Illustration of covid-19 vaccine
Credit: Photo illustration by Julia Terbrock

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Countless D.C. residents who tried to book an appointment for a COVID-19 vaccine this morning encountered any one of these messages if they called DC Health’s call center at (855) 363-0333 or visited Residents 65 and older, residents 18 and older with high-risk medical conditions, and specific frontline workers are eligible to book an appointment through DC Health. 160,000 residents have medical conditions that make them eligible for vaccination.

If they book through the government portal or website, the only verification they need to provide is self-attestation. The Office of the Chief Technology Officer told At-Large Councilmember Elissa Silverman 30,000 people tried to book an appointment online at 9 a.m., when DC Health released 4,350 slots for the portal and call center. “There is high demand and limited supply, and the same CAPTCHA and phone line problem that you have using Ticketmaster when you’re trying to get Lady Gaga tickets is basically the same thing here,” says Silverman. “This is why we need a pre registration system.” (D.C. does not expect to implement a new registration system until mid-March.) 

This is the second consecutive day residents and D.C. workers experienced problems using the government portal and call center. On Thursday, residents 18 and older with specific medical conditions became eligible but the portal did not recognize them. A “technical review failure” wasn’t responsible for today’s problems. Nevertheless, people experienced massive problems.  

Residents described having to fill out CAPTCHAs upward of 10 times before making it to the questionnaire. Then the website crashed for some. Some residents never made it to a call taker because the call would drop. (This reporter has an eligible condition and has been trying to navigate the process in earnest.) Some residents successfully reserved an appointment—one resident waited on hold for an hour to book an appointment by phone, another finally made it past the questionnaire on the website and strategically picked an appointment with a date farthest from today to find available slots. Residents have identified tricks to book an appointment—opening multiple browsers and using various devices. Despites massive problems with this morning’s rollout, residents booked the 4,350 appointments within the hour. “We experienced extremely high volume as demand for the vaccine remains high. DC needs more vaccine,” tweeted Mayor Muriel Bowser when she announced the appointments had been filled. 

This morning, at an unrelated oversight hearing, City Administrator Kevin Donahue said yesterday’s issue had to do with a coding error that should not have happened. Now, DC Health is releasing 3,500 appointments for residents 18 and older with specific medical conditions in priority zip codes on Saturday. This is the second time in two weeks that a D.C. agency experienced a technical issue that came at the cost of residents.

Local officials are very aware of the problem. The office of Ward 7 Councilmember Vince Gray, the health committee chairman, expects the vaccine rollout that’s been riddled with technical problems to be a major focus of a performance oversight hearing with the Deputy Mayor for Health and Human Services on Thursday, March 4. Gray intends to invite OCTO, who’s responsible for the technical glitches on the website, to the hearing. His office is also welcoming the public to testify about their experience. Seeing as OCTO does not expect to implement the new registration system until mid-March, for fear of rolling it out before it’s ready, councilmembers have voiced other tweaks to the system. “Expand age bands in smaller groups – 50-64 one week, 30-50 one week, 18-30 another week. Spread this out,” tweeted Ward 6 Councilmember Charles Allen. Silverman told DC Health in a Council call on Wednesday that she worried prioritization went out the door when the agency opened up eligibility to tens of thousands of people without any sort of verification this week. 

“We have to be strategic. We need to use these doses to help those who are most at risk of death, hospitalization, and severe consequences from catching the virus. And we have a big category of people,” says Silverman. “I do think … if not a round table, we need to set expectations for people. And I think we need to have a discussion about if we need to further refine the prioritization category.”

DC Health also directs a lot of doses if not a majority to hospitals and health centers that are vaccinators and reserve doses for their patient population. Gray’s office says next week, they will begin prioritizing the newly eligible group, focusing first on the most vulnerable patients. This week Howard University Hospital and United Medical Center, for example, are still focusing on vaccinating residents 65 and older.

“I believe the medical staff in the hospitals are best suited to prioritize medical conditions based on the likelihood that the condition could result in a severe reaction to COVID-19, which cannot be done through a web portal or self-attestation,” tweeted Gray.

In a statement to City Paper, a DC Health spokesperson said hospitals and health centers that are vaccinators “can vaccinate anyone who is eligible per District criteria. However, some may still try to prioritize their senior patient population.”

National Context: Most states have not opened up eligibility to people with high-risk medical conditions, according to the Kaiser Family Foundation. And there is wide variation on what medical conditions make someone eligible. In D.C., the health department included all conditions that put someone at increased risk of severe illness due to COVID-19, according to the Centers for Disease Control and Prevention, except smoking. And the health department included conditions that might put someone at increased risk, like asthma and hypertension or high blood pressure, but for which there are still limited data. (DC Health initially had people who smoke on the eligibility list, but changed course following public backlash.)  

States and municipalities are also taking different approaches to qualification and verification. According to the Washington Post, Colorado says people must have two or more of the high-risk medical conditions, while Louisiana says people with specific medical conditions have to be at least 55 years old. CDC clinician Sara Oliver says state and local officials are raising concerns about needing to verify a person’s medical history, as have a few D.C. councilmembers. A CDC panel is likely to advise officials that age-based eligibility can be a strategy if doses are scarce, two officials tell the Post. DC Health Director Dr. LaQuandra Nesbitt said at a recent press conference that her agency did not approach eligibility this way because some medical conditions shorten life expectancy.     

— Amanda Michelle Gomez (tips?

This post has been updated to include comment from DC Health.

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