Inefficient. Frustrating. Discouraging.
Those are some of the more polite words residents have used in recent days to describe the experience of registering for their second dose of COVID-19 vaccinations in New Hampshire.
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Much of the anger has been directed against VAMS, the free online platform rolled out by the CDC that promised state and local public health officials a streamlined system for scheduling vaccine appointments and monitoring vaccine stocks.
But while about 40 other states ultimately chose not to use VAMS and instead built or outsourced their own appointment scheduling systems, New Hampshire chose it and stuck with VAMS, despite the system’s apparent flaws.
The state declined to comment on a list of specific questions about why it chose to use VAMS. But recent statements from a top public health official, New Hampshire, may have had no other options due to a unique loophole in the state’s existing public health system: New Hampshire remains the only state in the country without a fully functioning vaccine registry.
“To accomplish this planning without a fully set up immunization registry, we used CDC’s VAMS system,” said Dr. Beth Daly, head of the Bureau of Infectious Disease Control for DHHS, told lawmakers last week.
Vaccine registries allow states to better track immunizations, according to public health officials, which could lead to higher vaccination coverage. In 2014, New Hampshire spent $ 1.3 million to set up a vaccine registry, but then saw the project fail in the late stages due to software glitches.
In December 2019, the same month that a new coronavirus was first discovered in Wuhan, China, the New Hampshire Executive Council approved a $ 1.5 million grant to rebuild a vaccine registry. However, the system is still not fully functional, making New Hampshire the only state without a vaccine registry.
“We are now working to rectify that,” Daly told members of the NH House Health and Human Services Committee on Friday.
In 2020, faced with the largest massive vaccination effort in recent memory, the CDC rushed to build a nationwide system for planning and tracking COVID-19 vaccinations. The federal government awarded consulting firm Deloitte a $ 44 million contract to design and launch the program.
But early reviews of VAMS seemed negative enough to convince most states to select different systems to roll out vaccine planning. That includes Maine, where Dr. Nirav Shah of the WMTW state public health office said that VAMS “didn’t live up to anyone’s expectations.” Instead, Maine chooses to build its own platform.
In South Carolina, “VAMS has become a swear word,” said Marshall Taylor, who heads that state’s health department, citing a string of frustrations over its introduction.
The CDC says a total of only ten “ jurisdictions ” and a single hospital system currently use VAMS.
One such jurisdiction is New Hampshire, where residents currently eligible for vaccinations interact with VAMS after first pre-registering through a state-run website. (Residents can also call the state’s 2-1-1 hotline to schedule appointments.)
After that step, residents receive an email from VAMS with the request to make an appointment. However, some residents complained that they never received the invitation email from VAMS or that after creating an account, they were confused by the language on the website.
There are also complaints about its usability for people connecting via smartphones and tablets, and that VAMS does not work when Internet Explorer is used as a web browser.
In recent days, anger at VAMS has only escalated following a failed rollout of new second-dose appointments for residents currently dealing with long waits between the first and second rounds of vaccination.
On Tuesday, New Hampshire officials blamed VAMS for the problem, apologized for the confusion, and promised to get new appointments into the system within 48 hours. A spokesman for Governor Chris Sununu called VAMS “inconvenient” and said the state is working on an alternative system for the next phase of vaccination introduction.
The CDC did not respond to a request for comment on the matter. Many New Hampshire residents, meanwhile, say their struggles with navigating VAMS are already adding to an already tense situation.
“The general attitude is it’s a mess or like the Hunger Games,” said Diane Freedman of Durham, who tried to use VAMS to reschedule her second dose appointment on Tuesday, but found no previous data was available.
A common criticism of VAMS is that it doesn’t allow users to search for appointments without first canceling their already scheduled date. Without that search functionality, some residents say they are unwilling to list already reserved time slots, even if those appointments fall outside the CDC’s recommended window of 42 days between vaccination rounds.
“I am totally frustrated,” said Dorothy Powell of western Lebanon, who tried to use the VAMS site on Tuesday to reschedule her second dose appointment. “I was so happy to be notified to go in and reschedule my time in April, but now I don’t even have that time because they told me to cancel it.”
While individual users may choose to vent their frustrations to local media outlets or on social media, states have been able to raise concerns about VAMS in regularly scheduled meetings with the CDC.
“We continue to be in regular contact with the CDC about issues that arise with people trying to schedule appointments at the appropriate time and location in VAMS,” said Jake Leon, spokesman for the New Hampshire Department of Health and Human Services, in a statement . “The CDC has responded in addressing these concerns.”
Leon added that “has successfully used VAMS to order and manage vaccines during phase 1A of the introduction of the COVID-19 vaccine. However, this is the first time that a system in NH has been used for mass pandemic vaccinations. ”
In an interview with NHPR this week, Daly said the state is working to launch a new vaccination management system that will require just a single step to register and schedule an appointment “which we expect will be ready in the coming weeks.”
However, it is not clear whether the state will fully break away from VAMS or still rely on the system for behind-the-scenes coordination of ongoing efforts to vaccinate residents.