SUPPLY, RI (AP) – The road to a COVID-19 shot often leads through a maze of scheduling systems: Some vaccine seekers spend days or weeks booking appointments online. Those who get a coveted lock can still be stimulated by pages with forms or websites that can slowly crawl and crash.
L. Shapley Bassen, a 74-year-old retired English teacher and editor in East Greenwich, Rhode Island, knows the technological hurdles. She lost the hours she spent making phone calls and navigating websites to get appointments for her and her 75-year-old husband, Michael.
“A lot of us don’t sleep at night worrying about whether or not we can get in,” Bassen said.
Technological shortcomings in the country’s fragmented public health system have frustrated millions of Americans trying to shoot and left officials without a complete picture of who has been vaccinated.
‘We create unnecessary amount of human suffering. It could have been avoided, and we could have done better, ”said Tinglong Dai, a professor of healthcare at Johns Hopkins University’s Carey Business School.
The White House promised improvements and promised to set up a new website and an 800 number by May 1 to help people find nearby entities.
“Look no further for a date for you and your loved ones day and night,” President Joe Biden said in a speech to the country on Thursday.
The administration has also promised to send technical teams to countries in need of help improving their sites.
The bottleneck in vaccine demand appears to be declining in some places, and on Friday the US exceeded 100 million doses. Nearly 66 million people received at least one dose. But sometimes it’s still so hard to get vaccinated that people resort to Facebook groups for vaccine hunters and search websites for open appointments. Vaccinators who are not accustomed to these methods and have no one to help are greatly disadvantaged.
Bassen finally landed a slot in a pharmacy near the house for her husband. The website even offered to plan the second dose, but when she clicked on it, nothing happened.
If they think it’s a mistake, they’ll print the appointment confirmation email. When he got there, he was rejected. They told him he had to plan the second shot at the same time as the first shot.
The rejection sent Bassen back into the rabbit hole of the websites of the state, local government and pharmacies and phone numbers. She compares it to a game of music chairs.
“From the point of view of the patient, the consumer, there seemed to be no continuity between these three entities,” Bassen said.
The confusion is not surprising. An investigation by The Associated Press and Kaiser Health News finds that since 2010 spending on public health departments has fallen by 16% per capita, and spending on local health departments fell by 18%. There was little money left to invest in technology.
To help prepare states for the rollout of COVID-19 shots, the Centers for Disease Control and Prevention began building a vaccine management system known as VAMS.
Many states are reluctant to commit themselves because it takes time for employees to learn new programs, and new systems often have kinks. Few state health departments have accepted the CDC program, and at least one has since decided to abandon it.
In New Hampshire, officials planned to switch to their own program after thousands of people could not plan the second shots within the recommended time frame. Others canceled their appointments after the system incorrectly allowed them to book slots for which they were not eligible.
Claire Hannan, executive director of the Association of Immunization Managers, has never drawn up a national program that has worked well everywhere, especially not in light of the unprecedented extent of the COVID-19 vaccination.
Prior to the pandemic, local vaccine registers across the country were mostly used to detect childhood vaccines. Some are decades old and were never intended to be used to schedule appointments.
“A lot of it is just a kind of spaghetti bowl of code, where you just keep adding,” said Rebecca Coyle, executive director of the American Immunization Registry Association.
Many vaccine providers, such as smaller pharmacies, were also not connected to the registers before the pandemic, due to the time and cost of doing so – including the necessary maintenance, which involves constantly uploading data and insuring it.
“There was always this perception that you were building it and finished it,” Coyle said.
Many states have concluded that they need a single, easily accessible ‘front door’ to plan shots, Dr. Deidre Gifford, acting commissioner of Connecticut’s health department, noted during a recent CDC forum.
The best system, according to Dai, is to send everyone to register at a central location and, based on their offer, give a reasonable estimate for receiving a vaccine. It may be a few weeks or months, but managing those expectations can ease your anxiety.
“The core idea is to give people confidence, to reassure people,” Dai said.
West Virginia has done just that with a one-nationwide registration system that uses crisis management software to gather the demographic and contact information of each person, as well as details such as occupation, so that certain critical workers can be targeted. Then they get a text message or phone call to discuss a saying when vaccine doses are available in their country, said Krista D. Capehart, who coordinates the state’s pharmacy response.
Other states have struggled with their vaccination sites, or design websites that provide help, but people do a lot of work to find available shots. The Massachusetts website was so overwhelmed that it crashed. On the Washington State website, people can print a piece of paper that says they are eligible, but the individual can still find and book an appointment.
Maryland has set up a pre-registration portal, but people still have to go to other sites to find a lock. Dai said he even struggled after being eligible and pre-registering in his country. When he was invited to schedule an appointment, the link did not work.
“By the end of yesterday, I got five links, but none of them worked,” he said Thursday. Eventually he discusses alone on Walgreens.
Given the confusion, many are worried about what will happen when an even broader population is eligible. People could find it so difficult and time consuming to score a shot that they simply gave up.
“The situation will be even worse,” Dai said.
Detectives of the disease monitoring the pandemic are also concerned about the lack of consistent data on vaccinations.
“If we do not have good systems in place to track the number of people and individuals who receive the vaccine, we may not be as effective and efficient as possible with the limited resource we have,” said Janet Hamilton, CEO, said. of the Council of State and Territorial Epidemiologists.
Data on race and ethnicity are only available for a little over half of the people who have so far received vaccines. This could be because vaccine recipients do not provide the information, or because the places where they receive the shot do not collect it, do not enter or enter too slowly.
In many cases, the data was imported, but errors with different software systems make the fields disappear, said dr. Marcus Plescia, of the Association of State and Territorial Health Officials, said.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Safety, calls the explosion of the vaccine an embarrassment.
“If we had fought World War II the way we do,” he said, “there is no doubt we would have lost.”
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Choi reports from New York. Associated Press Writer Carla Johnson in Washington State contributed to this report.