Slow Vaccine Documentation Impeding Access, House Members Told


WASHINGTON — The federal government needs to make it easier for community health centers and other vaccine distribution locations to report on how many vaccines they have distributed, Lathran Woodard told the House Committee on Oversight and Reform on the coronavirus crisis.

“We’re having provider burnout because of the hassle of having to individually enter each vaccine,” Woodard, who is board chairman of the National Association of Community Health Centers, said at a briefing Friday on ensuring equity in coronavirus vaccinations. “The flip side is we’re getting less vaccine supplies” because vaccine suppliers base their next shipment on how many vaccines a particular facility has already distributed, and the slow manual entry process means that facilities are appearing to distribute far fewer vaccines than they actually have administered.


The cumbersome system for documenting vaccine administration has caused problems in underserved communities, said Lathran Woodard of the National Association of Community Health Centers. (Photo courtesy House Oversight and Reform Committee livestream)

“One center I looked at had 2,200 doses, but VAMS [the Vaccine Administration Management System computer program] said they only gave 455 vaccinations, so they didn’t get the next amount of vaccinations they need” because they had fallen behind in entering vaccinations into the system, she said. “Our state wanted to use another system and CDC said, ‘no, we use this for flu.’ All we know is that it is overloaded and everyone recognizes you have to change something, but change is not going to happen immediately.”

Vaccine Hesitancy a Big Issue

The VAMS was only one of several problems Woodard said the clinics were having in trying to ensure equitable treatment in vaccine distribution; another issue is a shortage of vaccines and supplies. “When I see a rural health clinic who had 400 appointments in the category of 1A, but received no vaccine due to lack of timely delivery and also a limited supply of vaccine; that was 400 people we had to cancel appointments for,” she said.

Vaccine hesitancy is another problem, according to Helen Gayle, MD, MPH, president and CEO of the Chicago Community Trust. “We know there remains hesitancy on the part of many to take this vaccine,” she said. “In communities of color, especially Black communities, we justify that we see hesitancy about taking the vaccine due to generations of discriminatory medical practices that have caused harm and distrust.”

To combat this hesitancy, “we need more than brochures, flyers, and public service announcements; we need trusted local messages to mitigate, educate, and empower hard-to-reach and skeptical populations,” she said. “We also need to assure that real-life issues like child care and paid sick leave are addressed so people have the ability to take the necessary time to get the vaccine … and not have to make tradeoffs between getting the vaccine and keeping their jobs.”

Misinformation Not Always Addressed

Rep. Jamie Raskin (D-Md.) said he was “concerned that some people are choosing not to get vaccinated because of dangerous misinformation and propaganda about the coronavirus vaccine,” adding that among immigrant communities, a lot of misinformation is spread via social media platforms such as Facebook. “According to the Washington Post, an analysis found that … 20% of dubious Spanish-language posts get warnings, compared to 70% of dubious English-language posts.”

Frankie Miranda, president and CEO of the Hispanic Federation, agreed. “I will go even farther,” he said. “There are now fraudulent targets on our community — especially the Spanish-language senior population has been targeted trying to get their information, and also money, in order to get the chance to get a vaccine. Our solution to all of this is to continue investing in nonprofit organizations that work in the community and that have the bilingual, bicultural experience … that employ people from the community” to help get the vaccine messaging out. “They just need better resources to do micro and macro campaigns in our communities.”

Lack of Data Impeding Access

Lack of data on which ethnic groups are being vaccinated is also a problem, Rep. Bill Foster (D-Ill.) said at the briefing, at which no Republicans appeared. “There is an old saying in engineering that you cannot fix what you cannot measure,” he said. “If we’re serious about ensuring equitable access to coronavirus vaccines for all Americans, we need to have a clear picture of who has received the vaccines. Unfortunately, the data is woefully incomplete. According to a recent CDC report, the federal government has gathered race and ethnicity data for just 52% of all vaccine recipients.”

Only 34 states are currently reporting this type of data, “and among those that do, the early results are alarming,” Foster continued. “Data indicate that individuals from wealthy white communities are often being vaccinated at significantly higher rates than people of color.”

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Having a unique patient identifier would allow for easier collection of race and ethnicity data, said Rep. Bill Foster (D-Ill.). (Photo courtesy House Oversight and Reform Committee livestream)

One thing impeding access to this data “is the longstanding federal ban on an interoperable unique patient identifier, which would allow every vaccination, COVID test, and COVID-associated illness or death to be associated with a patient’s unique electronic health record,” he said, and would also enable collection of race and ethnicity data for patients who opt in. In addition, an identifier would “help prevent jumping the line by patients who do not qualify, and would be of the greatest benefit to populations who have traditionally been underserved by healthcare.” The House voted last year to overturn the ban on such an identifier, “and I’m hopeful the Senate will soon get this across the finish line,” Foster said.

Abigail Echo-Hawk, director of the Urban Indian Health Institute, agreed. “Right now we’re not even being reported in the data,” said Echo-Hawk, an enrolled citizen of the Pawnee Nation of Oklahoma, whose organization released a report on COVID-19 data collection for American Indian and Alaska Native populations; the report found more than half the states deserved a grade of C or lower on reporting race and ethnicity data. “We know that our folks are getting vaccinated at high rates at Indian Health Service facilities, but they’re not getting that same care at outside facilities. In fact, one of our programs in Great Falls, Montana, was telling us that people were being turned away and told to go to the Indian Center, which receives very limited vaccines.”

Gayle noted that “part of people being willing to give their data is also part of this issue of trust; people will not trust and give their data if they don’t feel like they get something in return … Part of this is predicated on us having systems in place and services in place so people feel they’re well served when they give their data as part of the interaction.”

Last Updated February 22, 2021

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow





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