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While Most States Avoiding VAMS For COVID Appointments, N.H. Trying To Make Flawed System Work

photo of VAMS homepage

Inefficient. Frustrating. Disheartening.

Those are some of the more polite words residents have used in recent days to describe the experience of registering for their second doses of COVID-19 vaccinations in New Hampshire.

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Much of the anger is directed at VAMS, the free online platform rolled out by the CDC that promised state and local public health officials a streamlined system for scheduling vaccine appointments and monitoring vaccine supplies.

But while 40 or so other states ultimately opted not to use VAMS and instead built or contracted out their own systems for scheduling appointments, New Hampshire opted in and has stuck with VAMS, despite the system’s apparent flaws. 

The state declined to respond to a list of specific questions about why it chose to use VAMS. But recent statements by a top public health official signal New Hampshire may not have had any other options because of a unique gap in the state’s existing public health system: New Hampshire remains the only state in the country without a fully functioning vaccine registry. 

“In order to do this scheduling in the absence of having a fully stood-up immunization registry, we have been using CDC’s VAMS system,” Dr. Beth Daly, Chief of the Bureau of Infectious Disease Control for DHHS, told lawmakers last week. 

Vaccine registries allow states to better track immunizations, according to public health officials, which can lead to higher vaccination rates. In 2014, New Hampshirespent $1.3 million to create a vaccine registry, only to see the project fizzle in its late stages over software concerns.

In December 2019, the same month a novel coronavirus was first detected in Wuhan, China, New Hampshire’s Executive Council approved a $1.5 million grant to again build a statewide vaccine registry. However, the system still isn’t fully functional, making New Hampshire the lone state without a vaccine registry in place. 

“We are working on standing that up now,” Daly told members of the N.H. House Health and Human Services Committee on Friday.

In 2020, facing down the largest mass vaccination effort in recent history, the CDC rushed to build a nationwide system for scheduling and tracking COVID-19 vaccinations. The federal government awarded consulting firm Deloitte a $44 million no-bid contract to design and launch the program. 

But early reviews of VAMS appeared negative enough to convince most states to select different systems to roll out vaccine scheduling. That includes in Maine, where Dr. Nirav Shah of the state’s public health office told WMTW that VAMS “didn't meet anyone’s expectations.” Instead, Maine is opting to build its own platform.

In South Carolina, “VAMS has become a cuss word,” according to Marshall Taylor, who leads that state’s health department, citing a range of frustrations with its roll out.

The CDC says in total just ten “jurisdictions” and a single hospital system are currently using VAMS. 

One of those jurisdictions is New Hampshire, where residents currently eligible for vaccinations interact with VAMS after first pre-registering through a state-run website. (Residents can also call the state’s 2-1-1 hotline to schedule appointments.)

Following that step, residents receive an email from VAMS inviting them to make an appointment. However, some residents complained they never received the invitation email from VAMS, or were confused by language on the website after creating an account. 

There have also been complaints about its user-friendliness for people connecting through smartphones and tablets, and that VAMS doesn’t work if using Internet Explorer as a web browser.

In recent days, the anger toward VAMS has only escalated after a botched rollout of new second dose appointments for residents who currently face long wait times between first and second vaccination rounds. 

On Tuesday, New Hampshire officials blamed VAMS for the problem, apologized for the confusion, and vowed to get new appointments entered into the system within 48-hours. A spokesman for Gov. Chris Sununu called VAMS “clunky” and said the state is working on an alternative system for the next phase of its vaccination roll out.

The CDC didn’t respond to a request for comment about the issue. Many New Hampshire residents, meanwhile, say their struggle in navigating VAMS is already adding to an already tense situation.

“The general attitude is that it’s a mess up or like the Hunger Games,” said Diane Freedman of Durham, who attempted to use VAMS on Tuesday to reschedule her second dose appointment, only to find that there were no earlier dates available.

One frequent criticism of VAMS is that it doesn’t allow users to search for appointments without first cancelling their already scheduled date. Without that search functionality, some residents say they are unwilling to give up already reserved time slots, even if those appointments are outside of the CDC’s recommended 42-day window between vaccine rounds.

“I am totally frustrated,” said Dorothy Powell of West Lebanon, who tried to use the VAMS site on Tuesday to reschedule her second dose appointment. “I was so happy to get the notice to go in and reschedule my April time, but now I don't even have that time, since they told me to cancel it.”

While individual users may choose to voice their frustrations with local media outlets or on social media, states have been able to bring their concerns about VAMS during regularly scheduled meetings with the CDC. 

“We continue to be in frequent contact with the CDC regarding issues arising with people trying to schedule appointments at the appropriate time and location in VAMS,” said Jake Leon, spokesperson for the New Hampshire Department of Health and Human Services, in a statement. “The CDC has been responsive in addressing these issues.”

Leon added the state “successfully used VAMS for vaccine ordering and management during Phase 1A of the COVID-19 vaccine rollout. However, this is the first time any system has been used in NH for mass pandemic vaccinations.” 

During aninterview with NHPR this week, Daly said the state is working to launch a new vaccination management system that will only require a single step to register and schedule an appointment “that we expect to have ready in the next few weeks.”

It isn’t clear, however, if the state will break free from VAMS completely, or still rely on the system for behind the scenes coordination of the ongoing efforts to vaccinate residents.


Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University. He can be reached at tbookman@nhpr.org.
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