Pre-Registration Would Enhance COVID Vaccine Rollout
Written by Catherine Bafaro, Dr. Kevin Vigilante, and Allison Kennedy
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Written by Catherine Bafaro, Dr. Kevin Vigilante, and Allison Kennedy
Abstract
While the Federal Government is committed to executing a comprehensive COVID-19 vaccination campaign, the distribution of vaccines falls individually on state and local government support. In our blog series on the vaccine rollout, Booz Allen’s Chief Medical Officer Kevin Vigilante and our health experts examine best practices and lessons learned from across the health landscape, including potential strategies and approaches that could help state and local governments improve vaccination rollouts.
Implementing a COVID-19 vaccine pre-registration process would help states and local health departments enhance their vaccine rollout efforts. While a few states have launched pre-registration sites, up to this point, it has been largely chaotic and frustrating to get a vaccination appointment for residents.
The limited number of available vaccination appointments listed online are quickly booked, leaving vaccine-seekers glued to their screens monitoring multiple websites and continually clicking the “refresh” button. Even after filling out identity, eligibility, and insurance information to book an appointment, registrants may then be informed the selected appointment is no longer available, and they’re back to square one.
It doesn’t have to be this way. Pre-registration of vaccination candidates would help streamline the process, minimize repetitive data entry, improve inventory management, and support clinic planning. Based on pre-registration data, states and locations could estimate demand and appropriately allocate resources, such as vaccination teams and number of doses within a defined geographic area. When “last minute” dose appointments become available, sites could rapidly notify “on-call” citizens, which in turn would significantly reduce waste of valuable vaccines.
Pre-registered candidates would be fairly ordered based on phase criteria or other prioritized vaccine rollout criteria such as age. Once all prioritized individuals are vaccinated, the pre-registration system would be a highly effective platform upon which to create an appointment lottery system. These efficiencies would improve the experience of those anxious to be vaccinated and have the potential to improve vaccine uptake. According to Dr. Kevin Volpe’s research, recently published in the Journal of the American Medical Association, “pre-commitments,” like pre-ordering a music album, highlight an item’s scarcity and increase the perception of its value.
Regardless of a state’s appointment scheduling system(s)—centralized versus decentralized—implementing a pre-registration process wouldn’t be difficult. Responses to a few quick questions and minimally sensitive information would be entered—such as name, general location, ability to travel within a designated radius, willingness to be on call, phone or email, and age. Providers could pre-register their patients who don’t or won’t go online. Pre-registration data could be loaded into scheduling systems to simplify appointment booking. As appointments become available, prioritized candidates would be notified to schedule their appointment or accept an on-call appointment the same day.
A pre-registration system could be developed in partnership with existing large-scale online supply chain and logistics platforms (e.g., Amazon, SeatGeek, Hotels.com) to leverage their existing systems and infrastructure. These commercial platforms have the infrastructure to support the volume of transactions and data as well as the technical expertise in house to quickly develop or adapt a solution to enable pre-registration. The pre-registration system could send a notification to the registrant directing them to the appointment scheduling site to schedule. This wouldn’t guarantee that the registrant would be able to schedule an appointment immediately (that would depend on the degree of integration with inventory management systems), but it would help direct the flow of inventory and control the flow of traffic to the scheduling systems.
Pre-registration simplifies the vaccination process and provides critical data to enhance equitable distribution. If effectively executed, it can reassure citizens the system is working and help to ensure that doses shipped are doses used. If pre-registration becomes a more common practice across the nation, more people would be able to take the initial step toward getting vaccinated.
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