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How to Navigate the Confusing COVID-19 Vaccine Rollout

Tech problems, dose shortages, and other frustrations across the U.S.

spinner image Vaccine stations are set up where care workers give out injections of the Pfizer vaccine
Ben Birchall - PA Images / Getty Images

Kathy Sykes, 61, spent hours online recently trying to secure a vaccination appointment in Washington, D.C., for her 95-year-old friend Roger, who doesn't have a computer. She filled out and submitted a lengthy online form for him but received no confirmation of receipt — then tried again repeatedly whenever a new batch of appointments became available. “Is this just a rat race for whoever can click with their little fingers to get in the fastest?” Sykes asks, frustrated. Eventually, after many tries — each requiring her to fill out the form again — she got him an appointment. “It was like trying to get tickets to a rock concert,” she says.

Half of adults waiting for the vaccine said they felt “frustrated” by the state of the vaccination efforts, and a third said they were “confused,” according to a Kaiser Family Foundation poll of 1,563 adults who had not yet received the vaccine in mid-January.

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As of Jan. 26, about 20 million adults in the U.S. had received at least the first dose of the two approved vaccines (from Moderna and Pfizer-BioNTech), which each require two doses, three or four weeks apart. The federal government has laid out a comprehensive plan to get more shots in arms — aiming for as many as 1.5 million a day, officials announced recently — and announced on Jan. 26 that it would be increasing the number of doses distributed across the country every week, from 8.6 million to a minimum of 10 million.

That news is offering some hope for those anxious to acquire some immunity to the deadly virus.

The efficiency of the nationwide effort is improving by the day, notes Jennifer Kates, director of global health and HIV policy for the Kaiser Family Foundation and an expert on the government's role in public health. “Everything is moving in the right direction,” she says.

But for now, many problems remain. They include vaccine shortages in some areas, unpredictable amounts of vaccine delivered, different plans for giving the shot across the states; growing demand as people become more secure in the safety of the vaccine and states open up eligibility to more groups; and problems with state and county online registration systems that confound even the tech savvy.

A rundown of a few problems:

Inconsistent eligibility rules. The Centers for Disease Control and Prevention (CDC) has outlined a recommended rollout schedule, but states make their own priority groupings. That has meant that in some states people who are 75 and up aren't even eligible yet (Massachusetts opens up to that older group, part of its Phase 2, on Feb. 1), while in others, including Florida, anyone 65 and older was able to claim a shot — or at least attempt to — weeks ago.

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Low supply. Far more people are now eligible for vaccination than there are doses available in many areas, and the pool of those eligible is growing steadily. On Jan. 25 in Virginia Beach, Virginia, 127,000 residents were suddenly eligible for vaccinations after the city expanded access to people 65-plus and younger people with high-risk medical conditions. That means long waits for many, if the city is correct in expecting to receive only about 5,800 doses a week.

Technical difficulties. Website crashes and wonky systems that don't acknowledge receipt of requests or are confusing to navigate are making appointment sign-up hard all across the country. Roy Delgado, 78, a retired warrant officer in Arizona's Maricopa County, spent days trying to get through to the health department online and, when that failed, by phone. “They give you this recording, and keep you listening to music and it just goes on and on.” He hung up when his battery started running out. Delgado finally got an appointment days later after receiving an invitation to sign up in an email from the hospital system where he was once treated after a heart attack. “We're desperate here,” he adds, referring to the fact that Arizona is one of the states hardest hit by COVID-19 right now. “We're apprehensive and scared."

Differing paces of rollout in different states. “We're just way behind here,” says Jan Thornberg, 68, in rural Racine County, Wisconsin, who's been baffled by what she sees as the sluggish pace of the vaccination effort in Wisconsin, which has so far vaccinated about 70,000 people — about 7 percent of people 65 and older — in comparison with other states (West Virginia is currently the star state as far as per capita vaccinations; 9.4 percent of its population has received at least the first shot). Thornberg technically became eligible on Jan. 25, when the state moved into phase 1b, but timing is uncertain, as supplies are extremely limited: While about 700,000 Wisconsinites are 65 and older, the state currently receives around 70,000 first-dose vaccines per week from the federal government, according to the Wisconsin Department of Health Services. This week she signed up as a volunteer at a vaccination site, helping with paperwork, which she hopes will allow her to get her shots sooner.

Advice for those waiting for a vaccine appointment

Be proactive. Know your state or county's vaccination plan, and when you'll be eligible, Kates says: “People who are either really savvy about figuring out how to get an appointment, or have an advocate who can help them, an adult child or somebody else, they're probably going to fare better than those who don't have access to the internet.” If you need to, ask a friend or family member for help with the technology. And network with others in your area: Ask neighbors if they've snagged an appointment, and if so, how. And take advantage of your neighborhood email group, if you have one. Many are full of advice from those who have successfully secured vaccination appointments.

Be patient. “We're really ramping up production,” says Gabor Kelen, M.D., chair of the Department of Emergency Medicine at Johns Hopkins University, “and those of us who have been involved in the vaccine delivery, we've really learned how to do this efficiently now. Hang in there."

Have perspective. We are so lucky to have this lifesaving vaccine, says Kelen, who asks us to imagine if we didn't. “If the pandemic was allowed to rage, or just go on, because there was no vaccine, there would be somewhere between 100,000 and 300,000 new infections a day … and it would take five, six years to get to herd immunity. And so here we are now with a vaccine, and people are frustrated that they have to wait a month or two, or even a few weeks.... Everybody just needs to chill a bit."

Keep protecting yourself. A more contagious strain of the virus is spreading, so you'll need to be even more vigilant with mask-wearing and other infection-prevention measures, Kelen says, until you are fully vaccinated. But even then, you'll need to continue to be careful. He adds: It's still not clear whether those who are vaccinated could still be carriers and infect someone else, and the vaccine is only 95 percent effective, so “1 in 20 people is not going to be fully immunized.”

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