Covid-19 vaccines: Dr B’s website will match you with remaining doses

In a rush to mark an elusive vaccine rendezvous, the remaining dose has become the stuff of pandemic lore.

Additional injections – which should be used within hours of leaving the cold store – have been distributed to drugstore customers who buy midnight snacks, to people who are friends with nurses, and to those who come to the hospital. closing time in some grocery stores and pharmacies. In some large vaccination sites, the rush to use each dose triggers a wave of end-of-day phone calls.

In any case, if the remaining dose does not find an available arm, it should go in the trash.

Now a New York-based startup is aiming to add some order to the rush for remaining doses. Dr. B, as the company is known, matches vaccine suppliers who end up with additional vaccines to people who are ready to get one at any time.

Since the service began last month, more than 500,000 people have submitted a wealth of personal information to sign up for the service, which is free and is also free for providers. Two vaccination sites have started testing the program and the company said about 200 other providers have applied to participate.

Dr B is just an attempt to coordinate the chaotic patchwork of public and private websites that allow eligible people to find vaccine appointments. Critics have said the current system is confusing, unreliable, and often requires internet access, as well as time to prowl websites for the rare date. In many places, it also largely ignores people who are not yet eligible for a shot, wasting the opportunity to put them on an official waiting list.

While Dr B won’t solve all of these larger issues, if he scales up the way some hope he will, he could serve as a role model for a better, more equitable way of planning vaccinations.

“I think that’s a great idea,” said Sharon Whisenand, administrator of the Randolph County Department of Health in rural Missouri.

Ms Whisenand said 60 to 80 people did not show up for the county’s first mass vaccination in late January, prompting her staff to make dozens of calls at the end of the day to people on a list of ‘waiting. “We looked a bit like a call center for a while,” she said. Workers eventually found enough takers to administer most of the extra doses, but a few shots were thrown.

Dr B is a for-profit company, created as a public utility company that includes efficient and equitable distribution of vaccines in its mission. But its founder, Cyrus Massoumi, a tech entrepreneur, has yet to describe Dr B’s business model. He said he was funding the project out of his own pocket and had no plans to collect income. The company is named after his grandfather, nicknamed Dr Bubba and became a doctor during the 1918 influenza pandemic.

Mr. Massoumi is the founder and former CEO of ZocDoc, which helps patients find available doctor’s appointments, and the founder of Shadow, a company that reunites lost animals with their owners using the technology and local volunteers. Like these two efforts, Dr. B seeks to make connections between groups who need something from each other.

“Ultimately, patients need this vaccine, and there are providers who need help getting it to priority people,” Massoumi said in an interview. “This is my motivation.”

After getting Dr B’s idea in January, Mr Massoumi recruited several engineers from Haven, a now-defunct healthcare collaboration between Amazon, Berkshire Hathaway and JP Morgan, to build his website and database. underlying data. Amazon also donated web services, Massoumi said.

The half a million people who signed up for the service entered basic biographical information, such as their date of birth, address, underlying health conditions and the type of work they do. If vaccine suppliers near them have additional doses, they will be notified by text message and have 15 minutes to respond. Then they should be ready to get to the vaccination site quickly.

The company’s database sorts people according to local rules about vaccine priority, giving providers a better chance of getting their leftover vaccines to those who need them most.

For many vendors, this orderly process would be a welcome change from the randomized systems they currently use. In some pharmacies and supermarket chains, workers have resorted to combing store aisles to find people willing to get their last-minute vaccinations. In other places, vaccine candidates wait in line at the end of each shift, which could pose a risk of infection, especially for the most vulnerable.

Despite some grumbling about younger, healthier people skipping the line by taking the remaining doses, public health experts and many ethicists say the most important thing is that vaccines don’t go to waste. Earlier in the vaccine rollout, some politicians, like New York’s Governor Andrew M. Cuomo, threatened claimants with sanctions for failing to follow priority rules precisely, and a Texas doctor lost his job after he given expired doses to people with medical conditions. , including his wife.

For those offered a last-minute vaccine, “that person shouldn’t say no because they want someone else to do it,” said Dr Shikha Jain, assistant professor of medicine at the University of Illinois at Chicago, and -Founder of IMPACT, a group that works to improve equitable distribution of vaccines. However, “it’s really important to be intentional and fair,” she said.

Mr Massoumi said he has taken several steps to ensure the service will be fair. This has involved denying early media inquiries to mainstream publications and promoting Dr. B’s calls on Zoom with representatives from groups like black churches and Native American community groups, given that the pandemic has disproportionately affected them. non-white groups.

“It was really important for him to let these communities potentially have a place on the front lines, or to get the information early,” said Brooke Williams, who is black and a member of the Resistance Revival Chorus in New York City. She joined one of the first Zoom calls and started spreading the word.

“Hearing about the shots being launched was just heartbreaking and infuriating,” she said.

The service suffers, however, from some of the same hurdles that have plagued immunization efforts so far. Although registration is straightforward, it requires an internet connection as well as immediate access to a cell phone. Due to the last-minute nature of the remaining doses, participants should have flexible hours and have access to transportation.

“He’s still heavily reliant on the Internet, so it will depend on who hears about it,” said Arthur Caplan, a medical ethicist at the Grossman School of Medicine at New York University. “It seems like he’s trying to solve a problem and do good, but I’m sad that governments – counties, cities, national organizations – haven’t prepared for this and haven’t reacted faster to give back. advice and guidance. ”

Mr. Massoumi noted that the site allows people such as community volunteers to register on behalf of others. The site is also available in Spanish.

He noted that the program’s setup, which allows people to sign up and then wait for a notification based on priority, is better than other sites that require hours of website refreshes in the odds that ‘they are lucky in a rare opening.

Some local health authorities, including Washington, DC and West Virginia, are moving to a similar pre-registration system, which may help level the playing field.

“There’s that feeling that you don’t know where you are at, and the only way to secure your place is to refresh a browser,” said John Brownstein, a Boston Children’s Hospital researcher who runs VaccineFinder.org, a online portal that helps people make appointments for vaccines.

For Brittany Marsh, who owns a pharmacy in Little Rock, Ark., Figuring out what to do with the remaining doses was a daily headache.

She said the number of no-shows increased as vaccines became more available and others had to cancel at the last minute because they had developed Covid-19 or had been exposed to someone who had done it. Although sometimes people call, she says, “most of the time we just have a no-show.”

Ms Marsh tested Dr B’s service for a few weeks and said it saved her from having to call a waitlist of other clients to quickly fill open slots. Along with Dr B, she said, “I know they call at least what we think is the right group of people to come in for the vaccine, so that we never have to waste it.

Dr B has revealed few details of the providers who have expressed interest in using his platform except to say that the providers are based in 30 states and include doctors’ offices, pharmacies, and medical departments. large academic institutions.

The company collects sensitive personal information that it is committed to protecting closely, even though, because the company is not a healthcare provider itself, the data is not protected under federal privacy law. of health care privacy known as HIPAA.

Asked about his long-term plans for the company, Massoumi objected, noting that the vaccination race was not going to end anytime soon.

“Right now we just want the vaccines to be allocated in the best possible way,” he said. “I can’t think of a better use of the money to help solve the pandemic, so we’re just head down, focused on this.”