Notes from Vaccine Discussion

Last night we held a zoom discussion on the vaccine rollout. Approximately 275 people participated in the meeting. A recording of the meeting appears at this link.

I began the meeting with an overview of the vaccine rollout and acknowledgement that it has been very difficult or impossible for newly eligible seniors to schedule appointments for vaccination through the state’s website.

I shared the fact that many of the state’s health care systems like MassGeneralBrigham will be in touch with their eligible patients to invite them in for vaccination. The majority of people in the state who already have a relationship with one of these systems do not need to go through the state’s website. They just need to wait for the invitation. Many of the systems are currently putting out word to this effect to their email lists.

Website issues discussed on the call

Although the big systems will be taking care of their patients, a great many do need to work through the website and the website needs to get much better. Issues raised included the following:

• If a user is successful in finding the state’s vaccine location page, the text heavy top half obscures the finder map “below the fold”, especially for seniors who might be using a larger type face.
• The use of a generic Google map creates confusion because when you zoom in because it includes a lot of irrelevant artifacts (e.g., hospitals and grocery stores) that invite clicking to dead end locations.
• Requiring the user to click each starred location to find if the location offers any appointments wastes time — locations not offering appointments should be presented differently.
• Of special concern, users should not have to complete forms at each location to find out if the location offers appointments. Some of the locations may be harvesting personal information for non-patients by forcing them to complete forms before showing appointment availability.
• Another problem, it is difficult to schedule two people in the same household — since some of the sites are remote, this should be easier.
• The question was asked whether the site was available in multiple languages. The site does include a page translator, but the page translator does not cover the data that comes up for each location. So, its utility is limited.

With all the divers forms to fill out, it can take a sophisticated user easily an hour to canvass the map of nearby locations only to find that there are no appointments available. The state should invest in a more friendly preregistration front end that requires data entry only once and notifies users of available appointments. Some states have front ends similar to Massachusetts’, but some are offering much better interfaces.

Update on January 29: The state’s COVID team has acknowledged the website problems and expects to deliver improvements soon. Additionally, the team is rolling out a hotline as an alternative method to schedule.

Other Concerns Raised

• Are there vaccines being wasted at end-of-day in some locations? Should there be a wait list system to assure that there is less waste. People reported anecdotes of waste occurring.
• The state is likely distributing less first-dose vaccines than it could as a result of provider second-dose holdbacks. Should this change and is it changing?
• There needs to be a hotline for those who do not have internet access.
• There should be better communication from the major health care systems that they will be rolling out vaccines to their patients.
• There should be drive through locations so that at-risk patients do not need to expose themselves to infection.
• Those not in the databases of major health care systems and not an employee of an eligible large employer are at a real disadvantage in getting vaccine.

Update on January 29: The state has recently changed its distribution management system to put all vaccinators on a shorter leash, disallowing the reservation of second doses and requiring frequent accounting for supplies and amounts actually administered. The state is now taking unused vaccines back and reallocating them to other vaccinators. The state has also brought in supply chain management experts to make sure that the new process is working as effectively as possible. We should see the amount of idle vaccine sitting in the supply chain diminish substantially.