At a block-long Amazon facility in Seattle, it's people, not boxes, that are flowing in neat lines. One of them is Allison Sheafe, who has an appointment for her first COVID-19 vaccine at 11 a.m. at Amazon's Meeting Center, an auditorium and event space near the company's South Lake Union headquarters. After making her way through hallways and up a staircase, she gets her vaccine at 11:01 a.m., she waits for 15 minutes in an observation area and then walks down more stairs and out the door.
The whole experience? "Flawless," Sheafe said, a smile detectable behind her mask. "They really have it together."
Sheafe likely isn't the only one who feels this way. As of April 24, Amazon's Seattle pop-up clinic had administered 50,000 vaccine doses.
As 2021 rolled in, the US threw itself into the massive task of vaccinating the public against COVID-19. President Joe Biden aimed for 200 million vaccines to be administered in his first 100 days in office. The US has met that goal. Still, demand has outstripped supply in most cases, and some state governments struggled to quickly inoculate their citizens. At the same time, misinformation about vaccines has spread as social media companies have struggled to contain and remove inaccurate posts. About 8 percent of Pfizer and Moderna vaccine recipients missed their second shots as of early April, according to the CDC, although some of those patients may have received shots from two different providers who didn't link the information. Meanwhile, millions of others are shunning COVID-19 vaccinations altogether. About 105 million people are fully vaccinated in the US.
Just as the pharmaceutical industry rallied to help with the vaccine supply, tech companies stepped up in their own way. They include hosting physical vaccination clinic locations like Amazon's Seattle site. Other companies, like Google, Microsoft and Cloudflare, have provided software that manages web traffic to heavily visited appointment websites, streamlines pre-registration and appointment booking, and tracks how vaccines are distributed at state levels.
The moves underscore the scale of the effort to get more Americans vaccinated, something that has tapped into the resources of multiple industries and government agencies encompassing everything from media campaigns to software. Some of that software will also be key to the next step: letting governments tailor outreach programs to people who are still reluctant to get vaccinated.
Tech companies host vaccine clinics
At the start of 2020, Amazon, Microsoft and Google joined other large companies in pledging to make their facilities available for vaccine clinics. Disney, Costco and Starbucks have all set up clinics as well. Amazon, which offered its logistics expertise in addition to its space, has also delivered. The company has hosted vaccination clinics one or two days each weekend since January in Seattle through a partnership with local hospital Virginia Mason, and it launched another in Arlington, Virginia, in March.
Amazon has learned from running the clinic for so long. The Seattle location initially distributed fewer than 5,000 shots per weekend. As Washington state opened vaccine eligibility to everyone age 16 and older in mid-April, the site administered closer to 6,600 vaccinations each weekend, and organizers believe they can get that number to 7,000.
Washington Gov. Jay Inslee "called on Washington's business community to help accelerate this work," said Jay Carney, senior vice president of Amazon's global corporate affairs, in an April blog post. "As Washington state's largest employer, Amazon feels a special responsibility to answer this call."
Microsoft, meanwhile, opened a clinic in early April in nearby Redmond in partnership with King County, the city of Seattle and two local health care providers -- EvergreenHealth and Overlake Medical Center. The clinic serves patients by appointment only, Monday through Friday. Microsoft says the clinic will help King County build up its equitable vaccine delivery strategy by making doses available in a new location, which the county believes will help get more shots to under-vaccinated groups.
"Microsoft unequivocally supports equitable distribution and is committed to using our resources to support our community's most vulnerable and underserved populations," the company said in its blog post about the clinic.
Keeping appointment sites from crashing
As vaccine-eligible patients took to the internet to book appointments, they faced a common problem: crashed websites. Government and health provider sites, not built to handle the kind of demand that typically come with events like concert ticket sales, couldn't deal with requests from tens of thousands or hundreds of thousands of visitors trying to find information and secure appointments.
In San Luis Obispo County in California, the problem cropped up every Thursday when the county opened its system for appointments, said the county's web administrator, Tyler Penney. In the Central Coast county of fewer than 300,000 people, as many as 50,000 people at a time tried to book appointments every week, crashing the county's appointment page in the process.
Cloudflare, a tech provider that builds tools to help companies handle web traffic, offered support in the form of Fair Shot, a software tool that creates a virtual waiting room that lets site visitors know they will be in line to sign up for an appointment. It even offers a countdown clock for how long they'll have to wait. Once the appointment system opens, everyone in the waiting room is assigned a number randomly and allowed to book time slots one at a time. In addition to keeping the site from crashing, the system aims to even the playing field between those with speedy internet access and people with slower connections who might not be able to get in line or load the appointment page as quickly.
Fair Shot is a free service. Cloudflare came up with the idea while building a tool for organizations selling tickets to large events, which it plans to sell as a service.
Penney said it was the "one feel-good thing" the county could offer as vaccines rolled out. It let the county tell residents, "Hey, we got you, we know that you're here, you're in line," he said, "instead of [frustrating them with] a broken link."
When vaccine supply outstrips demand
San Luis Obispo County moved away from the waiting room model as more software tools emerged to help residents pre-register for vaccines and book appointments. Instead of having to obsessively refresh vaccination sites, residents hear from the county when they can book an appointment based on their eligibility and vaccine availability. Now several states and localities use pre-registration, thanks in part to programs created to streamline the process.
Google and Microsoft have both created software that lets governments pre-register residents and then notify them when an appointment is available. Early in the vaccination push, local governments in Virginia each used their own pre-registration tools, creating a patchwork of about 30 systems that didn't share information on who was signed up. Then, in February, the state government announced a statewide service using Google's Intelligent Vaccine Impact technology. The system first imported the 1.2 million previous pre-registrations into one service hosted by Google Cloud. Then it handled 180,000 pre-registrations on its first day, and reached 400,000 by the end of the week.
"Our infrastructure would not have supported it," said Suresh Soundararajan, chief information officer for Virginia. The experience was a promising test case for how cloud services could help governments deliver other services to residents, Soundararajan said, especially health-related services that include millions of records.
Google's tools allow government web administrators to adjust settings when eligibility rules change. And the technology helps states better understand how many vaccines they've distributed as they make requests to the federal government for more supply, Todd Schroeder, Google's director of public sector digital strategy, said in an interview.
Statistics on who has been vaccinated will become even more important as more people get their doses and demand no longer outpaces supply, he added. Governments can use their data to identify regions where people are not getting vaccinated and then design policies to reach out to those communities.
When there are more than enough vaccines to go around, "it doesn't matter about supply, it matters about what people believe," Schroeder said. "That is a whole different campaign."