The CDC paid Deloitte $ 44 million for the defective vaccine nomination system

• The CDC gave Deloitte $ 44 million as a federal contractor to build a vaccine appointment website.
• Most states chose not to use the tool due to concerns about its performance, but nine states opted for it.
• Several health officials in these states say they are experiencing technical problems, including website failures and canceled appointments.
• Visit the Insider Business section for more stories.

Americans eligible for coronavirus vaccines are still struggling to get consultations.

“Each clinic, each hospital has its own mechanism for communicating, recruiting and scheduling appointments,” said Dr. Thomas Dobbs, Mississippi state health officer, at a news conference on Thursday. “This is the real challenge because we have basically 100 different ways to do the same thing.”

It wasn’t supposed to be that difficult. In May, the Centers for Disease Control and Prevention signed a $ 16 million agreement with consulting firm Deloitte, a leading federal IT contractor, to create a centralized website through which states could schedule their vaccine appointments. . The system was also designed to monitor the vaccine inventory and report each injection as it was administered. Deloitte received another $ 28 million for the project in December – bringing the total to $ 44 million.

The tool produced by the company is called the Vaccine Administration Management System (VAMS). State officials and health clinics can use the site for free to coordinate vaccine launches. But in the end, only nine states chose to participate, with the rest – Mississippi included – deciding against VAMS. Many said no to the system due to concerns about its performance.

“We refused to use VAMS after examining it in January, spending a lot of time looking at it and kicking the tires,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, at Thursday’s briefing. market. “We found that it had several limitations and therefore we did not activate it.”

Most states are now without a centralized system to streamline their responses. But, of the nine states that started using VAM – including Connecticut, New Hampshire, South Carolina, Virginia and West Virginia – many encountered technological flaws, including website failures, canceled appointments and login difficulties.

Since mid-December, VAMS has helped administer about 4% of total injections administered in the United States, or more than 1.5 million.

Appointments canceled and no confirmation emails

Paula Bronstein / Getty Images

States encountered problems with VAMS shortly after vaccinations began in December.

Marshall Taylor, interim director of the South Carolina health department, told Greenville News that the system would spontaneously cancel appointments and could not differentiate between a first or second dose (Pfizer and Moderna vaccines require two injections).

VAMS, he said, “has become a dirty word” in its department.

Lorrin Pang, the district health officer in Maui, Hawaii, told MIT Technology Review that the tool would not let him send people instructions on how to prepare for vaccination appointments. The system often blocked him from the panel for clinic administrators, he added. Pang’s drive-through clinic quickly re-registered vaccinations by hand.

In New Hampshire, residents reported that they had not received confirmation emails for the second dose.

“The VAMS system clearly has problems. It is clumsy, confusing and we really cannot control it,” New Hampshire Governor Chris Sununu told the New Hampshire Union Leader.

Officials say VAMS ‘has not kept its promises’

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A Deloitte spokesman told Insider that VAMS was originally designed to help CDC track vaccine distribution and administration “in a limited number of pre-selected locations.” But, as a courtesy to states without the time or resources to create or purchase their own scheduling systems, he added, the CDC gave them the option of using VAMS.

“Since it went into operation to support the first critical phase of vaccinations, VAMS has had no downtime due to system or performance problems,” said the Deloitte spokesman. “Although some users have reported challenges, VAMS is not spontaneously canceling appointments.”

The CDC did not respond to Insider’s request for comment.

According to Shah, VAMS should be available to anyone who wants to sign up for an appointment. But the tool “didn’t really deliver on its promises,” he said. Without a centralized system, the vaccine nomination process in Maine has been “suboptimal,” added Shah.

“You can expect a successor [to VAMS] in the future, “he said.

But creating any centralized government-run website is “super difficult,” according to Pouria Sanae, CEO of ixlayer, a healthcare software company that helps streamline COVID-19 testing and some vaccines for businesses, healthcare systems and government agencies .

“Take taxes as an example,” Sanae told Insider. “We don’t have a centralized tax platform and this is something we do every year.”

A ‘Google-like effort’ with ‘old school’ technology

Valerie Macon / AFP / Getty Images

The CDC identified Deloitte as the only “responsible source” capable of building a centralized vaccination platform, so the company did not have to bid for the project. Many software experts, however, think that VAMS would be in better hands with a major technology company.

“It’s an effort similar to that of Google,” said Sanae. “It is not for government organizations to do.”

To avoid bottlenecks in launching the vaccine, he added, states need a website that can be updated consistently during use. Thus, if a patient misses an appointment or the clinics run low doses, these obstacles will not slow down the entire vaccination process.

Deloitte’s technology, by contrast, is “old-school,” said Sanae. It is based on a fixed “waterfall model” that, for the most part, cannot handle many changes.

“There is a reason why Apple and Windows are bothering us with these updates: because they are repeating themselves,” he said. “We really need this for any software that supports vaccination.”

VAMS is likely to create more bottlenecks along the way, Sanae thinks, as people return for their second attempt.

“One thing that you will see in a month, I guarantee, is the people who received the first dose showing up in different places with different vaccines, showing up in different states,” he said.

Switching systems pose new challenges

Sean Rayford / Getty Images

At least one state, Virginia, is already transitioning from VAMS to a different vaccination system, called PrepMod, which is also used by several other states. Tammie Smith, a spokeswoman for the Virginia Department of Health, told Bloomberg that the platform is “more customizable” than VAMS.

Still, in early February, a flaw in the PrepMod system allowed a handful of residents in Roanoke Valley, Virginia, to apply for vaccines before they were eligible. Residents got a registration link that was not to be sent, reported the local WSLS television station.

California clinics and nursing homes have also struggled to access the PrepMod system, according to the Los Angeles Times.

Sanae said PrepMod found this “a little complicated” for inpatients. He added that states may also have difficulty transferring patient data from VAMS to a new platform. He compared the process to switching each person’s Gmail account to Yahoo.

Changing scheduling systems can also be expensive.

“At some point with IT solutions, there is a certain blocking effect and the cost of switching from one registration platform to another can be significant,” said Shah.

But he added that some states are still looking to abandon VAMS as soon as possible.

“I spoke to at least one counterpart of mine, where his status was activated [VAMS], and they can’t wait to find another solution, “said Shah.

Maura Fitzgerald, a spokeswoman for the Connecticut Department of Public Health, told Bloomberg that her state is exploring alternative systems. New Hampshire also plans to launch a new scheduling system by March.