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In Mississippi, an online vaccine registration system failed in a sudden traffic attack. Staff at a local health department in Georgia had to rely on every dose they received before scheduling appointments. A $ 44 million national vaccine programming and tracking system is it is practically not used by the states.
And California, Idaho and North Dakota vaccinations counted less because workers forgot to click on a “send” button at the end of the day.
In the United States, a vaccination campaign designed to turn the tide of the pandemic and stimulate the country’s economic recovery is being hampered by technical failures and software problems. Cashless public health departments are trying to prevent their websites from crashing while making millions of appointments, tracking unpredictable stocks and recording how many injections they administer.
The situation that unfolds in the USA, home to technology giants, is frustrating an audience hungry for vaccines. In addition, data gaps could be distorting the national picture of how efficiently vaccines are being used, if some doses administered are not counted.
“Our impression is that it is a substantial amount,” said Marcus Plescia, medical director of the Association of Territorial and State Health Officials. “This will become clearer as data systems are improved and we have a better sense of what we are missing.”
Filling in gaps
It is a situation that some officials predicted. Former director of the Center for Disease Control and Prevention, Robert Redfield, cited “years of underinvestment” in public health systems in his testimony before Congress in September. He then said the Trump administration was planning to help states plug holes in IT capacity.
“Hopefully, there will be more resources to start filling those gaps, because it will be very important that we have the reports for monitoring and ensuring these vaccines,” he said.
Redfield and groups representing state health officials told lawmakers that billions in investments would be needed to help states distribute injections. But Congress did not allocate that money until it passed a funding bill in late December, after states have started vaccinating people.
Private vaccine companies are facing their own problems. Jarred Phillips, his sister, mother and father took turns searching the website Walgreens Boots Alliance Inc. to find a vaccine appointment for your mother. The process included creating an account, searching by zip code, then by store, per day and for a three-hour time interval.
Did not show anything. Phillips, a 36-year-old technology worker from Wilmington, Delaware, even searched for rural postal codes where there might be little demand. Nothing. Hours later, he couldn’t figure out why the process was so complicated.
“At some point, these solutions need to find people where they are,” he said.
Walgreens spokeswoman Kelli Teno said the company has “dedicated teams that actively work on these issues to ensure an easy, safe and transparent experience for all eligible individuals” who are trying to schedule their vaccines.
Patchwork Systems
Like much of the United States’ response to the coronavirus pandemic, the vaccination effort was implemented in a patchwork approach. And it was placed on top of an already fragmented health system. The result is a confusion of digital systems across the country that has angered many people who have tried to use them.
“The biggest mistake was that the government was a little too focused on the first problem: how to get vaccines and send them to different locations,” said Eren Bali, co-founder and CEO of Carbon Health Technologies Inc. “It was definitely an oversight that didn’t start before.”
So far, about 49 million doses have been distributed in the United States. About 23.5 million people received the first of the two injections and 5 million both, according to Bloomberg Vaccine Tracker. Last month, Trump administration officials had projected that 30 million people could be fully vaccinated by the end of January.
Registering people in advance is encouraged to prevent crowds at clinics, especially with the virus still growing in many communities. But registrations have sometimes been chaotic, especially for older people who are among the first in line for vaccinations, with lottery-like nomination sites.
Before opening consultations, the health departments of Gwinnett, Newton and Rockdale County in Georgia first count their inventory. The forecasted supply may change each week and the amount that arrives may actually be different. The health department relies on Bookly, a web plug-in that it started using last year for coronavirus testing.
New appointments are opened once a week. They are filled in hours.
“It is difficult to communicate with the public about when appointments are open,” said Audrey Arona, the director. “I know it is a lot of frustration to have to sit on the site constantly for when appointments open.”
The Georgia Department of Public Health is working on a centralized scheduling system. The tool should be ready by mid-February, spokeswoman Nancy Nydam said by email.
In Florida, several counties turned to the Eventbrite ticketing website when the state expanded eligibility for people 65 and older. Los Angeles discarded software called PrepMod because it failed to cope with the rush to register. Instead, the city turned to Carbon Health, which runs a network of health clinics. The company created an online tool to find test sites and built a vaccine platform from it.
Immunization tracking
The Christus Health team spent as much time documenting and reporting vaccinations as administering vaccines, said Sam Bagchi, clinical director of the health system based in Irving, Texas. Christus administered approximately 65,000 doses in Texas, Louisiana and New Mexico.
The shots are reported to states differently, depending on who is receiving them: an electronic medical record for employees, another for their patients, and, until recently, paper forms for people who were neither patients nor employees.
Christus separately counts its vaccine inventory manually and types the data into a web form for the state. The existing systems are not “meant to track minute by minute, hour by hour, day by day, what is being given and what is not being provided,” said Bagchi.
Public health technology systems are not built with the precision needed for the mass vaccination effort, said Joseph Kanter, a Louisiana Department of Health official.
“It’s like taking a Yugo and trying to go 150 down the highway,” Kanter said. “Sometimes the bumper falls off.”