Technology’s Attempts to Meet the Demands of Vaccine Distribution

Photo by Ivan Diaz on Unsplash

By Luiza Wolf (Duke ‘22)

The federal government has had a tremendous impact on COVID-19 vaccine development. Billions of dollars have been devoted to research and manufacturing of vaccines as a way of combating the pandemic. It’s starting to pay off: over 118 million vaccines are already in arms, with that number growing every day. Yet while in some places getting a vaccine might be as easy as checking Walgreens’s scheduling tools (even if you have to check every day), it’s not so straightforward everywhere around the United States. Vaccine rollout, in regards to actually administering the vaccines, has been largely left up to state and local governments. The logistics of vaccine rollout has been a stark reminder of the deficiencies of government technology as private companies work to fill in the gaps.

The decentralization of vaccine rollout has resulted in a hodgepodge of different solutions. Local governments and pharmacies have a lot of logistics to figure out: who’s eligible for the vaccine, when they can come in, when they get their second dose, how many vaccines were administered that day, and more. The recipients have similar questions, while also being plagued by the risk of misinformation and impeded by lack of technological prowess.

Many seniors may lack access to the internet and, if they have it, are struggling to use online scheduling tools. Even tech-savvy individuals have run into numerous technical difficulties with the different tools out there. When and if individuals find a phone number to call to schedule their appointment or get help, they run into long wait times because of the flood of calls that vaccine distribution centers are getting. Seniors in assisted-living facilities, many of which have already gotten vaccines due to higher prioritization, have the assistance of staff to navigate these complications. Many others don’t, and those without family willing to help are struggling even more. It’s no wonder that many are falling victims to scams as fraudsters set up fake, paid vaccination appointments.

There are lots of frustrations with vaccine rollout behind the scenes, as well. It truly seems that everywhere you look, there’s a different approach. The Center for Disease Control contracted Deloitte, a consulting firm, to create a tool to meet these exact needs way back in May 2020, but results have been underwhelming to many states. The $44 million no-bid contract resulted in the Vaccine Administration Management System (VAMS), which has been the subject of a lot of critique amongst state and local governments. Although it’s unclear exactly which states are currently relying on VAMS, many who have tried have ended up seeking alternate solutions after experiences with the website crashing, random appointment cancellations, lack of flexibility, and more.

Across the U.S., this need is being met by partnerships with startups and big tech, unspecialized scheduling tools, or in some cases, plain old paper and pen. Many states, including Oklahoma and New Jersey, have adopted Microsoft’s tool, only to find that they were running into similar issues with crashing or that it didn’t always work with the existing infrastructure across different local governments. Microsoft isn’t the only player in big tech trying to meet these needs; Google and Salesforce have also signed on to million-dollar contracts with states. Meanwhile, startups like Zocdoc and Carbon Health are also taking their shot with cities like Chicago, Los Angeles, and New York with relative success. Florida and other states have been using websites like SignUp Genius and Eventbrite (traditionally used for concerts and other events), which lack the additional infrastructure and tools that the aforementioned options have. More elegant tools have the ability to manage eligibility screening, collect insurance information, create waitlists, simplify scheduling for a second dose, and more. Yet, technology is prone to glitches and failures that have manifested throughout this whole process, in ways that paper and pen have not.

Many criticize the logistical mess that has cropped up all around the United States, pointing out that the government had months to plan this as vaccines were still in development, and that the responsibility shouldn’t be falling on the shoulders of local pharmacies and hospitals. The success of smaller-company partnerships, as opposed to the federal government’s history of partnering with Deloitte, has also led many to question the efficiency and validity of turning to bigger, more established companies. These larger conversations also indicate a more promising future for government and civic technology. Perhaps as more government officials and technologists begin to analyze technology’s success in this crisis, we’ll begin to move towards better ones.