THEOn Wednesday, federal authorities quietly opened access to VaccineFinder, a website that allows the US public to search across the country for approved Covid-19 vaccine suppliers.
At vaccinefinder.org, users can enter an address or zip code and select a search area – say, within 10 miles – and get a list of providers with contact information, eligibility criteria and, when available, a link to a vaccine programmer. Critically, users will also be able to see if each provider has doses available.
VaccineFinder is a response to dispersed and isolated systems that make it difficult to find accurate and timely information about where and when they can make an injection. But the site will not help everyone, anywhere – not just yet.
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The site will only include inventory data from 29,000 suppliers to start, about a quarter of the national total. They will include locations in four states – Alaska, Indiana, Iowa and Tennessee – along with suppliers registered with the federal pharmacy program. The decision to limit the initial launch of the tool comes in the wake of several high-profile failures on state websites to allow the location and scheduling of vaccines, tools that failed to control the multitude of millions of people trying to find information about a country’s just once.
However, there is another important feature of the site that has been in place since the vaccine was launched. It had to be. Apparently, VaccineFinder is a definitive tool to help the public answer a highly personal question. But buried in its back-end is a set of data that allows the Centers for Disease Control and Prevention to fill in their own blanks about delivering vaccines in real time.
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These capabilities are thanks to a team of public health engineers and technologists, who rushed to build the system in a matter of months.
youUnlike many of the data systems deployed during the pandemic, VaccineFinder has been around for some time. While the United States struggled with the 2009 H1N1 flu outbreak, a team at Boston Children’s Hospital built a searchable public map of vaccine providers. Over time, the tool – which is supported by a $ 12.7 million five-year grant from the CDC – has expanded to include a full arsenal of vaccines, from hepatitis to herpes zoster and polio.
So, as soon as SARS-CoV-2, the virus that causes Covid-19, started circulating in the United States, the team started to prepare.
“We didn’t always know what role we would play, but there was always an assumption that we would do it somehow,” said John Brownstein, Boston Children’s director of innovation and founder of VaccineFinder.
The Boston Children’s team already knew the CDC. “I think in many ways, we feel like a team,” said Brownstein. “We have worked with the same people for many years.” And recently, she used some extra CDC funding to start incorporating information about the flu vaccine stock into her tool, said Kara Sewalk, the team’s program coordinator.
As vaccine research progressed, the team realized that not only could VaccineFinder serve as a public resource, but it would also have the infrastructure to systematically collect data on vaccine delivery – whether in a large pharmacy chain, in an office local doctor or a huge vaccination site in an arena.
But when the Boston Children’s team met with the CDC over the summer, they recognized that it would be a project that required more scale, speed and safety than before. On September 16, the CDC published its first vaccine release manual, including instructions to states on “how to send facility vaccine information and daily inventory reports to Covid-19 vaccination clinics to CDC’s VaccineFinder”. The infrastructure needed to support these daily reports represented a major engineering challenge.
“It was clear that we needed a partner,” said Jared Hawkins, chief information officer for Boston Children’s Innovation and Digital Health Accelerator.
Help came quickly, uninvited. In October, health navigation company Castlight Health, which had previously worked on a Covid-19 test finder, looked to see if it could help build something similar for vaccines.
“This was at a time when the CDC asked us to play a much bigger role in its response than what we were traditionally used to,” said Sewalk – this meant not only showing publicly-provided vaccination providers, but reporting their vaccination data. supply directly to the CDC. Through its existing donation to the VaccineFinder group, CDC extended a $ 8 million subcontract to Castlight.
“We were very afraid to bring in a third party,” said Brownstein. “It was a huge risk. We didn’t have time to do a major supplier survey or something. “
VaccineFinder would have to be ready as soon as the vaccines are released. The team had expanded to meet the challenge: the Boston Children’s team had 15 members, Castlight added about 40, and the CDC had members of its own operational team working. In early November, the team finally began to seriously build its enhanced provider platform. The first approval of the vaccine was just a month away.
TTo help people find vaccines, VaccineFinder needs to first identify all the places in the country that distribute them, a list that is constantly growing. Today, more than 110,000 providers across 64 jurisdictions have been approved to deploy Covid-19 vaccines.
Before the first injection went to the first arm, Castlight and the Boston Children’s team had to build a system to integrate each of these sites into the VaccineFinder system and allow them to update their supply of available vaccines from Moderna and Pfizer / BioNTech vaccines every 24 hours – with luck.
