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Why it's so hard to sign up for Covid vaccine – and why it won't get easier anytime soon

Why it's so hard to sign up for Covid vaccine – and why it won't get easier anytime soon

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Western New Yorkers spending hours prowling state, county and drugstore websites in search of an appointment for a Covid-19 vaccination might wish that there were a single website that offered a chance to book any possible source for the vaccine.

It's not likely to happen, Gov. Andrew M. Cuomo said this week. And local information technology experts agree with him.

"It wouldn't have been as heavy a lift if that had been the vision from the beginning. That train left the station a couple of months ago," said Natalie Simpson, chair of the operations management faculty at the University at Buffalo.

Quoting what he believes to be the public's wish, Cuomo said during his news conference Monday, "Let me have one site where I can go to find out where I can get a vaccine in Buffalo."

"That's not how the system was set up from day one. That's what creates the confusion," Cuomo said.

"The scale of the problem is only surpassed by the seriousness of the scope. If you do this wrong, it would be a disaster," said Alan Katerinsky, UB professor of management science and systems.

"To vaccinate the entire human population inside of New York State, we have a fleet of different health care providers who are working together for the first time in history," UB's Simpson said. "Better to let, for instance, the chain pharmacies use their own systems than to create one new system to bind them all that might not work. That was probably their philosophy at the time."

Thus, people are sentenced to spend hours checking the state and county websites, and the sites of as many drugstore chains and independent pharmacies, as their level of patience will permit.

"We ask that people remain patient and diligent with our site, as we remain at the mercy of the state allocation each week," Tops markets spokeswoman Kathleen A. Sautter said.

Ruth Ngwu, a pharmacist at Middleport Family Health Center, said one way the state could improve the system is by being more open about who does and does not have any doses available and when they will be.

"That would help them to know when to check on the pharmacy's website and reduce the volume of calls we get each day for the vaccine,” she said.

Monday, Cuomo displayed a slide that showed 13 different shipment routes for vaccine: from the federal government to state and local agencies and locations, including pharmacies; from the state to local agencies and locations, many of which are the same ones the federal government is servicing; and from local governments to pharmacies and other community sites.

"We need better coordination between the federal government and the state government so we know what pharmacies they're sending to, (so) we don't send to the same ones, local government doesn't send to the same pharmacies," Cuomo said. "So if the federal government is sending to CVS, then I wouldn't send to CVS."

The National Governors Association, which Cuomo chairs, sent a letter Monday to President Biden, asking for improved coordination so the states know the sites to which federal government is sending vaccine directly, whether they are drugstores or community centers.

"We also know the need in the respective communities they serve and other efforts in the geographic vicinity. If the federal government distributes independently of the states to these same entities without state coordination and consultation, redundancy and inefficiency may very well follow," the governors wrote.

"There are these national rollouts and then at the federal level, the state gets an allocation and then the state allocates its allocation to people and there doesn't seem to be coordination between that," UB's Simpson said. "That's a mystery to me. It seems like we could coordinate that."

The state also set up rules that limited certain vaccine vendors to certain types of customers, adding to the frustration.

"Tops is only permitted by the state to vaccinate those ages 65-plus so we encourage those who fall within those parameters to check our site as well as other pharmacies who fall under a similar jurisdiction on an ongoing basis," Sautter said.

A state official, who was not authorized to speak on the record, said the Western New York vaccine hub is working on a website that may list all the locations that might have vaccine, but it will not offer appointments – only contact information for the individual locations.

Katerinsky of UB warned that trying to create a single website could turn out to be a train wreck.

In fact, there is a precedent for that: the disastrous rollout of the Affordable Care Act, better known as Obamacare, in 2013, which featured enough crashes to draw unfavorable comparisons to the Daytona 500.

"With the right resources behind it, it could work, but I remember the ACA rollout of Healthcare.gov in 2013," Katerinsky said. "I was in D.C. at the time and remember the mess and political fallout that came from it. If they’ve learned anything from that, maybe this initiative would have a chance. Otherwise, I see no good reason to spend the time, money and political capital on such a project."

A health-related website faces challenges beyond listing available appointments, Katerinsky pointed out.

"You’d need a robust hardware/cloud deployment with really strong security to follow (Health Insurance Portability and Accountability Act) guidelines, because if you want to prioritize the vaccine rollout to make personal appointments, you have to ask questions whose answers need to be protected," Katerinsky noted.

For example, the state Health Department website, which offers appointments only at state-run vaccination sites such as UB's South Campus, asks each applicant a long list of health screening questions.

People in the private sector around the nation have taken a whack at trying to supplement their state and local vaccine systems. In New York City, the New York Times reported last week, more than 20 volunteers surf the web and call distribution sites to post available appointments on nycvaccinelist.com.

Somewhat less labor-intensive is TurboVax.info, created by an Airbnb software engineer to gather appointment availabilities "from 45 city and state-run vaccine sites in the NYC area" and send the results out on Twitter.

But Tuesday afternoon, the site offered only a long list of locations with no appointments available.

That brings us back to the root cause of the problem.

"You would not be frantically checking multiple sites if everybody had enough vaccine," Simpson said.

"When does this end?" Cuomo asked Monday. "Because the system is set up the way it is, it's not really going to end until you have increased dosages."

And that, the governor said, probably won't be until May or June, when the federal government's massive purchase of 600 million doses begins to show up.

The Buffalo News: Good Morning, Buffalo

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