A user experience diagnosis of the COVID-19 vaccine rollout

The U.S. is leading the world in COVID-19 vaccines administered — as of Tuesday, we were leading China by over 47% (14.7M vs 10M). So why has the vaccine rollout fallen short? We’ve given fewer than 50% of available doses. The feds are also no longer holding doses in reserve. So the issue is not really supply.

A key issue is vaccine appointment capacity. This means more sites and more staff. Once we are able to get a handle on that, the next most important issue is getting appointments — especially for our most vulnerable. These include seniors, as well as other high-risk populations who don’t have reliable access to the internet or the skills necessary to sort through the excess of poorly curated information.

I’m based in Maryland. Now that we’re in phase “1B,” opening vaccination to all people over 75, I’m motivated to get my grandmother her vaccine. She’s 81 and lives alone. She’s been isolated since March, but luckily she lives in downtown Baltimore so she has a bit of a support network in her neighbors. How can I help get my grandmother a vaccine?

Operation: Get grandma a vaccine

After three days of sifting through state and county-run websites, it appears the best route is to go through your county’s COVID vaccine website. After finding Baltimore City’s “Registration Links,” which are buried at the bottom of an already buried page, you are taken to “PrepMod” which appears to be the state’s vaccination registration page.

Maryland’s vaccine signups start here. (Screenshot via State of Maryland)

By clicking “search” and not entering any criteria, you are given the full list of available clinics. How would I know what a “TIKE” clinic is? It sounds like it’s for tikes or children, but it also serves all ages.

Select from a list of returned locations to sign up for a vaccine at the specific site. (Screenshot via State of Maryland)

I get that you might want to get vaccinated closest to your home — but since there are no appointments available at this location, I need to page through four pages of results to see what appointments are available. There do happen to be vaccines available in Kent County and Caroline County. These are within driving distance for grandma, but you must be a resident of that county to get a vaccine (However, you can still register).

Vaccine info for Caroline County (Screenshot via State of Maryland)

I decided I’d still try to register Grandma at the Baltimore City Health Department’s (BCHD) TIKE clinic. Once you click “Sign Up for a COVID-19 Vaccination,” you are taken through a pretty straightforward enrollment process, adding basic demographic and comorbidity information. At the end, you are given the available appointment times, or “Add to waiting list.” This radio button was not a very clear option, and since there were no appointments available, I thought it should be the only option. The appointment selection buttons are still visible, but are not selectable. The existence of the “Find Another Location” button implies that you are only adding to the waitlist of this location. I added grandma to the waiting list and got a confirmation email. Good, at least now I hope that I’ll get notified once appointments become available.

On the waiting list. (Screenshot via State of Maryland)

Recommendations to health departments:

1. Make the “PrepMod” vaccine registration page more prominent. Why is it so difficult to find?
2. Leverage waiting list. If there are no vaccine appointments available, make this the call to action.
3. Add a waiting list by county. If I add to the waiting list at one site, will I be alerted to vaccine availability just a few miles across town? This vaccine is in high demand. People will travel for it.
4. Require search parameters by county. If you can’t get a vaccination across county lines, don’t permit search on other counties.
5. Think of vaccine registration as a funnel. Get the right kind of traffic to PrepMod, and convert users to waiting lists. Then, sort through leads when capacity becomes available.
6. Use Twilio to do auto-calls for registration. Many seniors do not have the same internet sleuthing capabilities of the younger generation. Alternative registration forms must be considered.
7. What else? What are you seeing? What is working?

Thanks, and let me know how you’re planning to get grandma a COVID vaccine!