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Earlier this month, New York photographer Hee Jin Kang woke up at 3 am and went online to register her elderly parents for the coronavirus vaccine.
She created accounts on five different sites, including portals for state vaccination programs, as well as hospitals, pharmacies and primary care settings. After hours of clicking and updating multiple landing pages, she guaranteed schedules for both parents.
“It’s crazy,” she said. “There is no centralized system. I just couldn’t stop thinking, if you weren’t tech savvy, that would be just impossible – they make you jump through many obstacles. “
People across the United States compared signing up for a vaccine injection in the past few weeks to updating a page for highly coveted concert tickets. In Michigan, a vaccine registration website crashed almost immediately after the state expanded access to the vaccine for people 65 and older. The site, which processes 900 queries on an average day, saw more than 25,000 people trying to register. In Texas, a website saw 9,000 appointments completed in less than six minutes. Users in Minnesota reported similar problems. Some Florida health departments are using the Eventbrite ticketing website, which raises concerns about money changers buying places and reselling them.
The Trump administration promised in November that 20 million Covid-19 vaccines could be distributed by 2021. This week, only 18.5 million people received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention. , and about 3.2 million people have been fully vaccinated.
New doses of vaccine can only be produced quickly, but supply is only part of the problem. For Americans whose vaccines are not being prepared in the workplace, scheduling can be a major setback.
Most states do not have a centralized registration system for consultations and those that do exist are fraught with flaws. Both obstacles made it difficult for those who are not tech savvy and people who don’t have time to update an online application all day to get a potentially life-saving vaccine spot.
In fact, online applications raise a number of ethical issues, say public health experts. Most states in the U.S. are in the second vaccine stage, which means that people aged 65 and over can be vaccinated. This poses problems for elderly patients and others with little technology education, said Susan Lee, a primary care Internet user in New York. “The only elderly patients who were able to get consultations – my parents included – are those who have someone who can defend them,” said Lee. “It’s heartbreaking.”
In addition, millions of Americans do not have access to broadband internet, and only 51% of the elderly claim to have high speed internet at home. These statistics are further affected by race: only 58% of black Americans and 57% of Hispanics have a computer at home, compared with 82% of whites.
Biden pledged to increase the distribution of the vaccine to 1.5 m doses per day for the next three weeks and said that anyone who wants a vaccine will have access to it in the spring, but America’s disjointed health care system presents unique difficulties. One of the only high-income countries in the world without universal health, the US depends on a combination of public and private health resources. The logistical challenges are compounded by the fact that states under the Trump administration had to implement their own vaccine distribution plan with little national guidance. At the federal level, the Trump administration’s hesitation to share data has delayed the vaccine’s launch, the Biden government said.
In a new 200-page report describing the launch of a vaccine, Biden said his administration will facilitate “new technological solutions” for Covid’s vaccine programming. “The federal government will provide technical support to ensure that these systems meet mission critical requirements to support a robust response,” said the report.
Simplifying vaccine delivery and scheduling as quickly as possible will be an integral part of controlling and eventually ending the coronavirus pandemic, said Seju Mathew, a primary care physician and public health specialist in Atlanta, Georgia.
“We need 85% of the US vaccinated to get collective immunity, so the next few weeks are going to be huge,” he said. “The only way to deal with this deadly pandemic is to vaccinate people very quickly.”
In the meantime, some states are taking action, private companies are struggling and community efforts are emerging. California, where the state government has been fiercely criticized for low vaccination rates, has just launched a state portal called My Turn, which will alert residents to the vaccine’s eligibility. This is after a crowdsourcing site in California called VaccinateCA organized volunteers to call pharmacies across the state to determine which ones are providing vaccines to whom and to publish what they have learned.
Google announced on Monday that it would place vaccination sites on its Maps feature. Private companies like ZocDoc, a platform for registering traditional medical appointments, offer infrastructure for scheduling vaccines. ZocDoc is partnering with major hospital systems and local governments to facilitate scheduling. Amazon has also offered to help with vaccine logistics and is working on an official proposal for the Biden government, a spokesman said on Saturday.
It is essential that the government allows for better scheduling logistics because both vaccines approved in the United States – from Moderna and Pfizer – require two doses to be effective. Mathew, the primary care physician, said that, based on what he heard from the news and directly from his patients, he worries that people who have trouble getting an injection appointment will hesitate to schedule a follow-up appointment.
“Scheduling a vaccine should be as easy as booking a trip on Uber or booking dinner on OpenTable,” he said. “Otherwise, we will be losing patients.”
This will not be possible without a more streamlined technological approach, said Seema Yasmin, physician and director of the Stanford Health Communication Initiative. The system should also keep in mind the inequalities that exist in the US healthcare system and in the spread of Covid-19 in the USA.
“The same communities that are dying disproportionately because of Covid-19 are being vaccinated at slower rates than white, wealthy citizens,” said Yasmin. “When something as basic as the ability to schedule a vaccination appointment or even find out when you might be eligible for a vaccine poses such enormous challenges, it can foster distrust in the vaccination system and in the vaccines themselves.”