“We ask you to report supply data every day,” said Sewalk. “Whether they do it or not, it’s a different story.”
Instead of registering large pharmacies individually, the team developed a way for national companies to report all their vaccine data for each location at once. “CVS, Walgreens, Walmart, all the major networks are reporting,” said Sewalk. Of the 21 pharmacies participating in the Federal Retail Pharmacy Program, 14 report delivery to all locations directly to VaccineFinder.
From then on, however, data collection from providers becomes more complicated. “The complexity is really understanding who is going to report at what level,” said Maeve O’Meara, CEO of Castlight. “For pharmacies, they can report at the store level, and often designate a centralized person who has these data being reported at their pharmacies.”
Then there are the aggregators: of the 64 jurisdictions in the U.S. responsible for dealing with vaccine implantation – states, territories and some cities – 31 have decided to collect data from all their own vaccine providers and report it in bulk to VaccineFinder.
That leaves the little ones: suppliers, including running only nursing homes, doctor’s offices and independent pharmacies. “For small entities, providers are reporting very directly, based on what happened that day,” said O’Meara. “There is a huge burden on these organizations.”
To get the most reliable data for CDC and the public, Castlight built the VaccineFinder integration process to be as simple as possible: after creating a new account, the provider could manually enter the inventory or upload an spreadsheet with your daily data.
He also built the platform back end to be more secure than previous VaccineFinder iterations. “Whenever you are building a system with this level of visibility, you are concerned about the attacks,” said Brownstein. “And there are not many federal systems that provide real-time data.” All data that comes from CDC and providers is stored on encrypted disks on servers that cannot be accessed directly over the Internet.
All of this work – integrating providers, establishing their data entry platform and setting up security – had to happen between October and when the vaccines arrived on the ground.
In mid-November, the VaccineFinder team was able to launch its initial provider platform. “It was definitely full court pressure to get what we needed to take action,” said O’Meara. The CDC did not respond to a request for comment. On December 14, when the United States administered its first Covid-19 vaccines, the VaccineFinder provider’s platform was ready and waiting for data.
THEIn the next two months, when the first wave of vaccines was distributed, the VaccineFinder team worked to improve the searchable map that was being launched now. While Castlight sends its quantitative data directly to CDC in a format, it also powers an application programming interface that empowers the public part of the tool.
What the public sees about the availability of the vaccine is not necessarily the same information that the CDC receives. Providers are required to enter the number of doses on hand, but also report a public statement as to whether they are in stock on a given day. A provider has the option of informing the public that it is at fault and, at the same time, reporting the correct numbers to the CDC.
Along with providing information, the team is also trying to facilitate registration and scheduling by providing links to these tools – for some providers, at least. For jurisdictions that send their data in bulk every day, it may not be possible to display registration information for each individual provider.
Of course, the team will not be the only vaccine tracking game in town. Some states and jurisdictions will provide their own portals, which may have more detailed information available than the centralized resource. CVS recently launched a map that shows where its pharmacies are delivering vaccines. And VaccineFinder is working with digital platforms, including Google, to integrate its data into its own products, such as Search and Maps.
Even with these tools available, the team expects a wave of visitors to the site greater than any yet seen, all relying on VaccineFinder as an island of information verified in a sea of confusing directives. To protect the tool, the standard features of VaccineFinder – tools to locate 26 non-Covid-19 vaccines – will be taken offline until its old platform can be integrated with the new Castlight backend.
And they are planning the best they can for the unexpected. Other vaccine locators, including the one built by Project Beacon, associated with the Broad Institute, for the state of Massachusetts, collapsed under the weight of traffic. “The team continues to run tests to see what number breaks the site, so we can prepare against it,” said Sewalk.
This is one of the reasons why the site is being launched with a limited number of states – to more securely check the limits of what they have built. So far, they have tested the site against 100 million national users for more than an hour. If it resists an increase in initial visitors, the site can be opened to accommodate more jurisdictions.
During the months leading up to the launch, the website displayed a simple banner informing people of what is to come: “VaccineFinder will be updated as soon as Covid-19 vaccination is widely available to the public to help direct people to find one vaccine provider close to them ”. That time, no doubt, has not yet come; most states still offer vaccines only for people over 75. But on February 24, 13% of the United States’ population had received one or both vaccines. Now is the time to help the rest of them map a route to their destination.