CDC Docs Show Confusion During Initial Vaccine Rollout

The initial rollout of the COVID-19 vaccines in America was a messy nightmare, with just a fraction of available doses ending up in arms. New emails obtained by Motherboard through a Freedom of Information Act request paint a picture of confusion and frustration as regional healthcare workers and CDC officials struggled to get the vaccine to the U.S.

Things are running more smoothly now, but the early days of vaccine deployment were frustrating, confusing, and complicated. At the heart of that rollout was a $44 million online system, designed by the contractor Deloitte, called Vaccine Administration Management System (VAMS), one of several interconnected systems meant to cover ordering and tracking of doses.

Emails sent to an address set up to handle problems with VAMS show that documentation was confusing and the sites didn’t always work as intended. 

“Question: I work for a healthcare corporation with facilities across the U.S. We have many facilities asking for information regarding the VAMS and VTrckS registration process,” a pharmacist said in an email to the CDC in December 2020. (VTrckS is a distinct system for managing vaccine orders.) “It is not clear if the facilities register on their own or if their jurisdiction will invite them to register. The instruction on your website and in the playbook does not clearly state. Could you please assist and provide the steps in this process?”

The emails between the VAMS help desk and regional authorities describe a mix of IT issues and human error. “A clinic administrator from Coastal Carolina Hospital just alerted me that the doses they have administered are not reflected in their patients’ records and not decrementing their inventory when scanning the Pfizer vial,” a South Carolina Department of Health and Environmental Control (DHEC) said in an email to the CDC that was marked high priority. “We need immediate assistance to troubleshoot this.”

Later, the DHEC employee reached back out to the CDC. “Did some additional investigating and it turns out they have not been scanning the vial. I apologize for the premature escalation,” they said. “However, how can they go back and rectify this for the patients they have already vaccinated?”

Sometimes, vaccines went missing. “[Healthcare provider] calling to ask where COVID-19 vaccine allocation to their healthcare facility is,” the transcript of a phone call emailed to a CDC official said. “They have reached out to SHD and SHD contacted Moderna. They are still not able to locate their vaccine supply.”

Issues are to be expected in the context of a system meant to aid in the tracking and distribution of hundreds of millions of doses of vaccine being rolled out. The soup of acronyms, phone numbers, and emails attached to the vaccine rollout process and its various websites led to confusion, though, with occasionally ludicrous results.

Often, simple IT issues couldn’t be resolved because healthcare workers couldn’t find the right person to call. And at one point, members of the public were calling the Vaccine Order Management Contact Center (VOMCC) for help scheduling their vaccines and using the website—and saying VAMS itself had sent them there. “VOMCC (which is the VTrckS help desk) has already received 14 calls today so far related to VAMS registration, VAMS username/ password issues, or V-Safe questions,” a CDC official wrote in an email in January. "Some of these callers are saying they are being referred to CDC-INFO to VOMCC, or VAMS is referring them back to the VOMCC. Please help stop this pattern; it is out of scope for the VOMCC to handle such questions.”

A quick investigation revealed that healthcare providers were giving out VOMCC’s contact information to the public, saying the CDC would help them schedule appointments. “Lady from the general public, calling about V-Safe registration, she called the number listed on ‘the form’ and they referred her to us, she did not provide the number/name of the help desk that referred her to the Vaccine Order Management Contact Center,” a CDC employee wrote, describing calls it had received.

VAMS and its sister systems were products of the Trump administration, rushed through in a desperate effort to coordinate deployment and tracking of the drugs. Many states developed their own systems. This didn’t stop the public from using the VAMS site and calling the CDC. 

“Called for help with scheduling the 2nd dose of the Covid vaccine, she said she received help with scheduling the first dose from the VAMS help but when she called back to scheduled the 2nd dose they referred her to the VOMCC,” a CDC official wrote. They were describing a person who called the wrong phone number while trying to schedule her second dose of life-saving medicine.