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Why Big Tech Doesn’t Dominate Vaccine Deployment

As the country faces one of the biggest logistical challenges in history with the rollout of the Covid-19 vaccination program, many Americans are wondering why Big Tech can’t lead the operation. If Amazon can deliver a phone charger in two days, why can’t it use its logistical prowess to quickly vaccinate a nation? With all the data Google collects on its users, why can’t it locate and identify who needs a vaccination?

A big part of that is because when it comes to getting a phone charger delivered, a company like Amazon handles every step of the way, from ordering to delivery. But when it comes to vaccine distribution, tech companies have learned they have a lot less control. The federal government pays for the necessary drugs and manages the supply to the states. Then states, counties, and businesses take over and figure out how to get vaccines into the guns. So while Big Tech certainly plays a role in the vaccine rollout, it’s not exactly what people can expect.

“We have the scale of this pandemic: you are trying to vaccinate over 300 million people,” said JT Lane, chief innovation officer for the Association of State and Territory Health Officials, a professional organization. for public health officials. “It’s the biggest effort of our life.”

Take, for example, what happened recently in Iowa: It only took the state a week to cancel its contract with Microsoft to manage its vaccine reservation system. But officials said it wasn’t because Microsoft’s technology was insufficient. It was too difficult, even for a tech giant like Microsoft, to combine the patchwork of existing digital infrastructure in 99 countries.

“We understand and support Iowa’s decision to optimize its existing system rather than building a different system on several of its existing platforms,” said Montana MacLachlan, a Microsoft spokesperson.

As Iowa Governor Kim Reynolds said at a press conference on Feb. 17: “It wouldn’t be possible in a timely manner without a significant disruption to their current systems, and we didn’t want to slow down. the progress we are making. ”

Many paths

Tech companies have certainly tried to help the pandemic response from the start. Almost a year ago, Google and Apple joined forces to help with contact tracing. But most states ultimately did not embrace the technology, and it had little substantial impact. Some of Big Tech’s technology that was developed long ago is finally being adopted into vaccine deployment: The VaccineFinder website that the Centers for Disease Control and Prevention encourages the country to use was started by Google and taken over by Boston Children’s Hospital in 2012.

Other tech companies are carving out their niche in vaccine deployment in entirely different ways. Uber and Lyft offered free rides to and from vaccination appointments. Google and Verizon help pay for ads promoting vaccine awareness. Google and Apple have participated in discussions about possible vaccine passports, but have not announced any concrete plans.

Companies like Amazon are bypassing all local vaccine rollout by working directly with the White House. On the opening day, Amazon executives offered to help the Biden administration distribute the vaccines, stressing that the company’s 800,000 U.S. employees should be among the first to get it. Biden’s team is currently in talks with Amazon about how the company can help the president’s national immunization program, according to Amazon and White House sources who are not authorized to speak publicly.

Mediation of battles

But one of the most common ways to help big tech companies like Google, Salesforce, and Microsoft is to get mixed results. This is because they are trying to build statewide websites that allow people to schedule immunization appointments.

On February 10, New Jersey Gov. Phil Murphy said the rollout of Microsoft’s website presented “real challenges” for the state. A senior Murphy administration official who was not authorized to speak publicly described Microsoft’s efforts to help New Jersey as a “poor experience.” She said Microsoft’s platform was “misconfigured” and was crashing regularly as recently as this month. There were even instances where vaccine seekers could register for appointments at inactive or closed sites.

“When tech companies get their hands dirty, we as a state and we as the public deserve as good service and availability as a company selling sweaters, and we shouldn’t have substandard experience, ”she said. .

Microsoft spokesperson MacLachlan said in an email that the company is working with New Jersey “to deliver vaccinations as quickly, safely and efficiently as possible, and that includes resolving some technical issues.”

Other states, including California, have also tried to set up a shared portal for vaccination registrations, but these sites are reaching limited populations. The unified California site, called MyTurn, is powered by Salesforce and a bay area startup called Skedulo.

But for now, MyTurn, which is run by the California Department of Public Health, only offers vaccines to much of the state’s urban area and has left out many suburban counties. as well as some agricultural and rural areas. This state-wide online research tool does not take into account CVS and Walgreens, two large retailers that have fully separate vaccine pipelines and do not seek help from Silicon Valley. It also doesn’t take into account the state’s major healthcare providers, like Kaiser Permanente, which operate their own separate enrollment systems.

But public health experts say these challenges aren’t necessarily Big Tech’s fault. Tech companies are caught between how state and county health departments organize immunization registrations. Some systems focus on immunizing as many people as possible. But other public health services are focusing on immunizing neglected older people, minorities and low-income people who have less reliable internet access.

“Everyone is talking about fairness with the vaccine. But given the choice, most people would prefer the volume because it would get us out of the pandemic faster, ”said Dr. Kim Rhoads, professor of epidemiology and biostatistics at the University of California at San Francisco, whose Recent research has examined Covid-19 infection rates in black communities in the Bay Area. “It’s the problem with website crashes and these technological systems crashing. We’re aiming for volume there.

High price

Still, some Big Tech companies are making inroads with local governments. Salesforce is expected to provide the engine for Nevada’s next website. According to Maha Neouchy, spokesperson for Salesforce, the company provides technology services to “more than 50 federal, state, local and private health organizations” for vaccine management purposes. This also includes Lake County, Illinois, among others. She declined to comment on costs. Microsoft has also signed contracts with Oklahoma, Montana, and Wisconsin to help deliver the states online immunization planning portals.

Local governments also seem willing to pay for these programs. Public record requests revealed that Oklahoma paid Microsoft nearly $ 500,000 to run its system from last December to the end of July. This represents nearly 1 percent of the Oklahoma Department of Health’s $ 59 million information technology budget.

Likewise, other public documents from Lake County, north of Chicago, show that Carahsoft, a partner company of Salesforce, told the county that it would cost $ 5.5 million to provide a “management solution.” vaccines ”, known as AllVax, for work that took place from the end of October. until the end of 2020. The county resumed operations of this digital system from the beginning of 2021.

Some local jurisdictions seem happy with the way big tech companies have helped them welcome an arguably discouraging number of visitors to their sites.

“Overall I’m really proud of the system and the fact that we haven’t had an outage yet – we’ve had 380,000 people signed up to the system,” said Jefferson McMillan-Wilhoit, CIO. and health technology for Lake County. Department of Health. He noted that without the $ 5.5 million deal with Salesforce, which is a notable part of his department’s $ 80 million annual budget, it would have been nearly impossible to get that digital infrastructure up and running so quickly.

North Carolina recently signed a nearly $ 1.1 million contract with Google to provide services for the next year to create a unified statewide system, rather than letting citizens and county public health entities manage theirs.

“We held it up and it was uploaded and we pressure tested it with 1.4 million users. [in a four-hour window] and we get hundreds of thousands [of hits in that same window of time]Said Sam Gibbs, North Carolina’s assistant secretary for technology and operations, noting that the state’s population is approximately 10.5 million.

Search for alternatives

But public health officials note that no matter how tech companies build vaccination registration websites, there are critical populations they will never reach. That’s because there are still millions of Americans who need vaccines but don’t even have Internet access to register. Rhoads suggests that local health departments find ways to reach populations who don’t have the skills, Internet access, or the confidence in big tech companies to use these sites.

“Bigger is not better. And it just comes down to volume versus equity, ”Rhoads said. “If we go big, we won’t get equity. With that in mind, if we make volume our priority, we shouldn’t be ultimately surprised when we don’t get fairness. “



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