Amidst all the hopes, nationalistic boasts and political wrangling over a vaccine for COVID-19, a critical technical challenge looms: administering vaccines fairly and safely when they are approved. The health IT company GYANT recently offered its partners a web application called GYANT Vaccine to aid in the multiple tasks associated with distributing a vaccine. I talked to co-founder and CEO Stefan Behrens about the problems that need to be solved, and how they are addressed by GYANT Vaccine.
First, institutions must deal with a staged roll-out. First-line responders and health care workers will get the vaccines before anyone else, followed by other parts of the world’s populations based on their vulnerability. The staged roll-out, Behrens says, may help to assuage fears about the vaccines. The first people to get access will be those well trained in health, and thus able to determine the benefits and risks of whatever vaccines are approved. If the regulators and manufacturers have undergone proper procedures, the health care workers will trust results, and their experiences with the vaccines will help people with less training to decide to trust the vaccines as well. Furthermore, if PCPs recommend a vaccine, Behrens thinks most of their patients will listen.
Behrens expects stages of the roll-out to resemble the following. I’m using his estimates for dates, which of course are speculative and may be disputed by other observers. (Also, there are many different strategies for distributing a vaccine, some counterintuitive, as explained in a New York Times article.)
- First doses going to first responders and health care staff (late November or early December of this year)
- More doses going to larger groups people with high exposure: staff at nursing home, schools, prisons, etc. (early 2021)
- Members of the general population at high risk for the disease, with precautions for those whom the vaccine itself might harm (March 2021)
- All of the general population (summer 2021)
Most people will be encouraged by their providers to ask for the vaccine at their appointed time. Because some will want to game the system (such as by pretending to be in a high-risk group), the early requesters will be interviewed by staff at the provider. In later stages, GYANT Vaccine can simply ask questions about age and medical conditions and screen applicants for the vaccines.
Follow-up is the next challenge. Some vaccines probably require second doses, so the provider will have to remind the patient to come in for the booster shot. The provider also must monitor the patient for side effects, and find out whether the patient was infected by the virus despite getting the vaccine. Some patients may be contacted every day for a while. GYANT Vaccine can track patients and issue the contacts. A bad reaction can prompt the provider to get on the phone with the patient.
GYANT is starting to roll out the application to its partners while working out many of the details. The application and the systems to which it connects will have to react fast to the particular requirements of whatever vaccines succeed, so many technical and organizational challenges are waiting in the wings.