Vaccine Appointment Screed

 

January 2021 was spent trying to get appointments for Lenora and I for the recently released COVID-19 vaccines. We were both over 65 and qualified relatively early but the process of actually getting the vaccine into our arms was frustrating.

It would be hard to define a more Byzantine system. The federal government bought the vaccine doses from the manufacturers and then gave them to the states. Each state was thus at liberty to define their own policies. North Carolina has a rational governor who, following the advice of a well-grounded science advisor, set rational high-level policies – so far, so good. But then, North Carolina delegated the distribution of the vaccine to the 100+ counties while retaining legal ownership. The counties were then at liberty to define their individual distribution policies and protocols. It also meant that 100+ information systems had to be created to make and track appointments resulting in mass confusion as there was no one right answer to the question, “How do I get an appointment?”

The most critical problem was that counties had physical control of the vials of vaccine, vials which they didn’t actually own, but the counties had no capacity to put needles into arms. The task of actually vaccinating people was therefore further delegated to the major medical systems, generally to the dominant one in a county, or, in some cases, to networks of local pharmacies.

The PSAs said that getting an appointment was as simple as registering with your county but that was far from the truth. We live in Chatham County but are nearer the epicenters of both Wake and Durham counties.  We registered in all three counties, each a slightly different process, but couldn’t get an appointment from any of them. Eventually, in the middle of January, we got appointments from the Durham County health department to be vaccinated in March.  We didn’t get any response from Chatham until long after we had our shots and never heard back from Wake County. We also registered with the three dominant medical systems in the area. Duke, UNC and WakeMed each had their own system that was supposed to notify you when slots were available but, similarly, the notices never came.

To add confusion to a tense situation, the rumor mill roiled with various stories of how people got their shots.  Some people reported that they were successful by calling the area medical system directly. There were apocryphal stories of people calling, the phone being answered and an appointment being available the next day. I tried repeatedly but was either put on infinite hold or told by the automated system that no appointments were available. Many in our area resorted to driving an hour or more to a county that was distributing through pharmacies on a first come, first served basis. As word got out, people from other states started coming to NC to take advantage of that opportunity and soon it dried up.  The impact of systemic racism was present also as the rumor mill told how people from affluent areas could go to pharmacies in disadvantaged areas as those locals didn’t have the transportation to get to their pharmacies allowing supply to outstrip demand. Ethically, we couldn’t take that path, but our deferral did nothing to get those doses into the intended arms.

As mentioned, we registered with the three major medical systems and waited as friends and neighbors reported serendipitously getting appointments that way. UNC was the system Chatham County was using but we never heard from them nor Wake. Duke’s system was simple – you could go online through MyChart or phone but appointments were never available, so you had to login again answering the screening questions or call back. The rumor mill indicated that batches of appointments were being sporadically released and snatched up by the lucky few who were online or in the phone queue at the right time. The only method seemed to be constantly trying and retrying. 

After Durham County gave us appointments – albeit a month and a half out – I stopped constantly trying but would occasionally login to Duke MyChart opportunistically hoping to get an earlier date. One Sunday morning the last week of January, while waiting for the church Zoom service to start, I tried and was stunned as a batch of appointments for that afternoon were available. Apparently, Duke had just opened a new vaccination site.  When we got there, the line wrapped around the building but was moving expeditiously. We each got our first shot without incident; the longest part of the process was entering the data into the state database which tracked whose arms their vaccine went into. Policies were changing so fast that, when I got home and checked to see if the data about my shot was entered in the state’s system correctly, it told me that I wasn’t eligible for the shot.

The symptoms were mild and two weeks later we returned on Valentine’s Day for our second shots.  The relief we both felt was palpable.