State House Bill Would Create A Central COVID-19 Vaccine Registry

Feb 19, 2021

As many Pennsylvanians continue to struggle through a decentralized system in their search for COVID-19 vaccines, some have called for a statewide resource to lighten their load.

The Department of Health has said it remains open to adjusting its decentralized approach, but that no statewide appointment managing resource is being developed.

A new bill in the state House could force the department’s hand.

The “COVID-19 Vaccine Registry Act” would require the department to host a database where Pennsylvanians would register to be put on a waiting list for an appointment. Vaccine providers would then be required to use the registry and contact registrants for appointment scheduling. The Department of Health would be tasked with maintaining the database.

Currently, the only way to book a vaccination appointment is to directly contact individual providers; most appointments are booked online. Providers who may have vaccine available are listed on a map on the health department’s website.

“This registry would just streamline the entire process,” said Rep. Austin Davis, chairman of the Allegheny County Delegation and co-sponsor of the bill. “I think this decentralized system just creates a lot of chaos and confusion.”

Democratic Reps. Ryan Bizzarro, Pam Snyder, and Jennifer O’Mara are also sponsoring the bill introduced this week.

According to Davis, registrants would enter their information as well as how far they are willing to travel to be vaccinated. Providers would be required to prioritize registrants for available vaccine.

Pennsylvania’s vaccine distribution approach has been decentralized since it began in December. State officials have said they can count on relationships local pharmacies and hospital systems already have with their patients to get appointments booked.

But the system has not been without problems. The state health department announced Wednesday that one or more vaccine providers used Moderna vaccines that were intended to be second doses as first doses. As a result, providers requested more second doses for this week than Pennsylvania could distribute. Thousands of appointments will have to be rescheduled as a result.

A centralized database could have made that rescheduling easier, according to Davis. “We would have a database of who is getting the vaccine; when they got it; and when they’re due for their second doses.”

States like New Mexico have launched a single statewide registration system. Others have created registration systems for state-run clinics while individual providers host their own appointment booking platforms.

Davis thinks one reason Pennsylvania didn’t initiate a centralized rollout could be due to the number of governmental bodies across the Commonwealth.

“We put such an emphasis on local government that a lot of the systems that states like New York might use are decentralized here in Pennsylvania,” Davis said. “We don’t [currently] have a structure in place to create a centralized system.”

According to data from the 2017 Census of Governments, the Commonwealth has 4,830 active local governments. This includes administrations at the county, municipal, special district and school district levels.

“We don’t even have a statewide dog licensing system because it’s so decentralized and controlled by every individual county,” said Davis.

That could explain some similarities with the country’s three other commonwealths, according to Jennifer Kates, senior vice president and director of global health & HIV policy at the Kaiser Family Foundation. Kates oversees policy analysis and research focused on the U.S. government’s role in global health.

Kates pointed out that most of the country’s other commonwealths also originally took a decentralized approach to their vaccine distribution. Kentucky does not have a centralized sign up; Massachusetts offers a sign up for state-run vaccination clinics, not local providers. Pennsylvania’s health department has not yet offered a state-run vaccination clinic, though the department has said they will be planned.  

Earlier this week, Virginia — a commonwealth facing criticism from residents similar to Pennsylvania — launched a state call center and online portal for COVID-19 vaccine pre-registration. WVTF reports the portal received high traffic from the moment it launched.

“At the peak, the new site was getting 300 registrations per minute and it averaged 150 registrations per minute,” Virginia Gov. Ralph Northam said during a Wednesday press conference. More than 240,000 Virginians had registered through the portal through Wednesday, according to WVTF.

Fairfax County, which has operated its own vaccine distribution separate from the rest of Virginia, opted out of the statewide registration system. Kates said Philadelphia could take a similar path if Pennsylvania were to create a registration system.

“Virginia is an example of a place that has not had a centralized sign up but is now moving towards a centralized sign up,” Kates said.

Hiring operations staff and a lack of technological resources could create more hurdles in propping up a state registry. “States already had underfunded public health systems to begin with, then COVID hit,” said Kates. “States were already operating at a deficit.”

The web development infrastructure required for a centralized portal to book appointments could be an insurmountable challenge for the health department, according to Karen Kornblum, an associate teaching professor at Carnegie Mellon University’s Human-Computer Interaction Institute.

“Getting the infrastructure in place for [a statewide portal] would delay the distribution of the vaccines,” said Kornblum on a recent episode of WESA’s The Confluence. She said providers would need time to bring their systems into compliance.

“It would mean that all of these pharmacies and health care providers … would all need to be using the same language and using the same information paths … and that can’t happen overnight," she said. "Ideally that would’ve been happening during the last year."

The state did launch Your Turn, a COVID-19 vaccine eligibility quiz, to help keep Pennsylvanians in the know about their vaccine eligibility status. The health department said the tool could show users where state-run clinics are scheduled in the future. Your Turn does not include an appointment booking feature and a department spokesperson said there are no plans to launch such a resource in the future.

A statewide portal where Pennsylvanians can find available vaccine does exist, though it's not operated by the state. VaccinatePA.org maintains a database with updated information about which providers across the Commonwealth are currently taking appointments.

The website was created about a month ago by three students; two at the University of Pittsburgh and one at Harvard.  Seth Rubinstein, one of the founders, is based in Montgomery, Pa. He said while limited vaccine supply is an obvious issue, better information presentation can go a long way to relieve frustrations for those searching for an appointment.

“Everybody wants faster subways and faster trains, but even if the subways and trains aren’t faster; having a sign that counts down how long until the next train … that can help people a lot,” Rubinstein said.

Vaccinate PA has seen 140,000 unique users since it launched in January. Rubinstein said the site is operated by ten volunteers, but more than 100 volunteers make calls to check vaccine availability at local providers.

Vaccinate PA uses a weekly list of provider locations published by the state where vaccine is expected to be delivered. Volunteers call provider locations to confirm vaccine availability and update the website accordingly. Rubinstein said the vaccine availability data is updated several times per week.

The state’s map lists which providers are expected to receive vaccine, while Vaccinate PA does the work of determining if that vaccine is actually available for appointments, said Rubinstein.

Users can enter their zip code and search for available vaccine at local providers. The site also lists information about restrictions at certain providers; some may only be vaccinating patients over the age of 75 due to limited availability, for example.

Rubinstein welcomes the idea of a state-run registration system. “What people really want is just to be able to get the vaccine as quickly as possible and as easily as possible,” he said. “Assuming [a registration portal] works, I think it would be fantastic.”