PROVIDENCE, RI (AP) – The road to a COVID-19 blow often leads through a maze of programming systems: Some vaccine applicants spend days or weeks trying to book appointments online. Those who receive a coveted space may still be hampered by form pages or websites that slow down to crawling and blocking.
The technological hurdles are familiar to L. Shapley Bassen, a 74-year-old English teacher and publisher in East Greenwich, Rhode Island. She lost track of the hours she spent making phone calls and browsing websites to make appointments for herself and her 75-year-old husband, Michael.
“Many of us don’t sleep at night worrying about whether or not we’ll be able to get in,” Bassen said.
The technological shortcomings of the nation’s fragmented public health system have frustrated millions of Americans trying to get shot and left officials without a complete picture of who was vaccinated.
“We create an unnecessary amount of human suffering. This could have been avoided and we could have done better, ”said Tinglong Dai, a professor of health care at Johns Hopkins University’s Carey School of Business.
The White House has promised improvements, committing to creating a new website and 800 numbers until May 1 to help people find nearby vaccine locations.
“Stop looking for a date day and night for you and your loved ones,” President Joe Biden said Thursday in a prime-time address to the nation.
The administration has also promised to send technical teams to states that need help improving their websites.
The blockage of vaccine demand seems to be diminishing in some locations, and on Friday the US exceeded 100 million doses administered. Nearly 66 million people received at least one dose. But vaccine slots are sometimes so hard to get that people turn to Facebook groups to hunt for vaccines and robots that scan sites for open dating. Vaccine seekers who are not accustomed to these methods and who have no one to help you are at a severe disadvantage.
Bassen eventually landed a slot at a pharmacy near her husband’s home. The website even offered to schedule the second dose, but when he clicked on it, nothing happened.
Thinking it was a problem, they printed out the confirmation email. When he arrived, he was rejected. They told him he had to schedule the second shot at the same time as the first.
The rejection sent Bassen back to the rabbit hole of state, local government and pharmacy websites and phone numbers. She likened it to a set of musical chairs.
“From the patient’s point of view, from the consumer’s point of view, there didn’t seem to be any continuity between these three entities,” Bassen said.
The confusion is not surprising. An investigation by the Associated Press and Kaiser Health News found that since 2010, spending on state public health departments has fallen by 16% per capita, and spending on local health departments fell by 18%. There is little money left to invest in technology.
To help states prepare for the launch of COVID-19 photographs, the Centers for Disease Control and Prevention has begun building a vaccine management system known as VAMS.
Many states have been reluctant to hire because employees need time to learn new programs, and new systems often have problems. Few state health departments have adopted the CDC program, and at least one has since decided to drop it.
In New Hampshire, officials plan to move on to their own program after thousands failed to schedule a second fire within the recommended time frame. Others had their appointments canceled after the system mistakenly allowed them to reserve slots for which they were not eligible.
Coming up with a well-functioning national program everywhere was never likely to happen, especially given the unprecedented scale for tracking COVID-19 vaccinations, said Claire Hannan, executive director of the Association of Immunization Managers.
Prior to the pandemic, local vaccine registries across the country were used primarily to track childhood vaccines. Some are decades old and were never meant to be used to schedule meetings.
“Many of them are just a kind of spaghetti cod bowl, which 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 pre-pandemic registries because of the time and cost of doing so – including the necessary maintenance, which involves constant data uploading and storage and sharing. corresponding to.
“There’s always been this perception that you’re building it and you’re done,” Coyle said.
Many states have concluded that they need a single easy-to-access door to plan photos, said Dr. Deidre Gifford, acting commissioner of the Connecticut Department of Health, at a recent CDC forum.
The best system, Dai said, would be to send everyone to a central location and, based on supply, provide each person with a reasonable estimate for receiving a vaccine. It could be a few weeks or months away, but managing expectations would ease some anxiety.
“The basic idea is to give people confidence, to give people peace of mind,” Dai said.
West Virginia has almost done this with a unique statewide pre-registration system that uses crisis management software to collect each person’s demographic and contact information, as well as details such as occupation, so that certain critical workers can be targeted. Then they receive a text message or a phone call to reserve a slot when vaccine doses are available in their county, said Krista D. Capehart, who coordinates the state pharmacy response.
Other states have struggled with their vaccination sites or designed sites that offer some help, but make people work hard to find photos available. The Massachusetts site was so overwhelmed that it collapsed. The Washington state website allows people to print a piece of paper saying they are eligible, but finding and booking a meeting is still up to the individual.
Maryland has set up a pre-registration portal, but people still have to go to other websites to find a slot. Dai said that even he fought after he became eligible and pre-registered with his county. When invited to schedule an appointment, the link did not work.
“By the end of yesterday, I had received five links, but none worked,” he said on Thursday. He ended up booking alone at Walgreens.
Given the confusion, many worry about what will happen when eligibility opens up to an even wider population. It can be so difficult and time consuming for people to score a shot that they simply give up.
“The situation will be even worse,” Dai said.
Pandemic disease detectives are also concerned about the lack of consistent vaccination data.
“If we don’t have good systems for tracking the number and type of people receiving the vaccine, we may not be as efficient and effective as we can be with the limited resources we have,” said Janet Hamilton, executive director of the Council of Epidemiologists state and territory.
Race and ethnicity data are only available for just over half of those who have received vaccines so far. This may be due to the fact that vaccine recipients do not provide information or because the places where they receive the shot do not collect it, do not enter it or do not enter it too slowly.
In many cases, data has been entered, but errors with different software systems make these fields disappear, said Dr. Marcus Plescia, of the Association of State and Territorial Health Officials.
Dr. Amesh Adalja, a senior researcher at the Johns Hopkins Center for Health Security, calls the launch of the vaccine embarrassing.
“If we had fought in World War II the way we do,” he said, “there is no doubt that we would have lost.”
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Choi reported from New York. Associated Press writer Carla Johnson of Washington State contributed to the report.