The Lack of Centralization of NJ COVID-19 Vaccine Administration and its Harms

by Adwik Rahematpura

After the FDA approved emergency use authorization for the Moderna and Pfizer COVID-19 vaccines in December of 2020, a portion of the focus on the pandemic shifted to vaccination efforts. With 50%-80% of the population needing to be vaccinated to achieve herd immunity, many states have gone to great lengths to get as many people vaccinated as fast as possible. As of January 30, 2021, 27 million doses of the vaccine have been given in the United States, with approximately 6.9% of the population of the US having at least one dose. Considering it has been barely one month since both vaccines’ initial approval, it is an impressive feat on the surface. However, discrepancies have emerged between the number of doses distributed and administered by various states, which raises the question of where there is room for improvement. With each state managing vaccination its vaccine distribution separately, one interesting case study is New Jersey. While there are various systems and steps in place to provide vaccines within New Jersey, these competing systems make it more challenging to schedule appointments and delay the process unnecessarily.

Ranked 23rd in terms of doses used as of January 30, it is clear there are points for the state to improve on. On the website created by the State of New Jersey Department of Health, four main avenues are listed for obtaining the vaccine. These avenues are: using the state vaccine scheduling system, making an appointment, either with a vaccine location directly, through one's place of work, or making an appointment through the VA if one is a veteran. On paper, these seem like very effective ideas, but in reality this system has issues.

The state system is well-built and places people in phases based on a series of questions. When an individual’s phase is called, they receive a scheduling link. Once again, on paper this seems highly effective. However, this clashes with the second option for scheduling a vaccine appointment. Many of the locations which are in the state system are also available via direct appointments, made outside the state system . Because of this, the two methods essentially impede on another. There is no way to centrally track the dosage and there is a high likelihood that there may not be enough doses for the intended recipients. It also makes it more challenging for individuals to get appointments on particular days,as each system is only half as effective due to their coexistence. While this is not the case for every location, it is twice as hard for a person to get an appointment in the locations in which this problem exists. Additionally, the direct method is particularly challenging as many locations require calling to schedule, and with just one phone line at many of these locations, the chances of getting an appointment decrease even more. These separate methods have also led to many instances of double booking, which has meant that one dose has been allotted for two recipients.

As with many states, the root issue is not enough doses. However with one singular centralized system, the state would be able to monitor and only provide appointments for when a set number of doses are available. It would reduce strain on the system and make it easier for individuals to get vaccinated.

Currently, there are 4 million people in New Jersey eligible for the vaccine, but there is simply no centralized method for people to sign up for them. The state recently set up a phone line to schedule an appointment, which ended up receiving 58,000 calls before noon of its initial day. By adding more and more methods, the state is actually doing the opposite of what it intended. It is flooding the system with too many requests for appointments, with not enough doses to meet them. Recently, two of the six megasites in the state had to close their doors when their number of scheduled appointments vastly outstripped their supply of vaccines. People had to be turned away and were forced to re-register.

With the task of scheduling second doses, the system is put under even more strain. With people going through multiple methods to get an appointment, getting a second exacerbates the problem. Many are reporting that the state system is not allowing for second dose scheduling, and those who scheduled it directly with the site are not receiving information about their appointments.

It is important to address that these issues are to be expected with a very new system. However, it is possible these issues could have been avoided through simply using one centralized system from the outset. With one singular tracking and monitoring for doses and availability, there would not be the current uncertainty. Now, by trying to rectify the situation by adding more means to schedule the second dose, there is an even higher likelihood of double booking, higher strain on the system, longer wait times for vaccinations.