On Monday January 25, 2021 I got my first round of COVID-19 vaccine. My wife has been quite ill with the virus for the past month, but has not had to be hospitalized. The presence of clear symptoms makes her ineligible for inoculation at this time. A few other family members have also tested positive with non-lethal symptoms. My family is quite large and I feel that we've been very fortunate. Although I have been my wife's caregiver and have almost certainly been exposed to SARS-CoV-2 virus, I've had no symptoms. With vaccination being such a critical priority in the US, my goal is to put into words here a few observations about what seem to be potential pitfalls. This is from a personal perspective.

The news that the vaccine was now available in our small town came through Facebook. An individual, who regularly posts updates on COVID statistics for our County, advised that the local Walgreens had a limited supply of Moderna vaccine available and provided a link to apply for vaccination. I followed the link and determined that I might be eligible due to operating a child care business out of our home. In Arkansas, my age doesn't qualify me at this time for inoculation because I'm not 70 or older (yet). I filled out the online application, which then popped up a page stating, in bright green letters, "Vaccination Recommended"

My wife also printed out the hard copy application that would need to be presented at the pharmacy. I had chosen a time when I could get "jabbed" and everything looked to be all set. The paperwork was very similar to the paperwork that one must fill out when visiting a clinic or hospital for medical evaluation/diagnosis. The section that qualified me for the vaccine was the education part. Teachers and child care providers were considered front line workers and were therefore eligible without having to meet the age criteria. I felt cautiously optimistic about the chances of actually getting immunized. The online questionnaire should provide for a quick in and out experience since my information was already provided to the Walgreens corporation and, presumably, to our local pharmacy.

I showed up at the Walgreens thirty minutes early, which was recommended when I chose an appointment time online.. The girl at the counter said, "May I help you?" and I told her why I was there and handed her the application. She looked at it and asked if I worked at a school or medical facility and I told her about the child care business out of our home. She asked me to wait a minute and I heard her ask another employee about something. "I'll let Glenn handle that," was the overheard reply. She went and showed my application to the younger of the two pharmacists on staff that day. There was brief conversation and Glenn came up to where I was waiting. "I'm sorry, but the government won't let us vaccinate you unless you are 70 or older," he said. I must have looked puzzled (I was) because he then asked if I worked at a school or hospital. I said, "Child care?". "Do you operate a child care business out of your home?" "Yes," I said. I was thinking, Hasn't this already been communicated and acknowledged? Twice?, but I didn't say that out loud.

"I'll take your word for it," Glenn said.

The rest of the process was quick and easy. The older of the two pharmacists, Harold, stuck my arm and I was on my way. The thing that I'd like to rant about a little bit is that, although the system was in place to provide information in both directions, (from me to the provider and from them to me), it only worked in one direction. The person (Glenn) making the decision whether I could be vaccinated, or not, didn't benefit from my filling out the online questionnaire, nor did he benefit from me providing the same data to the POS worker. One sees the same wasted effort way too often when accessing medical care. You fill out the same forms on every visit to a clinic or hospital. You tell the person who checks you in what you're there for. You then tell the nurse or technician the same information. Then you tell the doctor the same stuff, if and when you actually get to see one.

In my humble opinion, this is the weak link in the chain vis-a-vis getting the required number of vaccinations into people's arms to quell the spread of the COVID-19 pandemic in the USA. The current administration is going to get the supply of vaccine. It will be shipped to all fifty states and, for the most part, distributed to where it is needed. But the choke point will be at that last step where, with all of our technology, we still drop the ball on the individual level. In my case, I knew the people that I was dealing with. There were no lines of people waiting. Even though I was baffled when Glenn told me that, in spite of my establishing that I was eligible ahead of time, it was "no go", I had the presence of mind to ask one more time. "Child care?" turned out to be the magic words. Speed is of the essence here. Many thousands of lives depend on getting this right. The weak link is the broken down communications at the grass roots level and I just got lucky. Providing the information is useless if those making decisions don't get to see it. At least that's what I think.

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