PROVIDENCE, R.I. – The road to a COVID-19 shot often leads through a maze of scheduling systems: Some vaccine seekers spend days or weeks trying to book online appointments. Those who get a coveted slot can still be stymied by pages of forms or websites that slow to a crawl and crash.
The technological obstacles are familiar to L. Shapley Bassen, a 74-year-old retired English teacher and editor in East Greenwich, Rhode Island. She lost track of the hours she spent making phone calls and navigating websites to get appointments for herself and her 75-year-old husband, Michael.
“A lot of us don’t sleep at night worrying about whether or not we’ll be able to get in,” Bassen said.
Technological shortcomings across the nation’s fragmented public health system have frustrated millions of Americans trying to get shots and left officials without a full picture of who has been vaccinated.
“We’re creating an unnecessary amount of human suffering. This could have been avoidable, and we could have done better,” said Tinglong Dai, a professor who studies health care operations at Johns Hopkins University’s Carey Business School.
The White House promised improvements, pledging to establish a new website and an 800 number by May 1 to help people find nearby locations with vaccines.
“No more searching day and night for an appointment for you and your loved ones,” President Joe Biden said Thursday in a prime-time address to the nation.
The administration also promised to send technical teams to states that need help improving their websites.
The bottleneck in vaccine demand seems to be easing in some locations, and on Friday the U.S. surpassed 100 million doses administered. Nearly 66 million people have received at least one dose. But vaccine slots are sometimes still so hard to obtain that people resort to vaccine hunter Facebook groups and bots that scan sites for open appointments. Vaccine seekers who are not accustomed to those methods and don’t have anyone to help are at a steep disadvantage.
Bassen finally landed a slot at a pharmacy near home for her husband. The website even offered to schedule the second dose, but when she clicked on it, nothing happened.
Figuring it was a glitch, they printed out the appointment-confirmation email. When he arrived, he was rejected. They told him he had to schedule the second shot at the same time as the first.
The rejection sent Bassen back down into the rabbit hole of state, local government and pharmacy websites and phone numbers. She likened it to a game of musical chairs.
“From the point of view of the patient, the consumer, there seemed to be no continuity amongst these three entities,” Bassen said.
The confusion isn’t surprising. An investigation by The Associated Press and Kaiser Health News found that since 2010, spending for state public health departments has dropped by 16 percent per capita, and spending for local health departments has fallen by 18 percent. Little money was left for investing in technology.
To help states prepare for the rollout of COVID-19 shots, the Centers for Disease Control and Prevention began building a vaccine-management system known as VAMS.
Many states were hesitant to commit because it takes time for employees to learn new programs, and new systems often have kinks. Few state health departments adopted the CDC program, and at least one has since decided to drop it.
In New Hampshire, officials planned to switch to their own program after thousands of people were unable to schedule second shots within the recommended time frame. Others had their appointments canceled after the system mistakenly allowed them to book slots for which they were not eligible.
Coming up with a national program that worked well everywhere was never likely to happen, especially given the unprecedented scale of tracking COVID-19 vaccinations, said Claire Hannan, executive director of the Association of Immunization Managers.
Prior to the pandemic, local vaccine registries around the country were used mostly to track childhood vaccines. Some are decades old and were never meant to be used to schedule appointments.
Many vaccine providers such as smaller pharmacies also were not hooked up to the registries before the pandemic because of the time and cost of doing so – including the required maintenance, which involves constantly uploading data and ensuring it’s properly stored and shared.
