Pang says he spent three weeks trying to log into VAMS, but he consistently found himself in the patient dashboard instead of the clinic admins. In the meantime, its staff were vaccinating hundreds of people a day and keeping track of their information on paper forms. The college has set up a bank of volunteers to sit in a room and copy all the information into VAMS.
Eventually, the local hospital helped him log into the system. The clinic used it for three days. On the last day, 20 new volunteers arrived ready to work. But they had already logged into VAMS to get their mandatory vaccines, and there was no way to move them from patient accounts to staff accounts.
The next day, they went back to paper.
“A good system is easier to use than not to use. If people are writing this down, there is something wrong, ”says Stone. “How are you going to take 100 million shots in 100 days and let someone grab it all by hand?”
“There is no way this will happen without help”
“VAMS is difficult. There are days when VAMS works and days when VAMS doesn’t, ”says Courtney Rowe, a pediatric urologist at Connecticut Children’s Medical Center, who has volunteered to monitor people’s reactions after their injections. She takes the opportunity to help people prepare for their second date. “I basically work as a tech support,” she says.
Online registrations are especially difficult for older people, perhaps the worst group to test a new system in beta. Many seniors probably lost their access to the Internet when libraries and seniors’ centers closed; only 59% have broadband connections at home, according to a Pew survey 2019. While many states offer phone lines for making appointments, people across the country have complained about the endless waits.
“It won’t work on Internet Explorer; it only works in Chrome. The “Next” button is at the very bottom and to the right, so if you’re on a cell phone, you literally can’t see it, ”Rowe says. “In the first round, people using VAMS mostly had graduate degrees. If you are 75 and someone asks you to log into VAMS, there is no way it will happen without help.
After speaking with Rowe, Connecticut opened up vaccinations to anyone over 70. His prediction came true immediately. By day one of a new vaccination clinic in Vernon, Connecticut, 204 vaccines were ready, but only 52 seniors had made an appointment with AVAM.
“Our residents, and those across the state that we serve at this clinic, are frustrated, angry and confused by the ineffectiveness of this registration system,” City Administrator Michael Purcaro said at a press conference.
Seniors aren’t the only people who struggle if immunization requires online registration. Language barriers will become a significant issue, especially for non-native English speakers doing high-risk essential work. People in poor rural or urban areas often have limited access to the internet in the first place, a problem disproportionately affecting the same black and Latin communities that have suffered the worst trauma from the pandemic.
“There are real issues of fairness,” says Stone. “What happens when you go to a city and 20% of the population cannot receive the notices?”
So what is wrong? In an email, a CDC spokesperson defended the system and said appointments are not canceled at random, despite what many clinicians have claimed: The problem, she said, was user error. She also described several fixes that were made in response to the comments. VAMS now includes warnings when administrators do something that may affect patient appointments, for example.