SC paid $145K for COVID-19 vaccine scheduler after federal system became ‘a cuss word’
South Carolina health officials knew they had to act fast.
After residents 70 and older became eligible for COVID-19 vaccinations on Jan. 13, seniors around the state immediately began to blast the Vaccine Administration Management System, or VAMS.
The federal system, which was used for vaccine sign-ups, confused nurses and patients alike. It required an email address to access, making it virtually inoperable for some elderly residents.
Within two days of the state’s massive Phase 1a eligibility expansion, the S.C. Department of Health and Environmental Control, facing a wave of complaints, agreed to pay $145,000 to create its own vaccine scheduling portal, records show. At the time, DHEC said the new portal would be more user friendly.
Yet over two months later, it’s still unclear whether a large number of S.C. vaccine providers will ever use DHEC’s scheduler, which is called the COVID-19 Vaccine Appointment System, or CVAS.
Some of the Palmetto State’s biggest vaccinators are sticking with their own sign-up systems. And a few of the smaller vaccine hubs recently expressed no interest in CVAS — or didn’t know what it was.
CVAS has come to represent the challenges faced by the state health agency as it scrambled to address the federal government’s unwieldy, bureaucratic vaccine system.
Nick Davidson, DHEC’s senior deputy for public health, said in mid-March that CVAS would meet the needs of most providers who wanted a better scheduling option.
“It does seem like that’s gonna be the best system to offer,” he said.
‘Too confusing’
DHEC began to pilot CVAS at its mobile clinics and county health departments in early February, booking just over 70,000 appointments through Tuesday morning. McLeod Health also tested the system recently, including at two mass vaccination events in the Pee Dee region.
This past week, DHEC started to make CVAS available to other providers, Davidson said.
But it’s been months since DHEC first detailed its plans to launch the new system.
Dr. Brannon Traxler, DHEC’s interim director of public health, on Jan. 15 told reporters that the agency was developing a statewide appointment portal.
That was the same day DHEC agreed to pay $145,000 to use vaccine scheduling software developed by the University of Mississippi Medical Center. And it was two days after a wave of people 70 or older began to register for inoculations and eviscerate VAMS’ design.
Marshall Taylor, then-acting director of DHEC, while sharply criticizing VAMS during testimony before state lawmakers, said Jan. 21 that the agency’s new appointment system was “days and weeks” away from being launched.
“VAMS has become a cuss word at DHEC,” he said. “It is a clunky system. Nobody likes it. The hospitals don’t like it, the providers don’t like it, the users don’t like it, DHEC doesn’t like it.”
A day later, Traxler said the state portal was expected to go live the following week.
“It’s being finalized with our IT experts,” she told reporters.
But during a Feb. 3 briefing, Davidson said DHEC was piloting CVAS only “on a very small scale” at a few of its health departments.
“We want to make sure that anything we do, we do it well,” Davidson said, “particularly given the number of people who this could impact.”
The CVAS rollout grew more confusing on Feb. 8 when Stephen White, the state’s director of immunizations, said the system experienced “a few issues” over the past weekend. He added that the Centers for Disease Control and Prevention was working to improve VAMS, which it had developed.
White also stressed that CVAS was only a scheduler. It could never replace VAMS entirely. The federal system is used for vaccine ordering, too.
“We’re looking at both of these systems, our own system, and we’re looking at the VAMS upgrades,” White said. “We’re going to continue to assess both of those systems to figure out which one we will be continuing to move forward with as we go along.”
To search for appointments via VAMS, residents initially needed a working email address to create a system account (the CDC on Saturday updated VAMS to allow people to also register using a cellphone number, DHEC confirmed).
The email requirement was a major challenge during Phase 1a. Medical centers asked eligible residents to provide their emails, before then uploading those into the system. After that, the CDC sent people links to create VAMS accounts.
The system was widely panned as being inaccessible and needlessly complicated.
S.C. seniors were discouraged when trying to navigate it, said Ponchitta Young, assistant director at Agape Family Life Center, a nonprofit in rural Jasper County.
“So many just really got aggravated and frustrated, and decided not to go through the process,” Young said. “You had to have an email address, you had to wait 24 hours. ... It was just too much to keep up with. They thought it was too confusing.”
After White’s February remarks, the next major CVAS update came on March 17. Davidson told reporters the agency would make the system available to other providers beginning this past week.
“CVAS does seem to meet most of the needs that most providers have — those that don’t have their own system or desire a better system,” Davidson said.
‘We’re not interested’
But how many S.C. providers will actually use CVAS remains up in the air.
To better gauge facilities’ interest in the new system, The Island Packet and Beaufort Gazette recently asked five of the state’s largest Pfizer-BioNTech providers — and five of the biggest Johnson & Johnson providers — whether they’ll use CVAS.
The newspapers also asked CVS, Walgreens and Walmart.
Most of the providers said no, didn’t provide a clear answer or said they didn’t know much about the system. (DHEC as of early Tuesday said agreements weren’t in place yet to allow additional providers into CVAS.)
Prisma Health is using its own medical records system to schedule appointments and doesn’t plan to use CVAS, a spokeswoman confirmed. The same goes for the Medical University of South Carolina.
Roper St. Francis Healthcare isn’t using CVAS, a spokesman added. The Spartanburg Regional Healthcare System in a statement wrote that it uses its website and VAMS to book shots.
Walmart has no plans to use the DHEC system, a spokeswoman said. And CVS isn’t “in talks” with South Carolina to integrate the pharmacy chain’s scheduler with the new state-run system, the company confirmed.
Walgreens in a statement didn’t specifically answer whether it plans to use CVAS.
McLeod Health, though, on Monday said that it’s already using CVAS at four vaccine clinics and plans to use it at two more clinics in Clarendon and Florence counties. The health care system, which has administered more than 42,000 first Pfizer doses, also used CVAS during mass vaccinations events at the Darlington Raceway and Myrtle Beach Convention Center.
Michelle Dore, the vaccine co-coordinator at McLeod Health, in a statement wrote that the health care system has been piloting CVAS since March 8.
“It has performed well,” she wrote.
Some J&J providers, meanwhile, expressed confusion when recently asked about CVAS.
Thomas Beam, pharmacist at the Medicine Mart of Gaffney, said he hadn’t heard of CVAS before a reporter told him about it Monday. But, Beam added, he would probably be interested in using it.
The independent pharmacy originally used VAMS for its vaccine scheduling, he said, but later switched to hard copy forms. Seniors had trouble with the federal system, he said.
Daniels’ Pharmacy & Medical Equipment of Barnwell, which has administered over 670 J&J doses, though, will stick with its own web scheduler, a representative said.
Courtney Polin, a pharmacy technician at Grove Park Pharmacy in Orangeburg, said her pharmacy has a website for sign-ups and also allows residents to book appointments over the phone.
“Right now, we’re not interested in using any of their scheduling,” Polin said of DHEC. “We never even started with the VAMS system, cause we heard a lot of negative things.”
DHEC still expects other vaccine providers to be interested in CVAS, though, including smaller facilities that had a difficult time using VAMS, spokeswoman Laura Renwick wrote in a statement.
Consider, as an example, Sweetgrass Pharmacy & Compounding in Mount Pleasant.
Kathy Atkins, community liaison for the independent pharmacy, hadn’t heard of CVAS before the newspapers contacted her about it.
But, after looking at the portal, CVAS immediately seemed better than VAMS, she wrote in a Monday statement.
“That said, we have never been told by DHEC that we are gaining access to this system,” Atkins wrote.
This story was originally published March 28, 2021 at 6:00 AM.
