder.org management, said. people discuss vaccine appointments.
For Brittany Marsh, who owns a pharmacy in Little Rock, Ark., It was a daily headache to figure out what to do with the remaining doses.
She said the number of exhibits increased as vaccines became more available, and others had to cancel at the last minute because they had developed Covid-19 or were exposed to someone who did. Although people sometimes call, she said, “we just don’t have a turnout anymore.”
Mrs. Marsh spent a few weeks with Dr. B’s service tested and said it saves her workers the hassle of calling a waiting list of other customers to quickly fill in the open slots. With Dr. B she said: “I know they are at least calling what we think is the right group of people to get the shots so we never have to waste.”
Dr. B revealed little details about which providers showed interest in using the platform, other than to say that the providers are based in 30 states, which include doctors’ offices, pharmacies and medical departments at major academic institutions.
The company collects sensitive personal information that it promises to carefully protect, even though the data is not protected by the federal health care law known as HIPAA, because the company is not itself a medical provider.
Asked about his long-term plans for the company, Mr. Massoumi disputed this and pointed out that the race to vaccinate was not going to end any time soon.
“At the moment, we just want to allocate the vaccines in the best possible way,” he said. “I can not think of a better use of money to solve the pandemic, so we are just on the point, focused on it.”