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Mass. will offer more help for people struggling to get vaccination appointments

Lawmakers urge Baker to scrap the dispersed system of finding vaccinations for a centralized registration site

With demand for the shots running high, a doctor was kept busy at a one-day vaccination clinic in Seattle this week.
With demand for the shots running high, a doctor was kept busy at a one-day vaccination clinic in Seattle this week.Ted S. Warren/Associated Press

Governor Charlie Baker said Thursday that Massachusetts will soon unveil a telephone hot line to help people struggling to book COVID-19 vaccination appointments, responding to widespread complaints that the online system has proved maddening for eligible residents, seniors especially.

The move is a tacit acknowledgement that the current patchwork system made it difficult for many to even find available slots, forcing them to navigate a constellation of online registration systems run by individual vaccine providers.

The call center should come on line next week, and Baker said the state will be adding available slots. He also acknowledged the frustration of many seniors and their family members who couldn’t book appointments Wednesday, the first day that people over 75 could register for a vaccination.

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“It was a very frustrating day, we know that, for everybody, especially for those who were looking for an appointment and couldn’t find one,” the governor said.

Under the current Web-based system in Massachusetts, there is no centralized spot for booking appointments, no way to sign up for a waiting list, and no readily available phone number to call for help. Instead, a state site directs people to vaccine providers displayed on a map. That approach puts the onus on residents to scour multiple reservation systems ― pharmacies, health providers, and other partners, each with their own signup protocols.

It requires patience, technical savvy, and a little bit of luck, akin to scoring tickets to a sellout show on the morning they are released.

“I don’t understand how we weren’t ready for this, given the time they had,” said Elizabeth McKinstry, a librarian in Springfield who spent Wednesday trying to get an appointment for her 76-year-old stepmother in Dedham. She eventually found one for next month at a church — across the state in North Adams.

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Baker suggested that the logjam is, in part, a result of a shortage of the vaccine itself.

“We knew from the start of this, and we said this, that the first few days would be difficult because there are far more people who want to get a vaccine than there are vaccines available,” Baker said.

However, the problem doesn’t appear to be solely about supply; federal data shows that Massachusetts is far from administering the number of vaccine doses it does have on hand. Just 48 percent of the 1.02 million doses delivered to the state have been administered, according to data posted Thursday by the Centers for Disease Control and Prevention.

And some public health specialists and state legislators say the problems go beyond the underlying supply and distribution issues, and say the state’s basic technology setup for finding appointments is unnecessarily aggravating.

Senator Eric Lesser, a Democrat from Longmeadow, has cosponsored legislation requiring Massachusetts to set up a centralized booking system, as other states have, along with a 24-hour help line for people seeking doses.

“I think the Baker administration is taking this approach of bringing people to the vaccine, when really the mindset needs to be bringing the vaccine to the people,” said Lesser, who called the registration rollout “an objective and unambiguous failure.”

Rebekka Lee, a research scientist at the Harvard T.H. Chan School of Public Health, said the reliance on Web-based signups could exacerbate inequities, as non-native English speakers, people with limited access to the Internet, or those who have trouble navigating technology struggle to get appointments. For example, she pointed out that important parts of the state’s main portal are not built to readily translate into other languages.

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“We don’t want this registration infrastructure . . . to widen inequalities in access, and as we go through each phase, the number of people who are eligible is going to grow and grow and grow,” Lee said.

At the core of the existing system is an interactive map displaying locations where vaccinations may be available, each of which links to an outside site run by one of the organizations providing the actual shots. Sometimes, users must fill out forms on the individual websites in order to even see whether there are any appointments available, a time-consuming task.

In response to questions about the administration’s approach, Baker’s COVID-19 Response Command Center said that its goal was to consolidate information from multiple providers in one place to help residents find sites near them, and that the state intends to add new tools to improve user experience.

Jurisdictions around the country have taken a variety of approaches to the design of COVID-19 vaccination sites, and many continue to adjust on the fly weeks into the campaign. None, so far, have found a bulletproof system to support what will be one of the most complicated logistical efforts in modern history.

“The website is just one little part of a very large system, and all the things technical and not, that feed into it,” said Dana Chisnell, who teaches about design in government at the Harvard Kennedy School. Choices including who is eligible, which organizations are in charge of distribution, and federal decisions about the vaccine supply also play a major role in what users experience.

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“It is very common for a website and a service like this to improve over time,” said Chisnell, also a senior fellow at the National Conference on Citizenship in Washington. “I think all the states are struggling, and this is not exclusive to vaccination websites. It’s a big challenge to reach people this fast.”

But while centralized systems may be easier to navigate, they have their drawbacks: they are more difficult to build, according to some experts, because they must connect and communicate with numerous other systems operated by third-party organizations providing vaccinations.

A decentralized system that sends users out to individual providers can have advantages, too: those providers have already built the software for registration, and users have more control on where they want to be vaccinated.

Regardless of approach, some experts said a state such as Massachusetts, with its vast technology industry, should do much better. The state has had other computer system issues — most notably the unemployment benefits portal that seized up for many applicants at the beginning of the pandemic.

Jascha Franklin-Hodge, the former chief information officer for the City of Boston who now runs a technology foundation advising governments on mobility issues, noted the state successfully rolled out a computer system for the new Paid Family and Medical Leave program.

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“But it’s clear from the state’s vaccine scheduling rollout and its many confusing legacy systems that much more investment is needed,” Franklin-Hodge said. “More and more, residents rely on the Internet for all types of government services, and that means great digital experiences are table stakes for good government, not something that’s just ‘nice to have.’ ”

Meanwhile, the new phone hot line planned by Baker may have more of an effect on getting people vaccination slots, particularly seniors, than any design changes to the state’s Internet system.

Dr. Valerie Press, a University of Chicago professor who studies patients’ use of technology in health care, said person-to-person assistance will be perhaps the most important factor in how smoothly the rollout goes.

“Whether there’s one option or 27, leaving people on their own to get that actual appointment is very stressful,” Press said.

Steve Annear and Travis Andersen of the Globe staff contributed to this story.






Andy Rosen can be reached at andrew.rosen@globe.com. Follow him on Twitter @andyrosen. Hiawatha Bray can be reached at hiawatha.bray@globe.com. Follow him on Twitter @GlobeTechLab.