Medical Examiner

What’s Up With Coronavirus Vaccines and CVS?

A pharmacist, wearing masks and gloves, inserts a dose of a COVID vaccine into a vial.
A pharmacist prepares a dose of the COVID-19 vaccine on Thursday in New York City. Anthony Behar/Sipa USA/Reuters

Retail pharmacies in some states are now able to distribute the COVID vaccine through a program the Biden administration unveiled last week. Officials hope that the rollout at chains such as CVS and Walgreens will smooth out a bumpy distribution process that has left the country roiled with frustration. But local news and Twitter feeds would argue otherwise: Error messages. Crashing sites. Canceled appointments. The only consistent part of the rollout so far appears to be continued confusion.

Below, we break down what’s happening and—although we can’t guarantee anything—how experts hope it will improve.

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So what’s going on here?

On Thursday, the White House sent out 1 million coronavirus vaccine doses to more than 6,500 stores at 21 pharmacy chains. Previously, the majority of vaccine doses had been distributed by hospitals and health departments. The government eventually hopes to deliver vaccines to over 40,000 stores and prioritize those located in underserved communities.

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Which pharmacies are part of this deal?

All the big players, including Walgreens, CVS, Rite-Aid, the Kroger Company, Costco, Walmart, Albertsons, and H-E-B.

How do I know where to go?

It depends on where you live. For example, North Carolinians should schedule an appointment with their Walgreens, while their neighbors in South Carolina should use CVS. Nevadans have one option (Walmart), while Californians have two (CVS, Rite Aid). Texans, of course, have H-E-B (and three others).

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Why these pharmacies?

Both experts and government officials have promoted pharmacy chains as the answer to the country’s vaccination vexations, citing their annual distribution of the flu shot to millions of Americans, as well as the fact that most Americanslive within 5 miles of one of these retailers. Larry Merlo, the CEO of CVS, oozed confidence on the Today show in December saying, “We have our logistics plan, we have our staffing plan, and we are ready to go.”

Were they ready to go? 

Well, not so much. Overwhelming demand, a lack of clear messaging, and an uncoordinated effort seem to be at the root of the pharmacies’ rollout woes earlier this week.

For example, at CVS, people thought they could sign up beginning this Tuesday, but due to shipment holdups, the chain pushed back the date to Thursday. But a loophole remained: Those in Virginia who pre-registered with the state’s health department reported they secured an appointment.

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At Walgreens, the website couldn’t support the surge in traffic. People trying to sign-up for appointments were met with an error message until late Tuesday afternoon. “Your website has too many barriers for entry for a lifesaving vaccine. Now stuck at ‘Loading’,” a person tweeted at Walgreens. Other pharmacy websites faltered too. Walmart’s was down on Wednesday. And for the millions of Americans without internet access, as well as non-tech-savvy seniors, booking an appointment online poses an insurmountable barrier.

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Problems extended beyond technology. A CVS in Ohio hadn’t caught up with state guidelines and blocked a newly eligible age group from signing up, and one in Rhode Island booked appointments for people at stores in neighboring states. A Rite-Aid in Pennsylvania didn’t even realize it was administrating the vaccine and turned legitimate appointments away.

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Yikes. 

Yeah. But Bunny Ellerin, the director of Healthcare and Pharmaceutical Management Program at Columbia Business School, is confident the process will improve. “Whatever the issues are today, tomorrow—those are hiccups. Those are not systemic problems.”

Some chains seem to be hitting their stride after a rocky start. The Walgreen’s site was up and running by end of day Tuesday. CVS fixed its website issues and confirmed that its locations would have 250,000 doses starting Thursday. And Kroger, after initial bugs in its booking system, said in an email to Slate that it is “launching a new scheduling tool soon to improve the patient experience and high volume of appointment requests.” It is also working on an appointment phone number for those without internet.

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But why has it been this bad?

A huge factor behind the chaos: pharmacy booking websites.

Erick Katzenstein, a software developer who helped create a third-party site that streamlined appointment booking at Walgreens, boiled the issue down to a “user-experience crisis.”

Pharmacies are using a scheduling setup that was created for prescription pick-ups—not vaccines—to handle their appointment bookings. “These pharmacies have not anticipated the drastic supply and demand inversion that comes with COVID vaccines. So what ends up happening is the user is selecting a location, selecting a date, selecting a time, and then, of course, seeing that no spots are available.” Katzenstein said most all pharmacy sites are relying on this ineffective system. “You’re not going to be able to search every conceivable combination of location, date and time. Those slots won’t get filled. It’ll prolong the pandemic,” he said. “We’re facing a bottleneck for vaccine rollouts as a result of these unusable interfaces.”

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Walgreens, he’s noticed, has changed their system slightly in recent days, so you can search by your address first. “There are still a lot of things that needs to be improved. But that’s a huge step in the right direction,” Katzenstein noted.

So how do I get an appointment? 

First, check if you’re eligible. Each state has different guidelines, and pharmacies are following those orders. And in many states, hospitals and health departments will also remain distributors. As will Disneyland. And high school gyms. And the NFL plans to turn all 30 of its stadiums into vaccine megasites (seven already are). Depending on where you live, you may have several options available.

Second, make an appointment at one of your state’s partner pharmacies. Don’t just walk in! And don’t be like these people.

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What about these “extra doses” I’ve heard about?

Some people have had luck getting the vaccine by being at the right place at the right time, when pharmacies are closing for the day and don’t want to trash any expiring shots. According to the Wall Street Journal, “Retail pharmacies are taking varied approaches to extra doses, with some saying they’ll give priority to their employees while others say they’ll try to find takers among the public and only vaccinate employees as a last resort, if at all.” You may have also seen tweets about a national standby list called Dr. B, a website that will alert you when last-minute vaccine appointments free up near you. Over 30,000 people have already signed up, but it’s not clear which (if any) distribution partners are using it.

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