Glitches, supply cuts, and grumbling over priorities dog Massachusetts vaccine rollout

State’s largest hospital system working to fix software problem

Mass General Brigham received its first shipment of Pfizer COVID-19 vaccine on Tuesday.Sarah Evans/Mass General Brigham

The state’s COVID-19 vaccination rollout is less than a week old. Yet it’s already facing computer glitches, supply cuts, and complaints about people cutting in the vaccine line.

Mass General Brigham is racing to fix faulty software that crashed its vaccine enrollment website, leaving thousands of frustrated employees unable to sign up. At Boston Medical Center, some staffers treating coronavirus patients complain they weren’t invited to get vaccines in the first batch at all.

And tensions are running high at Boston Children’s Hospital, where some employees are irked their president was near the front of the line for a shot.

Medical leaders attribute the rocky start to limited early supplies of the first vaccines authorized for emergency use combined with heavy demand for injections from staffers overwhelmed by a coronavirus surge.

“Our medical system is not used to scarcity on this scale, certainly not in this setting of strain and the emotional fatigue this workforce is facing,” said Dr. Paul Biddinger, medical director for emergency preparedness at Mass General Brigham, the state’s largest hospital system, where some employees have also complained about their place in line.

Hospital officials say an unexpected cutback in the shipment of Pfizer vaccines to Massachusetts exacerbated the shortages. But as vaccine supplies increase with the arrival of the new vaccine from Cambridge-based Moderna, they say they’re still on track to immunize front-line health workers and long-term care residents — those most at risk of the deadly virus — by the end of February.

“As of today, we have vaccinated more than 1,000 staff,” said a statement from Boston Medical Center. “With the new allotment of Moderna vaccine, we will be able to vaccinate the remaining COVID-patient-facing staff in the next two weeks.”

In recent days, leaders of Mass General Brigham have apologized to their 80,000 workers in employee forums and internal communications for the way they launched their vaccination program, including last week’s crash of an online system set up to schedule appointments.

Biddinger said Mass General Brigham is working to fix a software application that caused the website crash Wednesday night when a rush of employees seeking to schedule appointments overloaded the system.

Clamor for the vaccines from Moderna and drug giant Pfizer, which developed its vaccine with German partner BioNTech, is also causing stresses at other health care systems.

Some workers were upset that Children’s Hospital president, Dr. Kevin Churchwell, was the second person to be vaccinated when the shots rolled out last Wednesday.

“We were willing to put up with everything when there wasn’t a vaccine,” said one nurse who helps administer anesthetics, a procedure that often generates respiratory droplets that could be infectious. “But now that there is one and the president is second [to get a shot], it just seems like a slap in the face.”

Churchwell said that as an African-American leader in medicine, he felt it important to be publicly vaccinated to send a message beyond the hospital community that the vaccine is effective.

“As we know from research, less than half of Americans of color are planning on getting vaccinated for COVID,” he said in a statement. “My ability to be a visible example is important as both a physician and a Black man.”

At Boston Medical Center, some employees said administrators failed to prioritize staff facing the greatest risks of being infected — those who work with or near COVID-19 patients daily.

“I have been seeing administrative people who don’t go in and see COVID patients go in and get the vaccines before me,” said a physician at Boston Medical Center, who asked not to be identified for fear of professional repercussions. “It’s unfair because the people who are carrying the greatest burden are being pushed to the back of the line here.”

In its statement, Boston Medical Center said the number of vaccine doses it initially received is fewer than the number of health care workers who are its top priority. But the hospital said it expects to vaccinate others in the coming weeks.

Governor Charlie Baker said Monday that about 26,000 Massachusetts residents have received their first doses in the two-dose vaccine regimens. He said more than 100,000 Moderna doses will be arriving in the state in the next two days, with shipments going to about 240 hospitals and community health centers, expanding the network of facilities that are able to vaccinate workers on the front lines.

While the Pfizer vaccine requires ultra-cold storage capacity, the Moderna vaccine can be sent to a wider range of facilities, such as smaller rural hospitals or health centers in low-income neighborhoods, because it can be stored in standard refrigerators.

“We’d love to see everybody get it all at once,” Baker told reporters at a State House press briefing. “But ... it will take a little bit of a while to ramp up the distribution.”

Baker said the distribution was slowed by a reduction last week in the Pfizer vaccine allotments promised to the state by the Trump administration’s Operation Warp Speed. State health care sites will now be receiving 265,000 doses by year’s end, down from the 300,000 they had expected.

General Gustave Perna, the military leader of Operation Warp Speed, took responsibility Saturday for confusion over the allotments to Massachusetts and other states, saying he gave incorrect guidance because he didn’t have “a clear understanding” of the vaccine distribution process.

Baker, calling Perna “a very straight shooter,” said he accepted the explanation and was confident it won’t mean “a major change” in the shipments Massachusetts receives.

As complaints mount over priorities in the first phase of vaccinations, Baker said state officials and an advisory panel of outside medical experts and community leaders will study new guidance emerging from the Centers for Disease Control and Prevention over the weekend. That guidance, which puts residents 75 and older in front of some essential workers in the second vaccination phase, could set the stage for more resentment and jockeying over who gets inoculated.

Biddinger, who chairs the state advisory committee charged with setting vaccination priorities, said the initial problems won’t delay Mass General Brigham’s plans to vaccinate all its highest-priority workers by Jan. 8. Those include front-line health care and other support workers in emergency departments, intensive care units, urgent care, and respiratory illness centers at Massachusetts General Hospital, Brigham and Women’s Hospital, and 10 smaller community hospitals across the state.

Biddinger said Mass General Brigham received just under 9,000 doses of the Pfizer vaccine last week and expects to receive more than 30,000 doses of the vaccine from Moderna starting this week. Moderna’s vaccine was approved by the Food and Drug Administration for emergency use last Friday, a week after the FDA gave emergency use authorization to the Pfizer vaccine.

One positive note in the early rollout, Biddinger said, was that the Mass General Brigham medical staff has been able to squeeze six or seven doses out of five-dose vials that were purposefully overfilled by Pfizer. “That has given us a bonus of 20 percent vaccine supply,” he said, noting that using the extra doses was approved by the FDA.

Just as it has at Boston Children’s and Boston Medical Center, the vaccine rollout at Mass General Brigham has fueled complaints that workers who are not directly caring for, or exposed to, COVID-19 patients are cutting ahead of front-line workers to get the shot.

“We have identified a couple who I think legitimately misunderstood the guidance,” he said. ”We do not have evidence there were large numbers of people who misidentified themselves, but are trying to drill down on that data and will share what we find.”

Workers have also raised concerns about reports that some senior hospital executives received the shots last Wednesday. Biddinger said he has not found any evidence of that in the Mass General Brigham system.

“Our staff are concerned about the process and how it’s rolled out and that it may make staff feel they are competing against one another for shots,” he said.