The December 30 letter to state Department of Health Services Director Dr. Cara Christ described a multitude of problems that resulted, according to the county, from the state's failure to install a properly working vaccine management application in a timely fashion.
In one egregious example of the problems, thousands of people wanting to register in metro Phoenix were directed to go to sites as far away as Snowflake, more than 150 miles away in eastern Arizona. Some health care workers actually made the trip.
State officials, in comments to Phoenix New Times, blamed the county for any delays related to computer issues.
The letter obtained by New Times from the county comes a day after the revelation, made starkly in an interactive map on Bloomberg News' website, that Arizona's vaccine rate had been among the slowest in the country. New Times published an article about the low rate on Wednesday morning, learning that the state was already preparing a news conference later that day in which Dr. Christ would address the lagging vaccine distribution.
At the briefing, Christ told the media that Bloomberg's tracker had been updated with the latest data, and explained the benefits of a new executive order by Governor Doug Ducey issued that day containing a plan to speed up distribution. It directs the DHS to create a new model for a "uniform approach" to vaccination "rather than each county having their own implementation plans."
Ducey continued to deflect blame in an accompanying public statement: "This is a health emergency, and we need all levels of government and our health system operating as such. Vaccines don’t do any good sitting in a freezer."
"The main reason for the slow vaccine roll out has been the ADHS' vaccine management computer system, which was finally fixed yesterday," he tweeted. "Next week's performance improvement will be because they finally fixed the I.T. system, not this executive order."
The December 30 letter by Marcy Flanagan, executive director of the county's Public Health department, contains a narrative by Jeanene Fowler, the department's operations sector chief for COVID-19 response, that Flanagan asked her to put together. It details the delay in vaccinating thousands of people, as well as some of the specific problems the public encountered in trying to register in two county point of dispensing units (PODs).
Flanagan began by stating that the problems seemed to be fixed and all five PODs in Maricopa County were scheduling at full capacity. Glitches from last week, on the other hand, "may have slowed our process in getting individuals in Phase 1a ... scheduled and vaccinated," she told Christ.
Fowler then described a scenario that went far beyond Flanagan's understated "may have slowed" verbiage, saying the glitches "dramatically slowed down Maricopa County's vaccine operations."
First, she outlines the process that led to the snafu. The Banner and Honor medical systems chose to use their own vaccine management system from the beginning, she explained, which required the county to build three vaccine management systems that linked to one prescreening application to be used county-wide.
Over the summer, the county began talking with a company to purchase a management system, but the state stepped in, wanting a statewide system, Fowler wrote. The county acquiesced, but the state didn't procure its own system until "very late into vaccine planning. So late, in fact, that it was handed over to Maricopa County for operational use 2 days before the [southwest] and [southwest] Valley POD's opened."
It only got worse from there. "Many people" never received an invitation from Maricopa County that they were eligible for the vaccine and could make an appointment. People trying to schedule appointments in the county's southwest and southeast Valley POD locations, apparently mislabeled as "private" locations, could not find the locations in the system and were directed to "public" locations in Show Low, Snowflake, and Globe.
The main reason for the slow vaccine roll out has been the ADHS' vaccine management computer system, which was finally fixed yesterday.— Will Humble (@willhumble_az) December 31, 2020
Next week's performance improvement will be because they finally fixed the I.T. system, not this executive order. https://t.co/0ELDGHsAgd
"This brought thousands of calls and emails to Maricopa County from people wanting to know why Maricopa County was sending them so far away," she wrote. "Unfortunately, Maricopa County did have health care workers travel to Show Low, Snowflake or Globe looking for vaccine due to this error."
The county soon "mobilized" to redirect the people affected by what it called the "Snowflake" problem, but the system still has problems.
"This error slowed down the entire vaccine operation and put us days behind in delivering vaccine," the letter says.
The problems multiplied: Many healthcare workers expecting to schedule their second dose immediately after receiving their first dose were unable to, and are only just now getting invitations to schedule their second dose. People with Cox email accounts were unable to register. If the POD's physical location was closed, the system didn't let people register there. And the system still doesn't accept insurance information, "so that Maricopa County cannot currently bill the administration fee," Fowler wrote.
It has been "nearly impossible" for DHS staff to keep up with the glitches, she concluded.
Steve Elliott, spokesperson for the DHS, told New Times that Humble's claim in his tweet "is false. The state's vaccination management system is and has been functioning properly."
Elliott later expanded on that statement: "The state’s vaccine management system, developed and tested in concert with local partners, is and has been functioning properly. It has been used without issues in most counties. We have worked closely with Maricopa County to address an interoperability issue between the county’s prescreening tool and the statewide vaccine management system. We look forward to the benefits this advance will have for the pace and convenience of COVID-19 vaccination. It’s worth noting that two of the four large COVID-19 vaccination providers in Maricopa County aren’t handling registration through the state’s vaccine management system, which we make available as a convenience."
CJ Karamargin, spokesperson for Governor Ducey, said Maricopa County's system was "cumbersome for users" and noted that other county systems performed well. The pre-registration system is running at full capacity now, but "was apparently turned off yesterday."
Karamargin clarified that he wasn't sure how long it had been off before being turned back on yesterday, December 30. He added that if the vaccine is the "game-changer" everyone hopes it will be, it's critical to make sure distribution is running smoothly.
Yet when asked about Karamargin's statement, Fields Moseley, spokesperson for Maricopa County, told New Times that "The Public Health team tells me the pre-screen tool has not been turned off and on. You will see the tool here: https://gis.maricopa.gov/covid19/vaccine/prescreen."
"Most major issues have been worked out and PODs have been running at full capacity this week," Moseley said. "We have also seen a dramatic uptick in demand from healthcare workers over the past three days which we attribute to not only the systems functioning better, but getting past the Christmas holiday weekend."
Today, Bloomberg's COVID-19 tracker shows that Arizona's vaccination rate compares favorably to many states, and is now higher than that of California, Nevada, or Utah.
Below, you can views slides about Arizona's vaccination plans from the December 30 news conference: