With millions of doses of the COVID-19 vaccines manufactured by Moderna and Pfizer being distributed all over the U.S. and abroad, many healthcare providers have been anxious to get their shot. So, who goes first?
Some hospitals and facilities have enacted lottery systems, while others are prioritizing providers who have direct contact with coronavirus patients.
However, that wasn’t the case at Mass General Brigham hospital system in Boston, MA. Jennifer DeVincent, a nurse in the neonatal intensive care unit, says the vaccination process collapsed due to a technical error, leading to confusion and panic among the nurses on staff. It’s a horror story that she won’t soon forget and a lesson to hospitals and facilities getting ready to distribute the first doses of the vaccine.
Crashing the System
DeVincent has been a nurse at the facility for over 16 years, and 2020 has been tragic, to say the least. She was relieved when she first heard that her hospital was getting one of the first shipments of the vaccine.
To get the shot, providers were encouraged to sign up via the hospital’s online scheduling portal. Soon after it launched, however, the surge in users caused the system to crash.
The system went back online a short while later, but DeVincent says many providers were simply out of the loop. She was with a patient at the time, but overheard some of her colleagues discussing what had happened. “I remember I was sitting there in the rocker feeding the baby as I was hearing nurses talk from outside the room in the hallway,” DeVincent described.
After hearing some commotion in the hallway, she soon discovered that all the available appointments had been booked. Some nurses slept through the announcement that the system was back online, leaving others to snatch up the remaining slots.
“It turned into somewhat of a free-for-all. And, you know, those that work the most have had the hardest time getting an appointment because you can’t always log on at that exact moment.” DeVincent said. Many providers with direct contact with coronavirus patients say they still haven’t received the vaccine, including DeVincent.
That wasn’t how it was supposed to go down. When setting up the scheduling portal, the hospital hoped that administrators, care coordinators, and other high-level employees would respectfully wait their turn, so that those who needed the vaccine most would have first access to the shots.
“It definitely feels a little bit like a slap in the face,” she added.
Paul Biddinger, one of the administrators overseeing the rollout of the vaccine, quickly acknowledged the problem.
“It absolutely did create a frenzy, which is the opposite of what we wanted to do with this system. And it’s something that we’re working very hard on addressing right now,” he said.
Biddinger says the hospital should’ve done a better job in terms of managing expectations, considering the hospital didn’t receive enough vials for a staff of over 80,000, which meant that many people would have to wait.
“It’s actually relatively complex to figure out who is working where,” he added. “We have staff who move among our hospitals and work in different roles in different hospitals.”
He still thinks the honor code is necessary when using the scheduling portal and administering the drug to such a large population. While the initial rollout didn’t go as planned, he says they are working on adding more specific guidelines to the scheduling app, so that providers with less exposure to the virus know to wait their turn.
Biddinger has also been going through the data to see what went wrong. For the most part, he says it wasn’t about executives and administrators cutting in line. Instead, he attributes the problem to a misunderstanding.
Most hospitals have been able to distribute the first doses of the vaccine without running into trouble; the first shipments have exceeded demand among healthcare workers, so people will have to wait their turn.
Expert Advice for Facilities
Julia Swann is an expert in supply management that advised the CDC when it oversaw the distribution of the H1N1 vaccine. She has some advice for facilities trying to make sure the first doses go to those that need them most.
“One way is to send information out first just to the smallest group that is eligible for the vaccine and get them registered first,” she said.
These problems will go away in the weeks to come as officials continue to distribute the vaccine by the millions, with quantities increasing week after week. Swann also says facilities are quickly learning and correcting issues as they go to ensure the first doses end up in the right hands.
When there’s not enough vaccine to go around, it’s always important to prioritize those with the most risk.