Could a centralized vaccine sign-up ease Pa.’s rollout pains? Here’s the answer.

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HARRISBURG — Pennsylvania’s recent expansion of who is eligible for a COVID-19 vaccine was coupled with frustration and confusion as people clamored to sign up for appointments, only to be disappointed by a cumbersome, fragmented system.

The chaos is fueled by a lack of supply: Like other states, Pennsylvania is only receiving a fraction of the vaccine doses it needs from the federal government — which is purchasing the vaccine from drug companies like Pfizer and Moderna and distributing it to states — to meet the demand.

By the end of this week, Pennsylvania will have received about 1.5 million doses since it started vaccinating health care workers Dec. 14. As Gov. Tom Wolf pointed out this week, the state needs at least 8 million doses to cover the two-dose regimen for everyone in Phase 1A, which was recently expanded to include people older than 64 and those over 16 with certain medical conditions.

Without more supply, could a streamlined, centralized system for scheduling vaccine appointments make the process a little easier on the public?

New York manages a state-run signup portal that allows residents to receive vaccines at state vaccination sites, but also gives them the option to contact their pharmacy or health-care provider directly for a vaccine. New Jersey has a state-run portal that allows residents to pre-register to receive an alert when it’s time to make an appointment.

But even those states are struggling with supply, and have had to shut down vaccination sites or suspend appointments until more vaccines are available.

Pennsylvania does not have a centralized scheduling system, and is not operating any state-run mass vaccination sites at this time. Instead, the state is relying on individual health-care providers like hospitals, community health centers, and private practices, along with pharmacies, to create and manage their own scheduling process.

“The relationship that folks have with their provider or with their pharmacists is what was best suited to actually administer the vaccine, and so we are allowing those providers and those pharmacists to be able to use their scheduling systems that they might have already had in place,” Alison Beam, the state’s acting secretary of health, said Tuesday.

The extent to which the Pennsylvania Health Department is involved in the scheduling process is minimal: It has a map posted to its website with clickable pins showing where vaccines might be available. Spotlight PA has also created an easier, county-by-county listing of providers.

Scheduling an appointment for a vaccine involves calling or emailing a facility directly, or signing up through that provider’s website. Often, the effort results in a long hold, an overflowing voice mailbox, or a disheartening automated message stating that there are no appointments available.

Building a centralized system might be beneficial for residents, but it wouldn’t be simple to pull off. Health-care systems generally don’t have IT systems that communicate well with each other, and that makes scheduling or sharing records difficult, said Sezgin Ayabakan, a professor at Temple University specializing in health information technology.

And while New York’s centralized site works because its mass vaccination clinics are all operated by the state, individual providers administering vaccines in Pennsylvania — like pharmacies, hospitals, or private practices — all work differently, with varying staff or operating hours.

Given that the number of vaccines a site receives week-to-week varies — and as a result, the number of appointments a site can schedule — it’s better to let individual providers handle the scheduling, said Kristie Bennardi, CEO of the Keystone Rural Health Consortia.

The consortia is operating two vaccine clinics three days a week and is working through a waiting list of 1,426 people and counting.

A centralized system could help facilities cut down on the administrative work it takes to get someone scheduled, like weeding out people who sign up multiple times at different locations, but Keystone has been able to manage it by hiring a part-time staff member, Bennardi said.

Ayabakan said a single system in Pennsylvania would also be complicated by its numerous counties, of which only a small number have local health departments. A website also wouldn’t benefit seniors “or people from different social demographics” who lack computer literacy, he said.

In those cases, the most critical institutions to make sure people are getting connected with vaccines are the local pharmacies or social institutions like churches that are already embedded in communities, Ayabakan said.

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