- Allocating excess doses has been a challenge in launching the COVID-19 vaccine.
- Dr. B, a screened list of vaccines on hold, can help get these doses to high-priority recipients.
- The team behind Dr. B is trying to reach vulnerable groups through community partnerships.
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The COVID-19 vaccine is in high demand, with supersaturated enrollment sites and “vaccine hunters” eager to get a dose. This mad rush for vaccines sometimes results in excess doses, however counterintuitive it may seem.
It is usually because someone has scheduled several vaccine appointments and was unable to cancel the extras. Ultimately, a vaccine provider may find that doses are left and be forced to use them six hours after thawing.
At the start of the launch, these extras were for well-connected friends and family or “someone who is buying chips at the pharmacy,” Cyrus Massoumi, founder of ZocDoc, told Insider. Massoumi estimated that 20% to 30% of doses of the vaccine were distributed in this way – essentially by chance – and said he was determined to create a fairer solution.
Paging Dr. B, an online vaccine waiting list with the name of Massoumi’s grandfather, who was affectionately called Dr. Bubba and was a doctor during the 1918 flu pandemic. The website is a screened waiting list for receipt leftover doses of vaccine for people in need.
More than half a million people have signed up for Dr. B. To join, you must enter your name, zip code, phone number and any information your local health department may collect to determine your priority status, such as your age, medical risk factors and occupation.
When there is an extra dose of the vaccine in a location near you, Dr. B will send a text message to anyone who is at the top of the list of priorities in the area. The list is designed to catch people in the early stages of eligibility who have not yet been vaccinated – much like priority boarding at an airport, Massoumi said.
“If because of your priority you got that first class ticket and there is a long queue at United, you jump to the front of the queue,” Massoumi told Insider. “This is how our system works, and it is inherently more just.”
Dr. B was launched silently with targeted community outreach
If you missed Dr. B’s smooth launch in January, it’s because the team was trying to give people in underserved communities an edge.
“There is some degree of benefit to signing up first,” Massoumi told Insider. “So, to the extent that we can go to communities that may have the greatest needs and make sure that we are especially focusing on them, this is very important for us.”
Blacks and Latin Americans are probably most in need, as they are at greater risk of severe COVID-19 and death, but have received fewer doses of vaccine than their white counterparts.
Massoumi said that within each priority level of the waiting list – among people of the same age, zip code, work and health conditions – extra doses arrive first, they are served first. Whoever gets on the list early has an advantage.
This kind of approach can make better connected people a priority, bioethicist Arthur Caplan told Insider. And Dr. B’s nature means that the service is only available to people with phones and the ability to sign up online.
Dr. B said he worked with community networks, church leaders and other unofficial partners to ensure that people with the most needs, not the most connections, were included in the early stages of the waiting list. Now that the patient side has grown to reach more than half a million people, the real job – coordinating with providers to actually distribute extra doses – has started.
The team is trying to reach high-risk groups
Dr. B is working with two vaccine suppliers: one in Little Rock, Arkansas, and the other in Queens, New York. More than 200 additional locations are available to join efforts as the service grows.
Massoumi told Insider that when he visited Dr. B’s pilot site in Queens, he was surprised to see that health professionals were using the service to get the remaining vaccines. Once the states opened their implantations, it can be assumed that doctors and nurses have already been fully vaccinated.
But some health professionals who are not affiliated with a hospital were overlooked in the first stage and are still trying to schedule appointments through a supersaturated system. Dr. B says that his prioritization ensures that these people will be the first to benefit from the service.
Uché Blackstock, founder of Advancing Health Equity, has been considering how to better reach communities of color since the first vaccine was authorized. She previously told Insider that reaching people vulnerable to COVID-19 because of racism can be tricky because states were not using race as an eligibility metric for vaccine launches.
Montana is the only state that explicitly prioritizes people to be vaccinated based on their race or ethnicity, and Dr. B does not ask for people’s race unless the state does, Massoumi said. But, by deploying the service in locations that overlap with vulnerable groups, the service can reach those in need.
“I think you could take a map at the postal code level and see, based on the communities most affected, which communities are going to need the most resources,” said Blackstock.